1. IT issues in T&O and the wider NHS
Sunny Deo, Clinical Lead T&O, GWH, Swindon

2. Personal background Our IT is awful “Upgrades” make things slower
No efficiency benefits to frontline clinicians at all cw past practice
Functionality poor
Our own bespoke system is unsupported and is likely to be scrapped
Internal audit system about to be scrapped
There is absolutely nothing that I can think of, in clinical practice that is sped up by computerisation in our trust

3. Background
NHS Information Authority→NHS National Programme for IT NPfIT , →Connecting for Health 2005 → Health and Social Care Information 2013 Centre → Apr16 NHS Digital
NPfIT originally expected to cost £2.3 billion over three years, in June 2006.
Total cost estimated by NAO £12.4bn over 10 years
Officials involved in the programme estimated the final cost to be as high as £20bn

4. Background
NAO "... not demonstrated that the financial value of the benefits exceeds the cost of NPfIT".
British Computer Society (2006) "...the costs incurred by NHS are such that…value for money from services deployed is poor“
£13-20B

5. Previous documented clinical issues: IT does create clinical risks
2008: Enfield PCT found that the system had failed to flag up possible child-abuse victims entering hospital to key staff, "leaving the responsibility to the receptionist“
272 elective operations were cancelled at the last minute for "non-clinical reasons"
Barts & London failure to meet targets for treating ED patients <4h & breaches of 2w cancer access due to the computer system &/or staff not being familiar with the system
The Royal Free: problems with 12,000 patient records, had to be manually amended and issues with the outpatient bookings

6. Modes of failure of NPfIT
Top down planning
Poor implementation
Poor selection of multiple contractors
Use of obselete technologies
Poor clinician engagement

7. Additional context: the public IT & computing evolution
Top 10 computing developments 2006-current
Universal internet
Phone = Mini Computer
Sharing Media – Physical Vs virtual. Network speeds ↑ up to 2,000 mb/s. UK avg 10 mb/s.
Desktop Apps to Web Apps. Web servers run from browser; more flexibility.
Apple technology – touch screens, swipe, multiple apps
Social Networks
The demise of regular TV – access to media on computers
Free software
Free phone & video calls
From Geocities to WordPress

8. Personal view is we’re stymied in improvement by the NHS cycle*
Major systemic
Issue eg poor IT
Sub-committee
Formed. How much
Frontline engagement?
No money
Critical point / event may
occur; may alter situation
Solution(s)
Provided, often
by clinicians
Discussion
Within division;
Business case
(time, effort, more
meetings
Funding is made available, but there is a “Matthew Effect” of the best placed trusts getting better,
as they are starting at a better place, or have key staff who have won previous awards