British Computer Society

From Nhs It Info


Central NHS IT may not work, warns BCS (29 Aug 2006)

Computer Weekly

"The British Computer Society has backed calls for a technical review of the health service’s £12.4bn IT programme, questioning whether the scheme’s centralised approach will work in the complex structure of the NHS. . . Some of the BCS’s concerns are set out by Glyn Hayes, chair of the society’s Health Informatics Forum, in a letter sent to Martyn Thomas. Thomas, a visiting professor at Oxford University, was one of 23 senior academics who wrote to the House of Commons Health Committee calling for an independent technical audit of the NPfIT. Hayes’ letter says the BCS is greatly concerned that a centralised IT approach will not work in the complex organisational structure of the NHS. He tells Thomas, “I do indeed support your proposal for a review of NPfIT.” . . ."

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BCS 'has not changed mind' about CfH review (30 Aug 2006)

e-Health Insider

"The British Computer Society has denied changing its tack by backing the growing calls for a technical review of the health service’s £12.4bn IT programme. Glyn Hayes, chair of the society’s Health Informatics Forum, has defended his position following a report in this week’s Computer Weekly, which detailed a private email from Dr Hayes to Martyn Thomas. . . However, Dr Hayes told E-Health Insider: “Our position has not changed at all. We are wholly in support of NHS Connecting for Health and the national programme.” The BCS has always had concerns about centralising data and the structure of the clinical record but had expressed these directly to NHS CfH, he added. “We have acted as a critical friend,” he said. On the question of a centralised versus a distributed architecture, he said: “There is an argument that says it would be better having [data stored in] individual systems as long as they could communicate with each other. We are not arguing for that but it is a question that needs discussing.” He said the BCS was in favour of a technical review but that it must not hold up the project. He said: “If the politicians lose their nerve because of pressure from Computer Weekly then the health service is going to suffer.” Professor Thomas admitted to being mystified by the furore. “I believe that Glyn Hayes, the BCS health informatics forum and the 23 academics are completely in agreement about what needs to be done to help the national programme,” he said. Dr Thomas added: “I think the BCS is walking a very delicate line and believe that they can influence the national programme better by talking quietly with Richard Granger and his team and believe that the very public campaign that Computer Weekly is running is causing damage. I am not convinced that they are right.” . . "

Call for co-operation on new way forward for NPfIT (11 Sep 2006)

e-Health Insider

"A call for the ‘old guard’ of health informatics and the ‘new kids on the block’ to work together to take the National Programme for IT forward has come from the British Computer Society Primary Health Care Specialist Group chair. Speaking at the group’s annual meeting in Oxfordshire, Ewan Davis, said relations between the two groups had been characterised by mutual disrespect “and that gets us nowhere.” He said some the old guard had said “here we go again” and assumed they had nothing to learn from the new arrivals, while the new kids coming from oil wells and supermarket chains and bringing new levels of skills in software engineering and project management had failed to recognise the expertise of people already in health informatics. Davis emphasised the need to work together and explained some of the thinking group members had been doing to take the national programme forward. . . The solutions under scrutiny were those that could integrate a number of heterogenous solutions, crossing boundaries of functionality and geography, but which also allowed competition between vendors. . . Analysing the reasons for the need for alternatives, Davis pointed to the nature of the NHS. “One of the reasons we have had problems with the current approach is that people perceive the NHS as a corporate entity and then are surprised when it doesn’t behave like a corporate entity.” His alterative was to see to NHS as a supply chain – a group of organisations of varying size and power that simultaneously compete and co-operate towards a common goal."

DH carrying out 'confidential' review of CfH (15 Nov 2006)

e-Health Insider

"E-Health Insider has learned that an urgent 'confidential' review of the NHS IT programme and structure of Connecting for Health, the agency responsible for its delivery, has been launched by the new chief executive of the NHS David Nicholson. The new boss of the health service has commissioned a review of the £6.2bn NHS digitisation project as one of his first actions since taking up post in September. The CfH review, which has already begun taking evidence, is understood to be focusing on reviewing how to re-structure CfH to make it and the programme it is charged with delivering more locally responsive. . .Calls for a review of the project, including calls from both the British Computer Society and from a group of 23 eminent computer academics, have all previously been rejected. . . Dr Glyn Hayes, vice-president of the BCS and chair of its health informatics forum said: "If this review is designed to refocus CfH towards a more local implementation approach we are all in favour as we want those successes that have been achieved to be built on." Dr Hayes added that a local implementation approach potentially provided the way to address a lot of the very real anxieties around confidentiality. The BCS is itself due to publish a full review of the technical architecture of the NHS IT programme within the next two weeks."

BCS calls for complete overhaul of NHS IT project (15 Dec 2006)

e-Health insider

A new report from the British Computer Society has called for a fundamental rethink of the NHS IT programme, including putting one hold current plans for a national system of summary records and for the scope of NHS Care Records Service to fundamentally re-defined. Rather than attempt to build a monolithic national database of records the BCS report urges that that electronic Care Records it argues that to resolve outstanding data and technical difficulties a distributed model based on existing systems is a better bet: "a virtual service offering views of the distributed records available for a patient would seem appropriate". The report urges that the £12.4bn NHS national programme for IT be completely recast as a locally based programme, based on delivering specific niche clinical systems from a range of competing suppliers, supported by standards and core national infrastructure. The strategic paper from the BCS says there is a pressing need to realign Connecting for Health (CfH) if it is to be an enabler of business and service transformation and be seen as useful by NHS staff."

BCS report sparks change in the NHS IT programme (8 Jan 2007)

Computer Weekly

"Connecting for Health, the government agency that runs the £12.4bn National Programme for IT (NPfIT) in the NHS, is considering a report from the British Computer Society that recommends putting on hold the development of the data spine of 50 million personal health records. The data spine is the cornerstone of the national programme. The report, The Way Forward for NHS Health Informatics, says the BCS wants the programme to succeed and believes it could benefit patient care. However, the report sets out key concerns about the approach being taken. Connecting for Health said it is giving the recommendations full consideration and is already acting on some of them. "The BCS is a respected body that we have worked with since the inception of the national programme. We note the report and that it contains a number of positive themes. The NPfIT Local Ownership programme, which has been considering the direction of the national programme in light of the National Audit Office report of June 2006, addresses a number of the points raised by the BCS," said a spokesman. One of the most radical changes the BCS recommends is to put work on the national spine for the care records service on the back burner. This is a core part of the NPfIT and has been designed to hold the personal details of 50 million patients in England. . ."

BCS calls for urgent realignment of NHS National Programme for IT (20 Jan 2007)

Computer Weekly

"A BCS report has linked the problems facing the NHS's National Programme for IT (NPfIT) to a pressing need to realign the programme via the English strategic health authority and trust structure. The BCS believes this is a major reason why so many NHS staff view informatics, and particularly the NPfIT, as having little relevance rather than as a key enabler of business change. According to the BCS Health Informatics Forum strategic panel, the NPfIT can make a massive contribution to safer and more appropriate patient care. The panel agrees with the Wanless Report (an independent review of long-term resource requirements for the NHS) that 4% of NHS turnover should be spent on business-led informatics. Glyn Hayes, chairman of the Health Informatics Forum strategic panel, said, "One of the fundamental goals must be to support the diverse business processes that recognise local constraints and individual patients' values, and focus on delivery and implementation at trust level. "Instead of the current monolithic systems intended to meet most of the needs of users in a local health community, we need a range and choice of more innovative and agile solutions." The key recommendations of the BCS report include:

  • The provision of a business context for the NPfIT at national and local level
  • A focus on local implementations at trust and provider unit level
  • An emphasis on standards to enable systems to interoperate
  • An evolutionary strategy, building on what currently works.
  • Adoption of a truly patient-centred approach at local health community level
  • Resolution of issues about the sharing of electronic patient data
  • Transformation of the NPfIT into an open partnership with NHS management, users, the informatics community, suppliers, patients and their carers
  • The clinical professions, NHS management and informaticians should collaborate to provide clear and comprehensive guidance for all sectors on data management. . ."

BCS sticks to its guns over NHS IT report (3 Apr 2007)

Computer Weekly

"The British Computer Society has come into conflict with Whitehall officials over the publication of a report that includes some far-reaching criticisms of the NHS's £12.4bn National Programme for IT (NPfIT). The BCS has for several years been a committed ally of NHS Connecting for Health, the government agency in charge of the NPfIT. But the two organisations have come into conflict over a report which summarises the views of health IT specialists on the strengths and weaknesses of the NPfIT. The BCS report, published in December, is largely positive about the NPfIT, but it also says that the "value for money from services deployed is poor", that political pressure has caused health officials to "deny problems and to defend the indefensible", and that implementation plans have frequently ranged from the "optimistic to the unreal". The report's author, Ian Herbert, who is vice-chairman of the BCS Health Informatics Forum, told last month's HC2007 Healthcare IT conference that Connecting for Health chief executive Richard Granger, after seeing a draft, did not want the report published. "It was an interesting process developing that report. Richard Granger was not keen that we publish it, he was keen that we did something else rather more opaquely behind closed doors. We were not prepared to do that. We owed more to our members. So we produced the report," said Herbert. A spokesman for Connecting for Health said, "It is a matter for the BCS and other bodies to publish any reports they commission. NHS Connecting for Health had offered to work with the BCS on a joint action plan but they chose not to accept that offer." The BCS revealed that it had made 17 changes to the draft report at the request of Connecting for Health, though it had not made all the requested alterations. BCS chief executive David Clarke said the BCS Health Informatics Forum had always sought a close working relationship with Connecting for Health. The BCS wanted to work with the agency on a joint action plan, but "not as an alternative to publishing our report, which we felt was balanced, fair and fully in support of the objectives of the programme", said Clarke. Martyn Thomas, a fellow of the BCS and one of 23 academics who have called for an independent audit of the NPfIT, said the BCS had in the past acted as a critical friend to Connecting for Health. "It may be that the BCS has taken the view that they have done all the good they can behind the scenes and cannot afford to compromise their integrity by backing away from being critical in public," he said."

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