By Steve Ranger, 5 October 2005 17:30
NEWS The success of the £6.2bn NHS IT modernisation programme should be better linked to the quality of the service delivered to patients, according to the director general of NHS IT Richard Granger.
Speaking at a silicon.com public sector briefing, Granger ran through a number of alternative measurements that could be taken to chart the progress of the NHS technology programme and criticised some of the existing measures.
"We don't have metrics about quality of service," he said. "We have these very blunt 'Let's have 100 per cent of this done electronically [targets]'."
One thing the public sector could look at is how long it takes to procure and implement large-scale systems. "I bet over half the money we spend on IT systems is buying systems that have gone at least half way through their product cycle by the time we start to install them," he said.
This is compounded by the scale of the NHS. Granger added: "When you look at the massive challenge we have in terms of scale - we are talking about national scale organisations - when we deliver change across the whole of the public sector your rollout activity necessarily takes a long time.
"Especially if you have the kinds of challenges you have with the NHS - I have 600 end-user organisations each of which has a unique configuration."
Granger also responded to criticism of the progress of the 'choose and book' electronic appointment system. So far only 9,000 appointments have been made using the system.
He said: "We've got a target that this has to be 100 per cent electronic and 100 per cent booked. It's a stupid target and I'm sure many people in this room are burdened by stupid targets.
"What we are focused on at the moment is making sure the outcome the public want in terms of choice is supported as efficiently as possible."
He said the NHS is working through the detail of how this patient choice will be delivered and said that many patients don't actually want to make the commitment about appointments with their GP "there and then" and would prefer to go away and think about it before booking an appointment.
He added: "The NHS is going through an experience that organisations that are more mature in terms of their use of technology went through 10 to 15 years ago - the reality of IT programmes meeting business processes and fitting the two things together."
The NHS is working on a project to put prescriptions online and get rid of 330 million pieces of paper every year. But Granger said the real measure of success with this is saving lives: "Tens of thousands of people every year have adverse clinical effects as a consequence of keystroke error.
"This is killing thousands of people every year in this country. We have this target about electronic prescriptions. Maybe we should have a target about how many people didn't get killed."
He added: "Wouldn't it be interesting to have a target on paper consumption because we know paper is dangerous. That would be an interesting measure of the move to an electronic NHS."
But Granger also pointed to some of the successes of Connecting for Health: "We've just delivered the largest VPN that BT runs anywhere in the last six months - 11,000 connections, knocking out over a 1,000 a month. Almost all primary care in England have new minimum 2Mbps connections with backup."
Comments
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1. Roger Huffadine
I have raised my concerns about the 'patient choice' system with the Secretary of State for Health and the Office of the Deputy Prime Minister.
Both of whom replied to let me know that they know better and are not interested.
Maybe they do know something that I don't but then I'm coming at the problem from 30 years of queueing theory.
When I questioned the report, earlier this year, from the Audit Commission it became clear that the underlying model upon which patient choice is based contains fundamental implementation errors that will dog the system until someone decides to bite the bullet and fix them. Until then it will never work efficiently and Richard will be fighting to implement a system built on a flawed model.
2. Karen Challinor
Here's a few statistics I would like to know
How many managers in the NHS have BUPA or an equivalent private medical arrangement as part of their package ?
How many of the managers in the NHS have any medical training and can therefore understand when a nurse tells them their otherwise perfectly reasonable request isn't in the best interests of the patient ?
Of the few managers in the NHS who do have medical training how many have budget control ?
Of the even fewer managers with medical training and budget control how many have to deal with non medical management to obtain further funding ?
This is the one I would really like an answer to. How many of the people who control the purse strings will end up in an NHS hospital being treated by NHS doctors and nurses should they fall ill
3. Richard Sarson
As an ageing patient, my target for Richard Granger has always been that he should allow my GP to exchange path reports and referral letters electronically with the five hospitals my GP refers me and my wife to. Not a big deal, one might think, in an age of any-to-any comms. After 3 years in his job, he is still miles away from achieving this.
I was at the silicon.com do, when Richard spoke. I asked for progress reports from the distingished Civil Servants on the platform on what I consider the three main Key Performance Indicators (a fancy name for targets) in the Public Sector:
- Are your e-services being used by real citizens?
- Are you meeting your Gershon job-reduction targets - and therefore costing me less as a taxpayer?
- Are you breaking down the Departmental silos, to create citizen-centric services, as promised by Government.direct in 1996 - six long years ago?
And, answer came there none. Or basically a load of waffle.