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Major change needed to NHS IT programme
Less monolithic systems, more choice

By Steve Ranger

Published: Friday 15 December 2006

Major changes must be made to the £12bn NHS technology programme - including a shift in focus away from "monolithic" IT systems - if it is to be relevant to health workers.

A report from the British Computer Society (BCS) warns that there needs to be "major emphasis" on standards to enable systems to interoperate effectively, rather than focusing on a few monolithic systems.

The report by the BCS Health Informatics Forum Strategic Panel said the NHS IT strategy should be evolutionary, building on what presently works, rather than revolutionary.

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Dr Glyn Hayes, chair of the BCS panel, warned that instead of the "current monolithic systems" being built, the NHS needs a "range and choice" of more innovative systems using national standards to deliver functionality in whatever way suits the users.

And there should be a focus on local implementations in hospitals and doctors' practices to encourage clinical involvement and give quicker benefits, the report said.

There are "major issues" about the sharing of electronic patient data which need to be resolved, the report warned, and said these must not be hijacked by technical issues. Informed patient consent should be paramount, the report said.

"IT enables change, is sometimes a catalyst for change, but it is not an end in itself. This misconception has been a prime cause of large scale IT project failure since computers first became common place," said Hayes in a statement.

Hayes said this problems has been heightened by the "top-down nature" of the NHS National Programme for IT as well as the "the patchy reflection of NHS requirements in the procurements in 2002" and "the subsequent changes in those requirements to meet the Government's NHS reform programme".

An NHS Connecting for Health spokeswoman said the agency would consider the recommendations of the BCS report and added: "The National Programme for IT Local Ownership Programme, which has been considering the direction of the National Programme in the light of the National Audit Office report of June 2006, addresses a number of the points raised by the BCS."