NHS's £12.4 BN National Program for IT - NPfiT - managing a collapsing system and service. Fuck healthcare sell 'em a system

Andrew Rollerson, leads (and hence is responsible for delivery) of the "health-care consultancy practice" at Fujitsu (who years ago swallowed the last UK computer mainframe maker ICL) and represents a major supplier to the NHS's £12.4 BN National Program for IT (NPfiT) - Fujitsu has an £896m contract to supply systems in the South of England. On December 13th Fujitsu announced the NHS Connecting for Health, Picture Archiving and Communications Systems (PACS) programme, had recorded the 100 millionth patient image stored in its data centre . PACS enables access to the right image, in the right place, at the right time – all at the touch of a button.83% of all PACS systems are now live in NHS Trusts in the South of England. It makes one one wonder how many images will ever be referenced again and millions of Terabytes of totally redundant and useless information will lie uselessly, as growing empires of non medical staff, IT support and administrators will adminstrate this exploding empire and Fujitsu keep installing data storage by the acre.

Mr Rollerson spoke at a conference last week "Successful implementation of NPfIT 2007" and his contrubution and Powerpoint slides were slept through with great interest and reported in today's Computer Weekly magazine and also remarked on in the Daily Torygraph.

Here are some fascinating (and devastating) quotations worthy of wider circulation.

There is ..""gradual coming apart of what we are doing on the ground because we are desperate to get something in and make it work, versus what the programme really ought to be trying to achieve".

A main aim of the programme - now in its 5th year - is - the provision of complete electronic health records for 50 million people that can be readily accessed is a principal goal - it is at least 2 years behind schedule and there are concerns it will never be completed.

"The more pressure we come under, both as suppliers and on the NHS side, the more we are reverting to a very sort of narrowly focused IT-oriented behaviour. This is not a good sign for the programme."

"What we are trying to do is run an enormous programme with the techniques that we are absolutely familiar with for running small projects. And it isn't working. And it isn't going to work."

"There is a belief that the National Programme is somehow going to propel transformation in the NHS simply by delivering an IT system. Nothing could be further from the truth. A vacuum, a chasm, is opening up. It was always there."

Rollerson however is probably headed for a rollicking when he gets back to the office. Ian Lamb, NHS account director at Fujitsu Services, said, "This is a significant misrepresentation of a presentation made in support of the National Programme.

"We refute any inference that has been drawn to the effect that Fujitsu in any way questions the success of the National Programme."

A Department of Health spokesman said, "David Nicholson, the chief executive of the NHS, has clearly said that he is fully committed to the National Programme for IT as it is a necessary part of a modern health service, fit for the 21st century. He sees this as one of his key strategic priorities as it is key to the successful delivery of patient-centred care."

Mr Rollerson elaborated on his main message with some juvenile but fascinating slides - a huge oil tanker being hit by a tidal wave, one with the word "Lost?" alongside a picture of a desert island and one with a man walking a tightrope.

Another slide declared "visionary leadership is still missing" alongside the famous World War One poster of Lord Kitchener declaring "Your country needs you".

For Herpetologists in the audience he had a picture of a huge alligator with the message "We have become obsessed by the alligators nearest the boat." The final slide showed two women mud-wrestling and asked: "Where would you rather be?"

He concluded with a damning, and often made conclusion on ambitious computer systems , purchased less to perform work and more a miracle of re-organisation - "There is a belief that the national programme is somehow going to propel transformation in the NHS simply by delivering an IT system. Nothing could be further from the truth. A vacuum, a chasm, is opening up."

Meanwhile The Copenhagen Post reports today on the success not only of the Danish Health Board in installing their IT systems, but of successful future sales in the US, Canada, New Zealand and surprisingly in the UK.

Only 13 % of all Danish hospital beds (Population 5.5 Mn.) were covered by electronic journals in 2003. By 2006, well over half were, with many health regions having achieved full coverage well ahead of the deadline.

Electronic recordkeeping, pushed ahead by the National Board of Health, has been the original and principal objective of IT in the Danish health services.

Denmark, according to Roskilde University technology lector Jesper Simonsen, has plans in the healthcare IT field 'that few other countries have'.

Those plans have caught the eye Acure the 100% owned IBM subsidiary, which develops technology for the healthcare industry. Hans Erik Henriksen, manager of the IBM's subsidiary Acure which develops technology for the healthcare industry said the country's reputation as a world leader had led Acure to choose Denmark as its proving ground. They have been undertaking work with The Danish Medicines Agency, The Danish Board of Health, the association Sundhed.dk, Copenhagen Hospital Cooperation, and the counties of Ribe, Ringkjobing, Copenhagen, Funen, Northern Jutland, Southern Jutland and Vejle.

IBM is currently working on a pilot project using electronic record keeping in Texas and interest in the standardised system of electronic health records is increasing..

'Denmark is seen by other countries as a leader in health IT,' he said. 'That position will be strengthened in the future.'

To date the modules in use (or under development - which might be ominous)....

• The National Danish e-Health Portal (sundhed.dk)
• The Electronic Medicine Profile - overview of medication

• DiaLog Shared Care - disease management for Diabetes treatment

• SUP (Standardized use of Patient Data) - easy exchange of EHR
• MedCom-in-a-box - for integration and communication

• ACURE Medicine Module - stand-alone or integrated EHR module
• ACURE Clinical Notes Module - the core of the EHR

• Central Reimbursement Register
• National Patient Register

Perhaps we can absorb the lessons of the Trident program and source the solution from a tried and proven system supplier - Anybody from the NHS can contact Nordic Healthcare Leader, GBS Allan Juhl by phone +45 4524 8002