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back to article NHS IT spree faces cutbacks

The chancellor Alistair Darling this weekend appeared to signal the pre-Budget report will include some major cuts to the £12.7bn NHS National Programme for IT (NPfIT). The hints, dropped in an interview on the Andrew Marr Show yesterday, have already drawn protests from doctors. Darling said: "I'm not doing a spending review …

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Tip for Mr Darling...

Just bin anything with an IT angle from your budget. It's pretty much all poorly scoped, specced, contracted with imbecilic deliver partners and none of the potential benefits (where those benefits were thought about) are likely to appear in anything like the short term.

To not do so would be daft for two reasons. Firstly, we need to make cuts anyway, and secondly the gov are promising all kinds of horrifically expensive things to anyone deluded enough to go to the polling booth and tick "Labour" on election day, so you may as well trim absolutely anything that isn't 100% essential just in case that bill comes due.

Hopefully common sense will prevail and Labour get voted out, but if not we may have some money that we can then use for food and heat, rather than having to sit around in caves eating mud for the next twenty years.

At least Darling looks like he's trying.

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Stop

Had? Not essential? £12.7bn?

".. the NHS had a quite expensive IT system that, frankly, isn't essential to the frontline."

'Had', not 'will have'.

'Not essential' - so why do it.

£12.7bn - for what?

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FAIL

An interesting simple question

Presumably the NHS has a global figure for how many "outcomes" it has a year. Discharged, discharged but re-admitted, died etc.

So it should be possible to find out those numbers before and after sections of the system have been rolled out.

And find out how many addiitional lives the £12.5Bn has bought us.

Pressuming the number has gone up of course.

I'll look forward to reading those numbers.

Fail because with the price hikes (roughly x5 over the original numbers IIRC) and massive delays is it ever likely to deliver the supposed benefits. I think it's doubtful that much will be saved even if they cancel it tomorrow. It's so muddled to an outsider it's impossible to tell how ocmplete the system is.

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WTF?

...an irrelevant question!

The primary objective of the new IT system is to save man hours and hence money not lives.

Figures for treatment outcomes are totally irrelevant. What we need is an NHS with budgets that don't spiral out of control any further than they already have under Labour rule.

Perhaps if the average GP wasn't taking home over 120k we might have money to spend on enough nurses, clean hospitals, drugs for patients - or to bail out a few more banks.

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Nev
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Well, well...

...looks like this will turn out to be a bigger and more disgusting waste of money than the Wessex affair.

Who'da thunk it!?

Glad I no longer pay tax in the UK.

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Anonymous Coward

Hmmm, non UK taxpayer?

Oh, I geddit. You're Lord Ashcroft aren't you?

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Nev
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Nope.

I just choose to live, work and pay (high) taxes in a country where you actually get public services and public IT systems that work.

Stop moaning, look at the other choices available and move, is my advice.

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Cuts != not spending as much !?!

I have to say, I do like the subtle distinct here. Not spending as much on something is somehow qualitively different from cutting the spend on something.

and while we are on the subject of cuts, why not drop the ID card/database, for about a much larger amount of money? after all, it's not frontline and won't stop any terrorists.

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Unhappy

What gets cut?

NuLab have spent a fortune on the NHS. All going to increase the useless bureaucracy at the expense of actual health services.

Now they're going to cut stuff. What's the betting they cut the services and leave the bureaucrats?

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Anonymous Coward

Bureaucrats

I do know its clever to talk about bureaucrats, but you do realise most of the bureaucrats are needed? These are mostly secretaries, accountants, procument, HR and, shock horror, IT people etc...

Gone are the days when Doctors could run arround in white coats doing what they wanted, and anyone who argued was discharged or fired. Life is far more complex than that nowadays.

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Flame

bollocks

Sorry ... last time I went to see my opthamologist, there was 1 doctor on (him). 2 nurses, and (I counted) 12 back room staff. Since I was waiting, I got chatting to the front-line receptionist, thinking they must work for other departments or areas.

Nope. They were *all* assigned to the opthamology. No, they weren't IT (they based off-site). Or procurement (off site). Or appointments (you guessed it - off site). These 12 staff were "admin officers (?)" all assigned to opthamology.

Without a hint of irony, the receptionist apologised for the delay, because they has some people off sick.

Doctors ? No - you guessed it - 2 more "admin officers" who had swine flu. They think. My suggestion that they should see a doctor then fell in deaf ears.

The sooner we have a revolution the better .....

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"'it isn't needed' - it is"...

Surely the best thing to cut (now that we're "out of the recession") is benefits.

Alistair Darling is wrong, and so is the system. There are plenty of jobs out there for people who *need* them. People on the breadline need to stop seeing themselves as so vital and accept that if they want a life, they should earn it, not sit around having children all colours of the rainbow in order to claim some outrageous figure such as £4000 a month (which a family of 11 is "entitled" to). These people are not entitled to anything. The world owes them nothing and their ovaries should be extracted after the 3rd if they have no intention of getting a job to pay for their gluttenous lifestyle.

*end of rant*

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Stop

what a pile of BS

Count your blessings [as I do] that we are gainfully employed!

If you had actually looked at the job prospects for yourself you'd realise if you lost your job you would be in shit street like the segment of unemployed who wish to return to work.

Agreed there are career benefiters that have been created by our system but its a symptom of offering a carrot [$$$] and no cane.

Perhaps if we asked those on benefits to travel to somewhere out of town to do something pointless for 9 hours a day in order to receive our hard earned taxes it would change things.

If the options were -

A Get up at 7, travel to a warehouse, start moving boxes from one side to the other and back again, leave at 6 = 70 quid a week

B Get a job like the rest of us that pays more than 70 quid a week

I think most people would get off their arses.

At the moment its a choice of hard work or permanent holiday, you can try to blame them but its the collective us that voted in a succession of govts that have created this mess, our responsibility is to object, if we do not we are deemed to support.

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Sun reader?

Number of UK job vacancies in the three months to October: 428,000. The "official" number of unemployed: 2.46 million (but in reality much, much higher than that).

Could you explain what the other 2million+ are supposed to do?

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Who get's cut

Well yeah right on - let's cut that waste and inefficiency. Its only public sector IT, not like the real proper IT stuff El Reg readers work on. Of course if Register reading specialists had been involved the NHS programme would have been properly scoped, efficiently designed and brought in at a fraction of the price. Its a good job none of those bandits at Accenture, ITSoft, or BTm ever read these pages, though you would have to wonder how an earth Accenture got the gig or any gig at all after Enron. When it comes to a change of name Windscale is still surprisingly available.

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I'm not disagreeing with you...

One cannot prove that Accenture, ITSoft BTM or whoever aren't at least partly to blame when these things go titsup, but I'm always shovel the most of the responsibility towards the client.

I'm thinking a big cause for failures of these great big public sector projects is because the original idea is crap.

I cannot believe that the projects always fail because the supplier is crap and the management worse (although that certainly seems to be an issue here).

Could it be that politico's have what they think is a brilliant idea, and only once untold millions have been spent getting it going does it turn out that the concept is fatally flawed. Either that or the benefits are so massively over shadowed by the costs that they never should have been given the green light in the first place

I cannot believe that the NPfIT's single patient data base will be signifcantly better than each PCT managing their own patient records. If I break a leg in Wales does the A&E really need to see my complete medical history (that lives in Berkshire)?

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you're right

most big IT project failures don't have a lot to do with IT, it's a basic lack of understanding of what you are asking for. Either you get exactly what you ask for, and believe me I've worked with offshore teams, getting *exactly* what you ask for is not what you wanted. Or you get something that kind of does what you want, but not quite. This is better, but usually the users hate it, and it's packed full of kludgy workarounds and bodges.

IT systems are quite simple, they are designed to solve specific problems. If you can't define what you're problem is though, you'll never get an IT system that solves it. And i mean properly define it, in detail. For you government types, in IT parlance, this is referred to as actually having a proper set of requirements or, less generously, being able to find your arse with both hands! Not just having some vague wishy washy crap idea about getting patients out of the door faster.

The main issue around the npfIT, is that software is not an end in and of itself, it is created to support a business process. If you want to roll out a standard IT system nationally, before you even start every hospital, and GP, needs to be working in at least a vaguely similar way. Yes, you can make software customisable to each individual site, and let the monkeys in these sites set it up for their own processes, but it's never going to come close to a piece professionally designed to properly support a single process.

If you even try and create a system that covers every separate site working in a completely different way then it's going to be a disaster no matter what you do, you might as well spend all the money in a pub, at least then you genuinely would be pissing it all away, rather than just metaphorically.

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WTF?

£12b?!?!

I mean seriously, £12b for ERP?! Jesus H ****ing Christ on a bike. It's not like they had to invent distributed databases is it?

For that kind of money we could have had 12 new destroyers armed to the teeth with....oh wait, that was a UKGov managed project too wasn't it?

I'm not a celebrity, but can someone please get me out of here?

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You can’t make an omelette...

As an employee of the NPfIT (full disclosure : I work for BT), I find myself in the strange position of actually defending one of the government’s projects (remarkable, but true). £12bn sounds like a lot – but employ a calculator and you can see that that is about £20 per UK-citizen per year (which, compared to the £14000 that HMG has given to ‘too-big-to-fail’ banks on my behalf, is peanuts). True, there has been money wasted along the way, and there have been failings in the way that it has been implemented, but the need for an NHS-wide information system is imperative.

Example : I was hospitalised with a severe injury a few years back and, when discharged, advised to see my GP a week later. Imagine my utter lack of surprise that my GP had no knowledge of what had happened, so he had to rely on my (hazy) recollection of what medical treatment I had received (which took up most of a 15-minute appointment), rather than having my medical record passed to him down the intertubes. How much NHS time (and therefore money) is wasted in circumstances such as that ? How many people get second-rate treatment because one clinician has no way of knowing what another one has done ? As Dr Ingrams from the British Medical Association said (quoted on the BBC), "The NHS pays out a third of a billion pounds a year on mistakes; a lot of that could be put right if the IT was in place."

Another example : two years ago the PACS – picture archiving – system was deployed: until then, in most hospitals, x-rays were *still* stored in cardboard folders on shelves in corridors. How many private businesses still keep everything in filing cabinets (with no way of searching for anything that is mis-filed) ? NHS trusts (there’s 127 of them) reported an average saving of £250,000 in their first year of using PACS (so a total saving of c.£32 million). Can anyone who reads El Reg say that their workplace has thrown money down the drain by getting some computer systems, and should just go back to doing all their work by hand and snailmail ?

Also quoted by BBC : Tony Collins, executive editor of Computer Weekly magazine, said the government should scrap central contracts..."They could save money by cancelling those central contracts and giving trusts the ability to choose what systems they want."

IMHO, as an industry insider, this is part of the problem, not a solution: before there was any central authority, a lot of Trusts invested in ‘what systems they want’, which (surprise surprise) were in no way compatible because they were developed by scores of different IT firms. What good is it if your doctor’s in Liverpool but you get hospitalised in Manchester, who have a different system ? How are the Manc hospital going to get hold of your GP’s records, or feed back the hospital notes to your GP ? What if you move house – are your PCT just going to print out a paper copy of your notes, send them to your new PCT, who have to type them up onto a different system ?

There’s plenty of things to deride this government for, but dragging the NHS into the 20th Century isn’t one of them.

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Black Helicopters

dead wood throughout [.gov.uk]

most of the bureaucrats are hangers-on who are only pushing a mouse about a pretty spreadsheet that says (YOU ARE BANKRUPT) whilst waiting to get their pension and golden handshake !!!

though the handshake should be swapped for a hand off a short pier.......

oh and @nev

(got a spare room mate your willing to let out, theres a long queue of ex-IT ppl here looking to leave the sinking ship DHSS-Britian)

failing that, anyone want a desktop support techy willing to work for food, board and internet :)

crashing copter cos there is no sinking ship

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Anonymous Coward

Expensive for a good reason

It would have been a world leading IT system. A national IT system with a backbone that could be used to distribute and collaborate.

It would have been the health equivalent of the Internet.

But we'll go back to snail mailing data on USB drives and hard disks, writing things down on pieces of paper and spending millions getting third parties to write middleware between the national systems and local systems.

The idea was great, the choice of companies wasn't. A few small IT expert firms with open minds to technology could have delivered it much faster and cheaper. But instead large IT firms with 'partners' who dictated the hardware and software (regardless of being fit for purpose) wasted a lot of time and money.

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If "the NHS "could not function""

how has it functioned in the many years since its inception without IT systems?

On a personal note, my very first job on leaving school was in the local regional hospital (not in the U.K.), which had approx 100 beds. It offered all of the services one would expect, but not the specialised ones, such as oncology. The hospital also performed all the lab. tests and x-rays for the GPs up to 20 miles around. Total admin staff (remember this is pre-computers) 11 people!

The hospital is still about the same size but even though fully computerised (if you can call it that as they use MS systems) the admin. has grown to over 150 people! It's so bad that they took over the nurses residence and turned that into offices. Every department now has substantial admin staffs of their own instead of just the receptionist/secretary that some had if the head of dept. did not do his.her own office work.

Expanding IT/Admin is merely following Parkinson's (?) Law. The only answer is to reurn every 10 years to the staffing levels of 10 years previously, not throw other peoples money at a non-existent problem.

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Big Brother

Is it is always worth wasting money?

..."the NHS had a quite expensive IT system that, frankly, isn't essential to the frontline. It's something that I think we don't need to go ahead with just now. But I will be setting out a clear direction of travel because it's important that we do that."

Well tell us something we don't know. Is that Newspeak for "We just wasted £12bn. So do we care" ?

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Anonymous Coward

SWMBO told me about that this morning

"They're cancelling that NHS IT programme - NPFIT"

"Remind me, which one was that?"

"The one that's really behind schedule?"

"You'll need to be more specific."

"And amazingly over budget?"

"No, you'll need to be more specific."

"And nobody thought we really needed it - it was just a goverment feelgood trick?"

"Aren't you even listening to me?"

You can probably work out why this is anonymous...

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