Whitehall and Microsoft thrashing out 1-year NHS WinXP lifeline The Department of Health and Microsoft are thrashing out a one-year support deal for tens of thousands of NHS PCs running Windows XP. The agreement would give hospitals, trusts and GPs across England and Wales time to back away from Windows XP and implement a newer operating system. A deal would mean Microsoft continues to …
The reason so many NHS trusts haven't yet completed (or in some cases, started) their migration from XP is nothing to do with the PC's themselves.
It's the archaic systems they connect to and that are fundamental to the running of GP's surgeries, Primary Care organisations and Acute Trusts.
A lot of the clinical and patient systems are spec'd to run in IE on the desktop - and in some cases that still means IE6 or (at best) 7.
The Trusts can't gamble on using a later version as the systems suppliers can't guarantee that when you save a patient record that it will really happen.
So - it's lazy good-for-nothing PAS suppliers to blame for this putrid stinking mess - mostly.
Not always - expensive large systems can be a dreadful lock-in. Look at SAP, for example, how long it hindered companies to upgrade/change their web browser because it stubbornly didn't work with latest versions, or required even more expensive upgrades? Switching from a large, complex ERP is not like switching to a different antivirus.
I've see software that refues to work properly if the OS is not Window NT or 2000, or some older versions of Red Hat, there's also the Java software written to use a specific JRE of Java 1.5... and not updateable because of cost or other factors.
Sometimes you need to select the right supplier from the beginner, or later you may find yourself in the bad situation to spend a lot of money to bring your systems up to data, or to protect them strongly because you can't update them.
"Sometimes you need to select the right supplier from the beginner, or later you may find yourself in the bad situation to spend a lot of money to bring your systems up to data"
Very easy to say, very difficult to put into practise.
Many 'reputable' ERP vendors suddenly discovered problems with their systems when the UK Vat rate changed a few years back. The main causes of the problem was down to daft programming associated with the assumption that VAT rates won't/don't change either at all or during a tax or financial year...
@lost all faith - "Here's how it works outside of the Public Sector.
This needs to work on Win7 / Linux.
What, you say it can't? Well, you fix it, or we find a product that will.
End Of."
Bear in mind the uk public sector is not allowed to waste money (stop laughing). Take an MRI scanner for an example, what would you like the MRI scanner to do? MRI scans. Good.
Now, compare* - MRI scanner 1 costs £2M, and the supplier will support it for ten years at £50K per year = £2.5M for 10 years;
MRI Scanner 2 costs £4M, and the supplier will support it at a cost of £100k per year = £5M for 10 years.
Both scanners will do the job, so I'm sure you know which one you will buy right? And if you were in charge of a publicly funded budget your answer wouldn't be any different even if it ran ICL COBOL.
The simple fact is that the OS often just isn't the most important thing about the product you need and therefore any extra money you spend getting the OS you want is money that should be spent elsewhere. Especially when departments are having to close core services anyway.
Don't get me wrong I think the OS and core configuration should be seen as more important, lock in is a hidden cost. But I think you are being optimistic about how easy it is to find alternatives that exist and how little it will cost to purchase them. In some parts of government, the number of options for what you want may be very small as the subject area may be very niche and the kit expensive.
* - Disclaimer I have no idea if these are at all realistic costs. Merely numbers, pulled out my ass to serve an example.
Go back to 2003 when many of these systems were proposed.
Look at the capabilities of web browsers back then.
You can't apply 2014 open source and cross platform ideology to a 11 year old system.
Bear in mind that even some of the government's own sites needed IE initially (due to the clueless technophobe Blair calling in bill Gates to help with IE).
It's not a case of quickly hacking the sites to work on Chrome or Firefox, it's a legacy system that needs to work 100% reliably not 90%. It's an NHS system and you can't afford mistakes due to the lawsuits and compensation that would follow.
Sorry, this is just a case of buck-passing. The fact that the systems still require IE6/7 (both moribund and renouned for bad security) is itself a disgrace. The end of XP has been known for years and those responsible for the back-end systems should have had them upgraded in good time. The NHS has enough financial and political clout to beat up on the PAS suppliers if the new versions are as bad as you say, but this should have been done some time ago not at or after the XP withdrawal deadline.
Hey - you're singing to the choir here.
To defend the indefensible a little though - part of the reason that all these old systems are in use is that we were told we mustn't spend on them as they'd be replaced by the National Programme for IT systems.
When that (predictably) didn't happen, there has been a semi-panic of trusts either buying new(er) systems (often properly configured version of the ones that failed during the whole NPfIT process) or starting work on updating the old ones. This often also means that the old PAS and clinical systems suppliers lost a lot of highly specialiased staff as NPfIT meant that a lot of them would be losing all their customers shortly, and the ones they had weren't spending anything with them.
But a PAS is a compex system and peoples live depend on it being right - and even where two Trusts run the same PAS, they will use it and have if configured very differently - so the updating, testing, configuring, re-testing process is slow.
Partly due to the budget cuts (more nurses fewer managers actually means fewer back room staff all round, and much less money for new PC's that will actually run anything later than XP) people are trying to do all this reconfiguration with too few staff, while at the same time trying to keep the old creaking systems running.
On top of all that, the government like to meddle, and the whole budgetary and reporting structure has changed 'to put GP's in control' and that mess has to be mopped up by the same people. It's not a good situation - but the people at the coal face are working hard to sort it out, despite what the press may say and what the general public think of this extended support deal.
This deal has not been made because we didn't want to upgrade to Windows7 - it's because we haven't been able to up to now.
Dr Dre
Sad, hurry up or you might end up reaching W7 EOL before you managed to upgrade the last box ... this shit takes a considerable amount of time to do right, especially if a million PC's are involved.
Have fun training staff to w7 ui ...
Keep in mind that, had you guyz had ANY CLUE or least listened, you would have gone the web standards route, like many of us freetards TOLD YOU as early as 2000 - but no, IE5/IE6 is standard, fingers in ears and lalalalalala - if you were a private business, I would not care, but you are spending taxpayers cash there, thank you very much !
If you had had Linux boxen, they would all be running latest kernel and patches on same hardware, same ui, same everything ... and you would wait for the hw to die ....
@Hans 1 - "Keep in mind that, had you guyz had ANY CLUE or least listened, you would have gone the web standards route, like many of us freetards TOLD YOU as early as 2000 "
I suggest you read up on your history - voices with much more clout than a bunch of techie freetards made the case for Open Systems back in the 1980's.
It was a political decision (probably heavily influenced by lobbying and party political ideas on 'market forces') to effectively remove the requirement for Open Systems commitments etc. in government procurement in the late 1980's. The result of this decision was the side lining of the CCTA in IT procurement and the effective abandonment of UK GOSIP.
Additionally, we have seen an increased focus on cost in government procurement, which also has served to further sideline anything that may increase the initial cost of IT systems.
So yes to some extent many of the current difficulties with government IT are self inflicted, however as the Cabinet Office has been discovering: bringing back a focus on Open Standards has been and is non-trivial. Mind you part of the problem has been getting the Cabinet Office to understand that Open Standards are not the same as and are far more important than open source...
"Keep in mind that, had you guyz had ANY CLUE or least listened, you would have gone the web standards route, like many of us freetards TOLD YOU as early as 2000"
I was busy pushing options other than MS long before 2000 laddy. Some of us have been in this game a long time, and the errors and problems you are seeing are because of a political decision , taken years ago - not because those of us responsible for the strategic direction of IT in the public sector were keen on Windows.
Our advice was ignored by our masters - and it has always been thus.
@Len Goddard - The end of XP has been known for years and those responsible for the back-end systems should have had them upgraded in good time. The NHS has enough financial and political clout to beat up on the PAS suppliers if the new versions are as bad as you say
No, the NHS doesn't have financial clout, it is a misconception that a large funding pot for health means big financial power. Unfortunately, the funding is split up amongst the trusts which are quite small entities. It it also hampered more in the last few years by the austerity measures, which drive tough decisions about what to fund and unsuprisingly they prioritised buying drugs and paying nurses over replacing systems that worked. Imagine the newspaper headlines, say two years ago, if a trust can't give heart transplants because they are replacing IT systems (that work). Like it or not fear of negative reporting (that will deliberately misrepresent the importance of IT support lifecycles) influences a lot of public sector behavour.
For me, the Treasury, Cabinet office and political strategy are more to blame - it is they who should have mandated moving away from XP, and possibly more importantly IE6, much earlier and provided specific funding for migration projects so that it didn't affect core output, acknowledging that wider governmental policy allowed XP and IE6 to become commonplace. It might not sound much but many people in government knew about the end of life, however getting funding approval from the Treasury would be nigh on impossible without it being mandated. The end of XP has been known for years but has been extended before, put yourself in the position of a hospital manager - this year do you upgrade the IT systems OR replace the aging ambulances?
I think it's unfair to blame NHS trusts (quite small in the grand scheme of things) for buying important IT systems that did their job, many years ago, when XP was the de facto standard. The fact that they locked themselves into a particular configuration, simply isn't as important as being able to get the system at a decent price.
I think now, having all of the difficulty with migrating and lock in, government departments are much more aware of the real price of lock-in but when there is limited funding, you can understand a decade ago, health trusts decidng to prioritise healthcare over IT strategy.
That said, I think you make a good point about how government departments should negotiate contracts at the highest level (the parent department or ideally cross government) rather than each individual little sub-body contracting for their stuff themselves. In fairness, the UK government has actually learnt this over the last few years and, as the deal in this story indicates, is trying to place contracts at government level to leverage buying power (and save money in only having one contract negotiation). This is something that didn't happen 10 years ago, and is happening much more now with IT spending. However, in my opinion, it is much more than IT spending that should be rationalised up to the highest level. For instance, each police constabulary buys their vehicles themselves, you could save a lot of money if the Home Office brought police vehicles for all of the forces under one contract, lets face it most of them are exactly the same for each force.
They should take the N out of NHS, there is nothing National about it, other than the name.
It is a loosely organised amalgamation of semi-competing acute trusts, privately owned companies (GPs included) and other health organisations (mental health, sexual health, ambulance trusts etc), attempting to provide health services within geographical national boundaries of England and Wales, Scotland, Northern Ireland.
"That said, I think you make a good point about how government departments should negotiate contracts at the highest level "
Unfortunately the failure of NPfIT seems to suggest otherwise. It was one aim of NPfIT to provide more purchasing power by amalgamating IT spend within England & Wales, but unfortunately the only real win was a national radiology imaging system. Much of the rest went into the pockets of suppliers, or, like Fujitsu, forced suppliers out of the market by being too punitive.
@JurassicPark - "Unfortunately the failure of NPfIT seems to suggest otherwise. It was one aim of NPfIT to provide more purchasing power by amalgamating IT spend within England & Wales, but unfortunately the only real win was a national radiology imaging system."
That's a fair point but I'm aware there are other initiatives which work well to drive better returns. The government only recently realised that if it negotiated with Oracle as a whole government rather than multiples on a small level it could leverage much better rates on licences (used by across all departments to varying degrees). It makes sense to do this for Oracle and Microsoft and large suppliers of standard software but other software is much more difficult as the requirements probably vary much more between departments perhaps that was a problem with NPflT
Just because NPfiT was a massive cock-up (let's throw more money at Accenture, et al.!), doesn't mean that it had to be.
Whilst I was quite glad to see the back of it, I don't think that it was a bad idea in principle, just very poorly handled.
As for green screens and UNIX-based PAS systems, they went out of fashion at the turn of the century (see, it's cutting edge in the NHS!).
Taking the HS out of it too, would be an excellent idea - the NHS doesn't give a flying fuck about your health. Okay, if you're hurt in an accident, then fine, but on a general, day-to-day basis…? It's just the UK sales and distribution arm of Big Pharma Worldwide, plc. Your GP is nowt more than a sales rep, need students are STILL being taught myths which were thoroughly debunked, discredited and exploded in the early/mid-'80s, as fact, and the NHS REFUSES to alter its dietary policy, despite OVERWHELMING evidence that it's WRONG.
I'm sorry, but the NHS is NOT a 'health service'; it MAY have been at some point, but it sure as hell ain't now.
If there's anyone here on statins, you'll want to read this: - http://www.drmalcolmkendrick.org. Still think avoiding fat is healthy…? Read this: - http://www.dietdoctor.com/FAQ.
I don't trust the NHS anymore. Neither should you…
"That said, I think you make a good point about how government departments should negotiate contracts at the highest level (the parent department or ideally cross government) rather than each individual little sub-body contracting for their stuff themselves. In fairness, the UK government has actually learnt this over the last few years and, as the deal in this story indicates, is trying to place contracts at government level to leverage buying power (and save money in only having one contract negotiation)"
And yet the very first thing this current government did was cancel the NHS EWA with Microsoft so that they could say they'd saved £x million per annum ... but didn't mention that Microsoft licensing is now costing the NHS £y million p.a. (where y > x) because each organisation has to now separately keep track of how many PCs they have and what versions of software they're using on them all.
(AC because I'm now spending a disproportionate amount of my time doing exactly that on behalf of several organisations)
I've a client who deals with a supplier which has the monopoly on its products. No-one else supplies this product and the only way that the client can get said product is via Active-X on IE6.
If the supplier refuses to update (they're an overseas state run industry) then my client is stuffed as they can't move elsewhere. So having clout is no good if the bloke at the other end holds the monopoly.
Now, my client would dearly love to move from IE6 but can't. And no amount of telling them that they have do bloatgrade to Win7 isn't going to help them unless they can bring IE6 with them.
This is Microsoft's fault for not making Internet Explorer backwards compatible before cutting off the old versions at the knees. And remember it was MS which pushed everyone into making Active-X apps in the first place. This is all their doing and they simply don't understand that IT doesn't revolve around each firm being responsible for the code it runs on its own desktops.
It is a disgrace, but I have first hand experience of similar problems in engineering & the Charity sector. I've even seen examples of "new" browser based software that requires IE8 to function properly.
To be fair to Microsoft they have improved Security & Reliablity over the years. However dumb down the ability to right software by introducing tools such as Visual Basic & you end up with muppets writing critical applications*, vendors get the cheapest coders they can & bolt some software to a product or service. Windows XP should not have being introduced to add compatibilty that Windows 2000 lacked as this opened the floodgates for a production line of medicore insecure software to continue.
*Thats not to say all VB coders are muppets just that it makes it easier for muppets to be coders :)
The amount of Money the NHS are spending couldnt they just bypass Microsoft and build a great big XP firewall, virtualise legacy apps & go to new suppilers that can provide decent software that is platform neutral?
Probably there are also issues with many external hardware devices that has drivers available for XP and never updated to support newer operating sytems. That HW may be critical and very expensive to replace, thereby it was easier to keep an old OS running them.
Sometimes that very hardware is run by monkey-written applications, there were (and there are) a lot of developers who learnt to code under Windows with 3.1 or 95, and never understood how to code properly on Windows NT, 2000 and beyond. But drivers, any application written to run correctly on XP will work with 7 or 8 without changes. Of course if that application was written as if XP was 95, there are good chances it won't.
The issue is the selection process - those in charge of buying equipement usually have no clue about how to select the proper one, and ink deals about long-term support, I would not buy an expensive medical machine designed to last several years if the supplier don't warrant me it will keep its software up to data for the machine expected life. Twenty years ago most of those machines were running on proprietary software and firmware - if they were software-driven, and were not networked. But in the last fifteen-ten years more and more are run by COTS SW/HW but some proprietary parts, and the obsolescence cycle of those COTS systems must be taken into account, especially since everything got networked, it means that systems may be compromised.
Just you need the personnell able to take this decision and manage thos systems the right way - and there's too few.
> So - it's lazy good-for-nothing PAS suppliers to blame for this putrid stinking mess - mostly.
Wait, some idiot in the NHS must have approved the idea of purchasing crappy IE based and other proprietary Windoze based software to begin with. That's where the blame lies.
1. The NHS shouldn't be using Windoze full stop. It's a malware magnet.
2. They definitely shouldn't be using IE or any other non-standard and proprietary web platform.
If they continue using MS software, which is inevitable considering our government loves to choose the most expensive solutions, then when it comes time to replace XP, they'll have to replace every single PC. That's going to be one hell of a bonanza for Micro$haft and its avaricious resellers.
It's such a sad situation because all those XP machines could be repurposed for GNU/Linux and given a new lease of life. It would save millions. But as we know government isn't interested in saving money unless it involves stripping citizens of essential services and welfare.
_1. The NHS shouldn't be using Windoze full stop. It's a malware magnet._
We had no choice in the matter. It was pushed down to us by accountants who liked it to run their spreadsheets in between golf games with the suppliers.
_2. They definitely shouldn't be using IE or any other non-standard and proprietary web platform._
See Previous item.
When I was interviewed for my first NHS IT job, they were on DOS and Netware with Windows 3.x creeping in. I was asked about my opinions about software security and Windows NT. I said that the two had nothing to do with each other. I explained why and this caused great amusement and I got the job. I then watched it pushed in by the impressively uninformed, but highly paid, people at the Ministry of Silly Ideas in a reclaimed swamp somewhere in the remote south east of the UK.
Here's a quick resume of the problem here.
1. The NHS has to justify everything it spends our money on. To a very great extent, public services have to do that much, if only to make sure that they don't lose their future budgets, but the NHS is more high profile than, say, a local authority trying to maintain a rubbish collection or monitor a public health breach.
2. There has been, despite lip service to the contrary, a notable lock-in mentality with the Government with Microsoft operating environments over many years. This is sometimes due to point 3 below.
3. User ignorance of GNU/Linux (or any other operating environment, for that matter) is not an unusual occurrance.
4. Software and hardware companies will often provide systems that will not upgrade easily, if at all. In some cases this is due to ignorance, in other cases laziness, in yet others it is used as a way to push sales of new systems.
5. Corporates don't give a toss unless you are prepared to throw money at them, regardless of who you are. The only other way they tend to shift is when public humiliation could cause a serious dent in their cashflow, but that's less common since corporates are big enough to hide such things to a great extent.
6. People are too eager to jump from old to new systems because some marketing shill tells them to, either by promising improvement or threatening degradation. While they aren't always wrong, the motive is more likely to be monetary and often the resulting situation matching the marketing hype is a matter of coincidence.
Am I being too cynical here?
Tyrion, I was 100% with you until your last sentence, which was the usual left-wing, populist drivel I read so much of on the Internet these days.
It's funny that most of the people that moan to me about being screwed over by the Government and having to resort to food banks still seem to find the money for Sky TV subscriptions, high end mobile phones and tobacco/cannabis.
"It's funny that most of the people that moan to me about being screwed over by the Government and having to resort to food banks still seem to find the money for Sky TV subscriptions, high end mobile phones and tobacco/cannabis."
Just because you say something, doesn't make it true.
Also we shouldn't overlook a rather important event a few years back. When many would of expected to begin their desktop refresh back in 2008, Windows 7 was still in the future and the financial crash was happening all a round us, with the UK government becoming particularly exposed due to the size of the tax receipts financial services contributed. Since then the mantra in government has been to avoid non-essential spending, so given that XP wasn't due to go end-of-life for a few years a desktop refresh wouldn't of been a priority project - in any government department. Obviously with the financial squeeze continuing (and we can expect it to last well into the 2020-25 government), the project has remained a low priority and hence been largely forgotten until now...
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Not just someone.
Lot's of people.
Bear in mind that the indecision that has resulted in (much of) the NHS not upgrading has not been made by a single person in a one large organisation.
Each trust that hasn't upgraded are responsible for this, so somebody in each and every trust must surely be responsible? ICT Director maybe?
That said, I'd be amazed if a single disciplinary occurred.
Some need to go to Jail. There as been a lot of campaigning to educate the Public Sector over many years. After getting an education on how to avoid lock-in and move to open standards many decison makers allowed themselves to move to vendor lock-in hell (Look at the introduction of Sharepoint in many Councils as a good example)
The NHS may have a million PC's, but they will be a mixture of XP, Vista, 7, 8 and possibly one or two Linux boxes. I do not know if there are more than 150,000 XP machines that would be difficult to update. I am sure that getting all the other software ported to Windows 8 is expected to cost £30,100,000 this year or about £60,000,000 next year.
I expect Microsoft's price next year will be competitive. That way they can take another year's funding that might otherwise go to third party Windows developers.
"Equally, setting a one-year limit on the NHS deal is important to force health-service organisations to get off Windows XP."
That statement and reality are poles apart.
Those same health-service organisations had several years notice that XP was due to be End-of-Lifed, yet they failed to migrate away from it, there is no reason to believe that they will migrate away from XP within the next 12 months either.
It seems easy to blame 'The NHS', the difficulty is that there really doesn't seem to be 'an NHS' there seems to be a group of independent organizations, trusts, hospitals, university hospitals, practices etc that are all responsible for their own IT wants and requirements and the integration of this into whatever special systems a particular establishment wants to use or be known for. If they have no money or vision or will to move forward then they don't and no-one will critisise them for that as they are independent. Yet when the gov tries to take over and make a centrally controlled system then they get hammered for interfering. At the front line of this are some dedicated and hardworking individuals (and some seat polishers I am sure) but no one wants to give them credit for trying to get off xp and onto a different platform arguing against the slings and arrows of 'it works so you don't need more money or time to look into other options' until the very last minute.
To be honest, its an absolute outrage they will be wasting 30 - 40 million on this, when they have known for years its coming. Had they started the process sooner there would be no need for this waste of money and don't forget time negotiating this, to then have to do the same work anyway you could have done earlier. Mind you, I guess that keeps a fair few mangers in jobs.
"To be honest, its an absolute outrage they will be wasting 30 - 40 million on this, when they have known for years its coming. Had they started the process sooner there would be no need for this waste of money and don't forget time negotiating this, to then have to do the same work anyway you could have done earlier. Mind you, I guess that keeps a fair few mangers in jobs"
People are posting here who work in the NHS. The NHS is not a single thing, it is a lot of different things with complex moving parts. 'They' is a lot of decision makers in relatively small organisations that have to work within limited budgets.
And if they work in primary care IT then they've probably spent a good part of the last18 months or so reconfiguring IT systems to support all the changes brought about by the "No top down re-organisation of the NHS" ... The one that moved Public Health staff to local councils, separated community services providers from commissioners, dismantled PCTs and Strategic Health Authorities and created CCGs, CSUs, NHS England, Property Services etc etc. Their Chief Executives were more concerned about having their new email addresses reflecting their new organisations, and having their data separated out and secured so that people who used to be their colleagues but were now their customers or suppliers couldn't access it, rather than having their PCs upgraded when (from their viewpoint) they already worked perfectly well.
"you'd free from vendor lock-in forever"
Unfortunately, whilst a noble goal, its not the OS that is preventing migration, in a lot of cases its clinical applications that have not been updated, tested and certified to run on Win 7 or something else.
It would be the same with any other OS. If a clinical application had been written in 2000 to run on RedHat7, it's unlikely that app could be moved today to Ubuntu 13 and just work. Would you trust your life on the results from whatever device was connected?
Admittedly if the clinical applications were also open-source, there would be less of a problem.
Unfortunately the history of very many of the NHS clinical applications is
1. Highly specialised clinical expert sees a lack of software for their discipline.
2. The clinician learns a bit of programming or works with a programming friend and develops the software.
3. Working in the field, the clinician meets lots of other like-minded clinicians and sells the software directly, bypassing any NHS purchasing requirements for supportability / maintainability etc. Clinical departments not only have their centrally funded budget, they have money given to them in wills etc. that they can spend as they want with no IT involvement.
4. 10 years later, the clinician has made his money and no longer supports the application, having retired at 50 to somewhere sunny. Unfortunately the app only runs on WinXP
"...
4. 10 years later, the clinician has made his money and no longer supports the application, having retired at 50 to somewhere sunny. Unfortunately the app only runs on WinXP"
5) Start with a cost-benefit analysis of each app in use. If you can't justify the cost, it goes.
6) For the unsupported crapola stick it on a VM, and reverse engineer it with suitably motivated (smart) undergrads/grads overseen by a chilled greybeard. Pay them >=2x the graddy salary contract style on a 3 month rolling basis. The output of this is process is an automated test suite that will accurately model the behaviour of the system.
7) Bring in some seasoned app devs and get the buggers developing the replacement. You can test the results using all those automated tests from the reverse engineering effort.
8) Open source it, mitigate the on going costs with offering support contracts, paid-for-development etc.
The key bit is keeping the effort very focussed and making sure that 99.99% of the testing can be automated. Everyone could make a very healthy wage and a decent career out of that process and it really would not have to cost the earth to implement. If you open source the process then other trusts can see what you're doing and contribute/collaborate and hopefully re-use stuff. The re-use will promote the spread of common interfaces, protocols and conventions - and through that organisations will be able to standardise processes and software.
If this process is replicated across a large number of organisations & applications you'll see knowledge spread (driving costs down), bad apps being culled through competition and good apps thriving - while allowing space for multiple solutions tailored for specific scenarios to flourish as well. By Crikey ! That's an ecosystem.
This isn't revolutionary, it has been happening for at least 50 years, and while the $payware guys get all the limelight, open-source & other collaborative efforts have been thriving in the background (particularly in cash-poor specialist environments)...
5) Start with a cost-benefit analysis of each app in use. If you can't justify the cost, it goes.
So what cost-benefit do you place on saving a life? 'X bit of kit only saved 2 lives last year - bin it'?
6) For the unsupported crapola stick it on a VM, and reverse engineer it...
Um... Wouldn't this break various laws? Just because it's not supported on Win7 or Linux means it's ok to reverse engineer it?
So, my Trust has a dev team as you suggest, in collaboration with every other trust we re-write everything we need to it's all open source. Then a blood-gas analyser breaks & the company refuses to touch it because we are not running their drivers or software.
Oh, lets not forget that budgets are being cut and apparently public sector workers are hugely overpaid as it is so your "Pay them >=2x the graddy salary contract style on a 3 month rolling basis" idea would never happen unless you were happy to cut staff elsewhere. Oh yes, we can cut it from the dept that failed the cost-benefit part of the process.
Try working in the sector, using spit and baling wire to hold ropey systems together because there just isn't anything else that does the job. We know it's a problem, we know it's not sustainable but whos life do you want to make that little bit worse by deciding X system is not worth running anymore?
"5) Start with a cost-benefit analysis of each app in use. If you can't justify the cost, it goes.
So what cost-benefit do you place on saving a life? 'X bit of kit only saved 2 lives last year - bin it'?"
Firstly: Fair question - but you are asking the wrong person, ask the NHS trusts.
Secondly: NHS Trusts have to make that kind of call all the time, as you well know they don't have infinite resources to throw at making everyone well all the time.
Thirdly: Cost-benefit analysis is not a synonym for getting rid of stuff that makes lives easier. In fact if it's done correctly and the decisions made are rational it should actually *improve* the situation, at the worst you'll find out that you've done as well as you can and nothing needs to change. ;)
"Um... Wouldn't this break various laws? Just because it's not supported on Win7 or Linux means it's ok to reverse engineer it?"
Depends on where you are working, the EU tends to view reverse engineering as a legitimate activity. Also keep in mind that I was responding to a post about software that isn't supported and the vendor is either not interested or not around any more. In those circumstances, I think that is perfectly OK to reverse engineer it.
"So, my Trust has a dev team as you suggest, in collaboration with every other trust we re-write everything we need to it's all open source."
I am not advocating rewriting *everything* in-house and open sourcing it, so that straw man can screw itself and the post that it rode in on.
"Pay them >=2x the graddy salary contract style on a 3 month rolling basis" idea would never happen unless you were happy to cut staff elsewhere."
The software is not going to be migrated by magic. At some point folks are going to have to do some work, and the chances are they won't work for free. So you have a simple choice of developing in house (pay salaries) or outsource the work (pay salaries + vendor's profit margin).
While paying 2x the going rate seems a bit generous, most undergrads & recent grads are paid sweet f.a, so 2x of f.a. isn't actually that much and it also will attract a bigger and better pool of candidates to select from.
Ultimately it depends on whether getting the job done is more important than keeping the headcount down. Either way you're going to spend money - and most likely more money if you pay a vendor for the work.
"Try working in the sector, using spit and baling wire to hold ropey systems together because there just isn't anything else that does the job."
I've found plenty of workplaces outside of the NHS where the only materials to hand are spit and bailing wire. It's not a problem unique to the NHS. For the record both my parents worked in and around the NHS for the majority of their careers, I chose not to because I figured there was no future for a developer in the NHS...
"we know it's not sustainable but whos life do you want to make that little bit worse by deciding X system is not worth running anymore?"
You know it is not sustainable but you are not prepared to change the way you work, stress, misery and failure is inevitable with that approach.
I don't want to make anyone's life worse, but equally I see the status quo is making lives worse, and I see nothing to suggest that peoples lives will get any better in the future as a result of continuing to run unsupported software on end-of-lifed platforms.
MisterHappy
5) Cut the crap - he means how much does it cost to update to w7 ? Else sell it and get alternative hw/software and NEVER buy from that supplier again.
6) In fact, you have two solutions:
1) company that designed it exists, kick their ass to get you a w7 version, if they don't want, same as 5, show em your middle finger goto 2) they will be out of business soon
2) get an alternative
3) company that designed it does not exist anymore, reverse engineer it
Oh, and, when you buy medical appliances, make sure the API's are open or don't buy.
LOL, you really think the NHS will sort themselves out within 12 months? If the main clinical applications are not ready for Windows 7 NOW, they sure as hell fire won't be ready in 12 months. Put this down to contract naivety and poorly written contracts, welcome to the NHS. I feel sorry for the boots on the ground who just get throw the mud by management who just say "make this work", and "oh, by the way, you have little to no money to do it with".
Posted this when they first talked about the & the comments were mostly the same so...
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I work in a large NHS trust, we have over 100 individual departments, 9000 staff and 8000+ PCs and laptops. When shouting about 'How dare they?' please bear in mind that there is no single vendor for everything.
When working out how many discrete applications we were using we moved them into categories of 'want, need & site-wide' before testing. Of these, many of the site-wide applications had been brought up to date and were able to be moved without an issue. If an application was in the 'want' category and did not work on Win7 then the dept or individual was consulted and an alternative was worked out.
The main problem is with the applications and drivers that are needed for individual departments, some of these areas are extremely specialised and may only have one or two suppliers. Hearing aid testing equipment is one example, blood gas analysers are another, some of these machines can cost £100,000+ so 'buy from another vendor' is not a valid possibility.
Some web based applications will work using compatibility mode but others will not, there are problems with getting some NHS wide applications with Win7 64bit as well.
So yes we are migrating but unless you can decide which departments we should close until the vendors bring all software and drivers up to date there will be areas that still rely on XP for a while longer.
***
If 'The NHS' will do all of this work for me I'd be happy to but it is not a thing or a person, it is an entity with many many independent branches, each with their own budget & strategy, all trying to save money to meet with the latest 'Public spending cuts'.
@Lost all faith...
"Well, you fix it, or we find a product that will."
Good luck with that.
Some of the NHS systems I've worked on were very specialised and there were at most 3 suppliers in the world. I was asked to investigate replacing a IVF system for very large hospital in the North West. Their current system was written by a guy who had a day job working as a medical consultant at a London hospital. He could only responded to questions / fix faults with the system after 5pm and on weekends! However this was substantially better that the previous system that was developed by a guy in Egypt who the hospital had not been able to contact at all for quite some time.
So if you've got a guy who's managed to sell a dozen instances of a package at £100k each, but only works on developing / fixing the software in his spare time, and his software is regarded as one of the best in the field, you can expect long lead times when retesting on a new operating system.
must be a huge problem, years ago I worked for a company and we upgraded the computer systems on CNC equipment, you had a very expensive machine that is fully functional electro-mechanically but the computer system is broken, limted, out of support..
But with MRI equipment and the likes you just can't go in and replace the computer system, certification needs to be done etc, imagine the outcry if the MRI software was moved to, windows 7, 8, Linux or OSX and a year later 10,000 people had been misdiagnosed. Yet the same applies the main equipment is working well it's just the computer controlling it has gone end of life.
Having had a quick look for prices for CT & MRI prices go from 65k to 1.2m USD without training, warranty or install
http://info.blockimaging.com/bid/92623/MRI-Machine-Cost-and-Price-Guide
http://info.blockimaging.com/bid/67932/How-Much-Does-a-CT-Scanner-Cost
In these cases paying MS $800 a year does not seem that bad a price.
Unless the NHS get a strategy in place to migrate to Open Source software, this is going to happen all over again when Windows 7 goes EOL, and again when whatever replaces Windows 7 goes EOL, and again when ..... Well, you get the picture.
The NHS is big enough to have its own in-house IT department; which could earn its keep by being subcontracted out to work for third parties, whenever things in the NHS are ticking along smoothly. And certainly big enough to insist on Source Code and Modification Rights as absolute, deal-breaking conditions of procurement.
Of course there are hundreds if not thousands of people out there who could write and maintain open source code for a clinical system to say, manage a haematology analyser or a cryogenic sperm / egg freezing system and who also know HL7 so it can communicate with other NHS systems. And if the system is dealing with patient data, each one will have to be SC cleared and the development must be done in England if the system is for NHS England as patient data cannot go outside England borders (I do mean England here, not UK of GB & NI, NHS Wales, NHS Scotland and NHS NI are separate entities).
It was called NHS Connecting for Health, now falls under HSCIC I believe.
NHS IT has loads of challenges, and one previous poster makes a good point, if an NHS tries to be innovative such as adopting a mobile work style approach the media jump on the case that they are wasting money on iPads or something rather than on patients.
NHS ICT cannot win, it needs a greater share of the budget imho, with greater investment in its own people and from the top ICT needs to be taken seriously by NHS management. The attitude to ICT in some Trust's is awful, you'd be surprised how many cupboards are used to house comms kit, then come a warm summer switches shut down, people are surprised! Or ICT computer rooms stuck in basements under water pipes that leak. I'm sure I've not see it all yet but just some experiences.
@A J Stiles - Do you think that this won't be a problem with Linux? The reason that they're scrambling to replace XP is because it's going end of life/no more support. The NHS wouldn't run a Linux distribution without support and those support contracts go end of life/no more support. Are the people responsible for not migrating off XP suddenly going to be proactive in migrating off out of support Linux, in the future? I doubt it.
They get a pass when it comes to scanners and the like, but back office? No excuse. Too many IT managers in the NHS are terrified of anything more complex than a couple of standard images. Go beyond the concept of "users" and "administrators" and heads start to explode.
I've been in places where they won't support source control. ZIp up a new version and save on the network... Mention virtual machines and you may as well be showing magic tricks to a kitten.
Even when buying in document management tools, you'll still find an email stating they've saved a spreadsheet on the Z drive, or hear clucks of terror because files have been deleted, meanwhile the several thousands pounds worth of SharePoint servers are busy hosting images of grinning people shaking hands and last Christmas menu for the local curry house.
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Yes SharePoint, so horrendously complicated that Microsoft boast about about much money Sharepoint Consultants can make to get it working as required :)
Absolutely no excuse for any Public Sector deployment of Sharepoint lock-in, if any thing it was probably a delibrate act of sabotage to make sure its harder to move away from Microsoft.
The NHS is one of the few organisations potentially (cos it's all split up into stupid bits and pieces) big and ugly enough to write it's own software in house, and be able to afford to keep the staff and have resource to make decent software, keep it up to date and fresh, with the added bonuses that it will actually do what they want, and the process of buying it doesn't need to line any shareholder pockets.
By now the whole lot could be HTML5 in a browser, so who gives a stuff what's actually running on the desktop? Hell it could probably even do it's own Linux distro. Standard NHS desktop anyone?
That places that are so massive that they have the scale to do that but rather still line corporates and their shareholders pockets while putting up with horrendous shitty software (XP included) astounds the hell out of me.
More and more applications are coming with web front ends. An increasing number of those can be made to run on modern browsers.
If you can run it on Chrome or Firefox, you can run it on not only Linux but a well known derivative of it called Android. Yes, the paperless office may never completely arrive but once you have cheap devices available to (almost?) everyone who needs one a lot less trees come to nasty ends.
Some rearguard actions are being fought though.
1. The iShinyShiny enthusiasts who feel that only non functional managers should have tablets and obviously they "must" be iPads because that is what managers must have.
2. Bad HTML writers insert the occasional item into their application - perhaps a date picker or item selector that only works well with IE. They want more COWS on the ward - much cooler.
3. The "We cant use that licence because it isn't as good as a Microsoft EULA. Not as good for Microsofts bankers but better for the UK taxpayer for sure.
4. "We can't put it on the AD so it's not secure". Fix your Active Directory then to deal with modern devices and I don't mean shonky Mobile Device Managers. Perhaps we should (deep breath here) get rid of AD!
3. The only license they should accept is GPL (or equivalent). That way the taxpayers who paid for the code can use it should they so desire.
Why would a taxpayer want to do such a thing?
Because a lot of the problems are common to many walks of life, the specifics are matters of configuration.
So the Met fails to migrate in time; must beg to pay MS lots of taxpayers' money.
The NHS fails to migrate in time; must beg to pay MS lots of taxpayers' money.
Seriously, where do they hire these idiots? High time they migrate off Windows as much as possible so that any tax money spent on extended support etc at least has the CHANCE of benefiting the taxpayer footing the bill.
Yes, such a project would cost and take decades; but the end result is more than worth it.
And there we have it. No government is going to spend all that cash now, only for a completely different government to reap the benefits (or have the whole thing crash and burn, again), unless they're sufficiently ideologically invested, I suppose (the Tories aren't, and Labour won't want a repear of last time - *cough cough* NPfiT *cough cough*).
Why would the NHS top brass care, they have managed to keep the IT spending low for upgrades, got a lovely bonus, might get some shit next year, and worst case a goodbye with bonus^2 ... that and I am sure they are paying more than 200/xp pc, waaay more - they don't care, as it is not their cash, it is yours guyz.
As an example, how many XP boxen have died a miserable death (motherboard, CPU) and replaced by new hw at your company since Vista launched ?
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