Re: First of all
"Sure - it can be done but not easily. Best way would be to establish the centralised IT service and then gradually migrate Trusts over as their stuff becomes obsolescent. And that's not a short-term process and won't be cheap."
As a disinterested and mostly uninformed outside observer, I'm wondering if the messy reality where each Trust has its own system, can't be harnessed using Darwin to make a better and more cohesive whole. There must be one Trust system that best reflects the ideal NHS system. Such a system already has elements of scalability, because it serves NHS facilities Trust-wide. Make it the default system. Other Trusts may continue with their own systems, but with their IT management budgets (by that I mean the amount paid to middle and upper managers, not capital or staffing by actual IT people) frozen. I imagine you'd want to start by incorporating one Trust (which need not be geographically contiguous) into the default Trust system.
I won't talk about how you make the choice of best Trust system an objective rather than a political decision. Nor will I talk about resistance from empire-builders in each Trust. Rather, I'd like to talk about the possibilities of humour if the idea of going with proven competencies takes hold:
"Mr. Trelawney, your operation is scheduled for 9 o'clock tomorrow morning."
"Already? That's wonderful. So that's here at Truro Hospital, then? When should I arrive?"
"No, Mr. Trelawney, your operation will be at Aberdeen Hospital. They have the best record for ingrown toenail procedures. And according to the Belfast Trust computer, which has the best timetables, if you leave now for Truro rail station, you will just make it to Aberdeen in time for the 7:30 a.m. check-in for your operation. And please don't eat anything for 12 hours before the operation."
"Not that I'd want to."
"Your surgeon is Dr. Ronald MacDonald."
[pause] "Blimey."
Biting the hand that feeds IT
