It's been 60 years since the National Health Service first opened its doors. Since its 1948 inception, the behemoth organisation has become a UK institution and a political hot potato. But now it's undergoing its biggest change ever, the introduction of wide-ranging IT systems and new technology-driven business processes.
Generally considered the largest non-military IT project in the world, the National Programme for IT (NPfIT) has also been called the biggest failure. In a government report to MPs, the government's accountability guru Edward Leigh said: "This is the biggest IT project in the world and it is turning into the biggest disaster."
What started in 2003 as a 2.3 billion project set to end in 2010 has turned into a 12.6 billion project expected to finish by 2014, according to a report from the National Audit Office. Fresh trouble with suppliers will likely delay the project even further, and some believe the costs will eventually top 20 billion.
So it's no surprise it's not a popular programme. But there are troubles aside from costs and timelines. Clinicians complain they haven't been involved in the process and NHS IT body Connecting for Health (CfH) has admitted as much. The four major suppliers are now down to two, after Accenture and Fujitsu stormed off. The project can't keep top executives, not since Richard Granger left for greener pastures. Systems have been declared not-fit for purpose or error-ridden, when they manage to get deployed at all. And others are concerned about the very core of the project, all that most personal information being held on a government database no small worry given function creep seen with the national identity database and data breaches from the HMRC.
CfH has grudgingly conceded things could have gone more smoothly.
The project
But taking a step back, what has the project accomplished so far other than to anger so many people? At the moment, the NPfIT is organised into three phases. The first included procurement and the rollout of some pieces of software, but mostly focused on bringing the aged and in places, non-existent infrastructure up to speed. The second phase saw national programmes rolled out; most of these are either finished or at least part way through.
Now, the project is hitting the third phase, which will see national programmes finished up and effort refocused on the three local' systems.
So what are those billions in taxes installing? The NHS now has its own broadband network, called N3, which is effectively one of the largest virtual private networks there is on the planet. Aside from linking up the following systems, it also allows hospitals to move to tech like Voice over IP (VoIP) to save cash in a more traditional business way.
The N3 will be used to access Spine, which is effectively the database and structures supporting the Care Records Service, which will hold and link patient records including (eventually) summary care records, those piles of files which sit at your GP's office. It will also link up the Choose and Book system, which lets patients book their appointments using an electronic booking system, and the Electronic Prescription Service does just what it says on the tin let clinicians send prescriptions to the pharmacy directly. There's also the PACS system, essentially a digital x-ray and image system. And NHSmail is the secure email and directory service for clinicians and other staff.
So to sum: a fancy broadband network, which lets doctors check email, look up patient records, book appointments, send diagnostic images and send off prescriptions. What's so hard about that?
