Five steps to help cure NHS IT

Once those in charge have established a clear strategy and learned how to negotiate, getting contractors who really deliver is the next step. How can you make an IT project a success if you don't even have the equipment in the first place?

CSC found itself under intense scrutiny after being accused of some significant shortcomings. It only managed to deliver the goods in three hospitals over nine years as part of a 3 billion contract, the committee's report said. Even Prime Minister David Cameron warned earlier this year that CSC may not be getting much NHS work in the future.

Luckily for the contractors in that case, it may cost more to cancel the deal than to see it through even if that eventually produces a system about as useful as a surgeon without a scalpel.

Yet for the future, much attention needs to go on who is providing what. If the Government wants to avoid future embarrassment, it needs to pick the right vendor from the start, holding comprehensive procurement processes and making the right choices when going out to tender.

Calls to punt for smaller providers are somewhat misguided, however. They may have the skills and tech ready to go, but delivering on a project as massive as an NHS patient records system will be something of a chimerical task for smaller companies. You need the clout, the workforce and the bank balance to pull off such initiatives.

"You can't have a tiny shop around the corner doing this on a nationwide basis," Wels-Maug said. "You really have to have a CSC or an IBM. If anybody can cope with this, then these guys can."

If the Government wants to avoid future embarrassment, it needs to pick the right vendor from the start.

Admittedly, it appears that in the patient records project the big players didn't do a good enough job. It's not just the prowess of a company that's important, honesty and a proven ability to deliver on time and on budget are vital too.

3. Look to the hybrid cloud

As the NHS has shown before, it's happy to use the cloud. It has a number of projects on the go, including one with young security firm Zscaler. The patient records system is itself a form of cloud computing, providing a single platform for many to access.

Yet the NHS should think about using the cloud more. By taking baby steps rather than diving blindly into public cloud offerings, the NHS would gain both experience and potential monetary benefits.

Obviously, there will be highly sensitive data needed in-house, but evaluating what can and can't be moved would seem sensible. The hybrid model will supplement this, enabling the transition of certain data off-premise, whilst providing the scalability an organisation like the NHS needs.

Greater use of the cloud would also mean less money spent on unneeded capacity or infrastructure, as well as less expense on upgrades if they are handled by the vendor. The technology is there, so why not use it?

"Hybrid cloud systems have the ability to provide dedicated and public cloud products as a combined offering," Torlini said.

"This enables organisations to host their core applications and data on dedicated hardware and then burst into the public cloud to cope with increased demand more cost effectively. This tailored approach also answers security worries that companies might have sensitive applications can be kept in-house in a private cloud, but still benefit from the unlimited flexibility and scalability of public cloud."

As long as the SLAs give the NHS what they need, the hybrid cloud offers a pill to cure at least some of the sick system's symptoms.