my mate dave etc etc
Some of the comments on this thread are laughably simplistic e.g. "my mate wrote a system that could do it all" etc etc.
To help inform an understanding of just how ambitious the National Programme is it might be worth looking at a few key metrics for NPfIT:
- 650,000 clinicians, nearly all of whom feel entitled to contradict Connecting For Health and their 649,999 colleagues on what the systems should / shouldn't do
- 30,000 separate physical locations
- Hundreds of Trusts each with their own set of "unique" processes holding the expectation that their different way of working should be supported- Hundreds of local IT Directors who can and do decide to do what's best for their Trust irrespective of the impact on regional or national plans
- Hundreds of different versions / providers of systems that need to be integrated into a new standards based architecture - and thousands (if not tens of thousands) of combinations of legacy systems that have been configured / tailored locally (often with very little documentation).
- 240m appointments in Primary Care a year
- 60m+ (?) appointments in Secondary Care
- a coding structure that contains over a million different clinical terminologies that will apply to each of the 300m appointments in Primary & Secondary Care (compare this to the simplicity of even Tesco with c40,000 SKUs)
- A key (and vociferous) stakeholder group of 140,000 Doctors who will always warn you that doing something will kill patients even when this is just an argument designed to protect their shonky ways of working or protect the cosy set of working arrangements they've fooled the government into accepting and who are represented in public by spokespeople who will often say something completely different in private
When, and only when you've actually had some exposure to this can you really understand the scope of the challenge or comment with any real insight on what Connecting For Health should do / could do / has done / hasn't done.
Many of the commentators on here seem to have missed the key point that Connecting For Health pays on results. Key contractors don't get paid until they deliver - with the result that although the programme is late, CFH haven't paid for the privilege - they are reportedly c£2B underspent at present.
Finally, many of you probably haven't worked in environments where even small changes can involve consultation across hundreds of separate organisations and thousands of key stakeholders. Until you have, it's very easy to come out with all the "my mate dave in his shed" scenarios which make for entertaining reading and not much else.