NHS drops another billion on tech in the hope of finally going digital

The UK's health system has added £1 billion to a tech deal for software and infrastructure after an "engagement" with suppliers. NHS Shared Business Services (SBS) has published a contract notice for the Digital Workplace Solutions 2 mega-framework, saying it could manage a maximum spend of £2.5 billion in the NHS and other …

[Anonymous Coward]

Place your bets...

It will overrun on time, and cost.

It won't work properly.

Parts won't interface with other parts correctly.

Niche sectors will see functionality reduced, because the software has been designed by an MBA and/or IT geek who "know better".

Training and support costs will rocket.

Some friends of the government will get very rich, and not suffer consequences of the above.

Hell, they were doing this expensive "wonderful digital connected system" when I was involved in health IT, and that was 25 years ago....

[Anonymous Coward]

Re: Place your bets...

And it won't be the fault of ANY of the decision makers.

[Sir Sham Cad]

Re: Place your bets...

This is a Procurement Framework model rather than a Big Plan like the old, doomed, NPfIT.

No, this will fail because the NHS organisations who need the kit and software don't have the Capital funding to afford to buy it.

[Anonymous Coward]

Re: Place your bets...

Yes, this is a procurement framework, not a deal.

These frameworks are supposed to make it easier to procure services and equipment , and often have discounts built in.

In reality, they are difficult to navigate and if you need something quickly (I.e in months) then a Single Action Waiver is often quicker.

Re: Funding.

I am aware of several projects collapse because while an area has been allocated CAPEX for the project, they have no revenue budget for ongoing maintenance / support and licensing costs.

Hint: The IT department does not have budget for what it needs to do, never-ending picking up the maintenance costs for your new project.

[John_Ericsson]

Re: Place your bets...

And when it goes dreadfully wrong the NHS will defend the contractors, consultants etc.

[Doctor Syntax]

Re: Place your bets...

They have to, otherwise they'd have to blame themselves for choosing them.

[wolfetone]

Re: Place your bets...

"Parts won't interface with other parts correctly.

Niche sectors will see functionality reduced, because the software has been designed by an MBA and/or IT geek who "know better"."

When my wife was giving birth to our boy, during the 24 hours it took, I was sat watching the midwife fucking around on the laptop taking notes during my wife's labour. I was talking to her about it and she told me it was designed in part with a former midwife so it should be good but they found it really hard to use. As well as that, it was specific to the trust the hospital was part of. Another one in Birmingham would have a completely different system.

People make these things to hard when there is no real need. Ask them what they want, then give them what they need. Don't allow yourself to be bullied in to pleasing everyone because you'll never do it. It needs to do the job it's required to do, and people need to get used to it.

[Jim Whitaker]

Re: Place your bets...

I was once involved with an NHS project to put a mobile tablet into service for a domiciliary activity. The project was floundering a bit and when I pushed for an answer, it became apparent that "Ask them what they want, then give them what they need" was the essential problem. Because, of course, they asked a number of different people "what they wanted" and of course they got as many different answers as people and those answers were sometimes incompatible; indeed diametrically opposed. I moved on before the project came to a conclusion!

[Anonymous Coward]

fuck plantainr, just sort it out internally

My daughter in law is pregnant and for one reason or another went to our doctor to get some tests done. She as told to go to one of the clinics which is not far from us. Did so and had to go back on the Wednesday for more blood tests - which she did. On Friday, she went to the hospital where is going to have the baby and where her midwife is to get the results checked. Got there and was told they do not have the blood tests, cannot get the blood tests so she had had to have more.

So. These are 2 boroughs in London that are next to each other. This now means 2 lots of blood tests for the same thing.

1. Why not have an internal system that works (I found the same from our hospital and Cambridge when I worked there - maybe a bit more understandable vs 2 x London boroughs.

2. The sheer waste in resource, time and cost in having to have 2 x blood tests as they cannot talk to each other.

Talk about waste in the NHS, this is a classic example

[Briantist69]

Re: fuck plantainr, just sort it out internally

6 clusters...

"NHS London provided strategic leadership for all of the NHS health services in the capital. NHS London overall responsibility for the performance of 31 Primary care trusts, in 6 clusters, 20 acute trusts, three mental health trusts and the London Ambulance Service. A further 16 trusts in London are self-governing as foundation trusts."

[BebopWeBop]

Re: fuck plantainr, just sort it out internally

Obviously a problem but not one that is necessarily related across the UK. My partner has had to have multiple blood tests (mainly run through her GP), as well as scans in three different hospitals (based on facilities available). All of the information has been available within a day to her consultant and team. This is based on hospitals in Inverness and Edinburgh and a GP in the Highlands with the SNHS. So there is good practice in some places.

[Anonymous Coward]

Re: fuck plantainr, just sort it out internally

As far as I can tell, medical personnel are just technically incompetent on both sides of the pond.

For example, if you say the words "Google" or "internet" when discussing your symptoms, they just stop talking to you and stomp off in a huff.

I've seen my doctors get furious at a requirement to log into a PC after it timed out, and throw a temper tantrum until a nurse came to take care of the situation.

And that's "doctors" plural. I'm not talking about just one self-centered asshole.

For another example, a friend had his eyes measured for cataract surgery next month. That was a week ago, and they still have not been able to transmit the results to the surgeon's office. Fortunately, his wife is an ex-nurse who is hounding them daily to get things done.

So I'm not surprised hearing any of this.

[andy the pessimist]

Re: fuck plantainr, just sort it out internally

My GP sent to ely for a scan. I asked the provider to email the results to the gp and hospital. Oh no we can only send to gp. I ring the gp ,asking them to email to hospital, they don't know the hospital departments email address. They did manage to email it to me.

I ended printing it out and taking it to the appointment.

Nhs share email addresses between gps and hospitals and providers. It doesn't cost anything. Use bcc if necessary. If in doubt phone them.

[AndrueC]

Re: fuck plantainr, just sort it out internally

..and if you go into hospital you're advised to bring a list of your regular medications because the hospital might not have access to that information.

[Anonymous Coward]

Austerity my fat R'se

I keep on seeing articles that reference years of austerity, but I have to wonder in which universe it is austere to spend £120 billion pounds a year more than is raised in taxes, for a total government spend of £1.1 trillion?

[codejunky]

Re: Austerity my fat R'se

@AC

"I have to wonder in which universe it is austere to spend £120 billion pounds a year more than is raised in taxes"

You are right there wasnt austerity. It sounded good to the tories and a good thing to attack for their opponents but it never happened. So now we are in a situation where the gov that claimed it would spaff more is having to find cuts to fund the spaffing and continue to manage the decline.

[Yorick Hunt]

Re: Austerity my fat R'se

Which Tories are you referring to, the ones led by Johnson or the ones led by Starmer?

[codejunky]

Re: Austerity my fat R'se

@Yorick Hunt

"Which Tories are you referring to, the ones led by Johnson or the ones led by Starmer?"

Eh? What on earth does your comment have to do with mine? Who cares what the party is? They still spend more than they take and to deal with the debt we need economic growth.

[Like a badger]

Re: Austerity my fat R'se

"They still spend more than they take and to deal with the debt we need economic growth."

Given that growth has had a persistently slowing trend since 1945, it seems improbable that any government knows what drives debt-free growth. Debt-fuelled growth, that's easy, and is associated with most measured economic growth in recent decades in both Western and emerging markets.

Which means their only real levers are some combination of raising taxes and/or cutting spending. There's nothing wrong with either approach, merely a choice, but there's no national acceptance that our government spends beyond its means, and that it needs to reform.

[codejunky]

Re: Austerity my fat R'se

@Like a badger

"Which means their only real levers are some combination of raising taxes and/or cutting spending. There's nothing wrong with either approach, merely a choice, but there's no national acceptance that our government spends beyond its means, and that it needs to reform."

Well said. Unfortunately they have people fooled with debt fuelled growth.

[Anonymous Coward]

Re: Austerity my fat R'se

60 billion a year lost to Brexit doesn't help matters either.

[Anonymous Coward]

Re: Austerity my fat R'se

Pick a number, any number.

[Anonymous Coward]

Re: Austerity my fat R'se

Austerity for us, not for them and their rich mates!

[Roj Blake]

Re: Austerity my fat R'se

Austerity is for the little people.

[Dr Who]

9 months late?

We're 40 odd years on from the widespread use of mini computers and private networks in the NHS to deliver patient administration systems at a regional level, yet our new prime minister still has to say "We've got to have fully digital patient records." A national electronic patient record is more like 30 years late. The magic IT wand to fix the NHS is waved around with gay abandon by each new government, deliberately avoiding the real problem which is that the NHS is too big and too complex to fix. The way to tackle a hugely complex problem is to break it up into smaller chunks, which can each be solved separately.

[Like a badger]

Re: 9 months late?

Au contraire, the NHS is very easy to fix, but fixing it not politically acceptable as it's entirely about money, lots of it.

The key issues (see Kings Fund) are not so much efficiency despite widespread public and political belief: the NHS spends far less than most comparable economies on health administration, however we have far fewer doctors and nurses per capita than any high performing health service, we have less equipment (beds, scanners, diagnostic and treatment kit), and we have a daft "everything free for everybody" model that's similarly at odds with most high performing healthcare systems. And as a result our preventable mortality rate is worse than any comparable economy.

To put this into substantive terms, the Dutch healthcare system is a mid-high performing health service, and it has about 80% more in the way of CT & MRI scanners - I'd guess other equipment will be the same, and it has about 20% more doctors and nurses per capita, and about 20% more hospital beds per capita. If we assume that taking the NHS to Dutch standards of performance would increase net costs by 20%, then that's an extra £30bn a year government has to find, and it won't be finding that by sacking hospital managers, or the mythical "efficiencies" that politicians keep talking about.

[Doctor Syntax]

Re: 9 months late?

"the real problem which is that the NHS is too big and too complex to fix. The way to tackle a hugely complex problem is to break it up into smaller chunks, which can each be solved separately."

The NHS has been broken down into smaller chunks. That's become part of the problem. Did you not read the thread above about those chunks not talking to each other?

[GioCiampa]

Re: 9 months late?

The REAL problem is decades of "reorganisations", by governments of all hues, adding layer on layer of (expensive, inefficient) bureaucracy.

[sanmigueelbeer]

I bet £950 million is to pay the *cough* "consultant(s)" *cough*.

[Doctor Syntax]

move from "an analog to a digital NHS."

As a patient I definitely function on analog.

[Doctor Syntax]

The other day SWMBO got an email pretending to be from the local hospital trust saying she had a letter and should log into a site, link provided, to see it. In fact the email was from a 3rd party domain, also the domain of the link along with the domain of the op-out link and the noreply Reply to: address. Typical phishing email in fact.

Of course on chasing the trust it turns out that this is their new supplier (or maybe partner) and we should have known about as the posters are up all over the hospital where we can see* them. Of course in order to go to the hospital to see them and be assured it was OK to trust the link and we'd have to trust the link to follow it, get the appointment and go to the hospital. Or maybe we should occasionally go to the hospital just to check on the posters.

Obviously nobody involved, including the presumed IT specialist supplier, sees anything wrong with clicking a link in an unsolicited email that doesn't come from the source it pretends to. If they really don't they're a menace to their employers because they're prey to be phished. If they know enough not to do it themselves they still see nothing wrong in training the public to be phished.

This is the NHS "going digital".

The malware guys have it too easy.

* Taking into account that this is an appointment for an eye clinic.

[s. pam]

You've just described Bucks NHS

This kind of crap is what they're all about -- thankfully I've trained our family fairly well. So it lands on me to inspect and pass judgement.

Yet this kind of boll lox is perfectly A O K -- perhaps on Mars it might be.

[Doctor Syntax]

Follow up on that:

She rung up and found the appointment (routine long-term monitoring) had been made for a clinic in a different hospital than normal, further away and, more to the point, one with a serious parking problem. She got them to change it to the normal location. A few days later two letters arrived, one confirming the revised appointment, the other rearranging it to the other hospital. On the phone again to get it arranged back to the usual location, same day, earlier time. So far no more emails or letters so fingers crossed.

(Could do with a fingers crossed icon)

[Anonymous Coward]

"Obviously nobody involved, including the presumed IT specialist supplier, sees anything wrong with clicking a link in an unsolicited email that doesn't come from the source it pretends to. If they really don't they're a menace to their employers because they're prey to be phished. If they know enough not to do it themselves they still see nothing wrong in training the public to be phished."

As I believe I've mentioned on here before, several years ago I started a job at one of the big Email Security companies. About 3 or 4 weeks into the job I received an email from an *external* address containing a *external * link for me to go to and sign in with my company credentials to do mandatory security training...so I ignored the email.

A couple of weeks later I get an internal email telling me that I had not yet completed the mandatory online security training and I must do so immediately. I replied saying I believed I had already passed as I had ignored the earlier obvious phishing email. Eventually I was told that the original email was valid and I must complete the training. I pointed out that I had followed company security policy by NOT clicking on an external link in what looked like a phishing email and not logging in there using company credentials.....eventually HR admitted that indeed doing what the email stated was a breach of company security policy but I still MUST follow it to do said mandatory security training or I'd be fired...

If an email security company cannot even follow their own security policies then how you do expect them to "train" others? "Do as I say, not as I do" perhaps?

[Doctor Syntax]

Quite horrendous but am I in the least surprised? Not a bit.

[Anonymous Coward]

The same company gave everyone Microsoft *unencrypted* wireless keyboards in the office (remember they're supposed to be a "security" company) for which I found a project online able to read those from 10-20 metres away using Pringles cantenna...

They couldn't be bothered to spend a couple of pounds more per keyboard to buy the encrypted ones.

[Tron]

In house...

would have been much, much cheaper. But then the politicians wouldn't be able to funnel public money to companies that would give them jobs when they get booted out of politics. Govt tech is essentially a privatised gravy train. And despite the cash, it rarely works.

It seems that the people in charge of pretty much everything in the UK are either incompetent, corrupt or both.

Particularly, have very low expectations of anything the UK government do. Even lower after Brexit as there is no longer the cash or the staff.

And digital is not a magic solution, as they will eventually find out.

[Doctor Syntax]

Re: In house...

One of the problems with doing it in-house would be having the likes of the Daily Wail going on about the NHS employing all these staff who aren't doctors or nurses. Sometimes you just can't win.

[GioCiampa]

Re: In house...

What... like me? Glad to know my existence pisses off Daily Mail readers...

For the record, I work on an NHS in-house rule-based prescribing system that has, in one form or another, existed since the 90s. It talks happily to other systems using a standard message structure that has its origins even before then, and both have evolved over time as you'd expect.

Is it based on the latest (over-)hyped technology? Of course not, but it works as intended... not that this "minor" detail will prevent the fuckwits on high from pushing some pile of junk on us eventually I'll wager.

[Doctor Syntax]

Re: In house...

Are you by any chance in Newcastle? I did some prescription-related work with NHS folds from there.

[GioCiampa]

Re: In house...

Birmingham (though I work from home in Wiltshire)

[yetanotheraoc]

Re: In house...

"And digital is not a magic solution, as they will eventually find out."

Watch us make the money disappear!

[Anonymous Coward]

Shoddy? Improvements? ...but not "digital".........

Quote: "We've got to have fully digital patient records," Starmer said.

Yup....good sound bite!!!!

.....except for the fact that WE ACTUALLY DO HAVE DIGITAL PATIENT RECORDS!!!

The only snag......these "digital records" are in THOUSANDS OF DIFFERENT FORMATS!!!!

So....."digital" is NOT THE PROBLEM!!!

I hear you ask.....So what is the problem?

How about "no convergence"? How about "no standards"?

How about billions spent over forty years?......and here we are.....shoddy implementations......piece wise "improvements".......

How about catching up with forty years of shoddy, unplanned "improvements"?

[Doctor Syntax]

Re: Shoddy? Improvements? ...but not "digital".........

How about "no standards"?

Or too many standards.

[Anonymous Coward]

Re: Shoddy? Improvements? ...but not "digital".........

https://artuk.org/discover/artworks/dr-syntax-68580

So.....Doctor Syntax was a famous race horse.......

....and now deceased race horses know more about technology than ACTUAL PEOPLE!!!

Why am I not surprised?

[Doctor Syntax]

Re: Shoddy? Improvements? ...but not "digital".........

Wrong Dr Syntax.

Think Rowlandson. https://i.pinimg.com/originals/33/40/af/3340afdbeb4e0076ce2a6944392e129f.jpg

However, next time I'm at Brodsworth I'll take a look at my namesake. It's a while since we've been there so it's time for another visit.

[ColinPa]

We are solving the wrong problems!

Can we take another country's systems and use them instead of starting from scratch.

Yes there will be a migration cost - but this cost will be the same for whatever new system they come up with.

It will be a difficult period while a) data migration b) run systems in parallel (no big bang here), and transition the end users. I picture a team who go round each hospital in turn and sit with the hospital staff for a couple of weeks. This team then move to the next hospital.

Colin

[s. pam]

Utter bonkers it'll ever happen

I'll believe it the day I can see a Dr in Berks and the information shows up in my local GPs surgery here in So. Bucks so I don't have print a stupid form, hand carry it from one to the other, only to have to make a safety copy before giving it in (less it be lost, again!).

Until then, boll lox

[xMrDo]

LOL, 'news' for public (plebs) consumption...

The NHS will continue to throw CA£H at such projects, yet my GP will continue to ask me to repeat the same blood tests I had just a couple of days ago at the hospital. Why? Because some companies have executives who need to maintain their extravagant lifestyles.

>"engagement" with suppliers.

in the same bed ie like those shemale pr0n screwing each other then they both screw another guy (patients in this case)

[martinusher]

Day late, dollar short (or so)

Whoever is behind these contracts needs to get out more. The NHS might be a large health system but its not the only health system in the world and its not even that large by global standards. So the obvious first place to look for ideas for an IT infrastructure is in some existing health system, partly to see what's available and partly to see if there's any expertise that can be borrowed. bought or hired.

I belong to a HMO in the US, its a health system that's vertically integrated like the NHS that includes both in-house and contract providers, procurement and all the details that you'd expect from a health service. Its one of many different types of coverage we have here and is very different from the notorious 'fee for service' traditional setup that gives the consumer a wide choice (of ways of going bankrupt). As a system it works well and is very efficient and part of this is due to it being fully connected, you not only get the care you need when you need it but costs are very tightly controlled so its comparable to the NHS for end user costs (we do have some co-pays but we don't pay ripoff prices for parking......swings and roundabouts). A lot of routine interactions are done on line -- appointments, pharmacy, even some consultations and having your medical record available anywhere, a record that's updated in real time, helps keep treatments flowing. (They do contract outside the system for some services; its then that you realize just how inefficient paper borne systems are.)

Anyway, I'd expect people to have at least studied these systems. Naturally the IT providers will naysay them, you obviously need a fully custom solution etc., but that's to be expected.

[IGotOut]

I went digital...

...I went to my GP, where I was handed and badly photocopied sheet to fill out.

I then had to hand it back and wait for an email.

A week later I got the email.

I then had to create an account for NHS online. Once I'd set it up and logged in, it told me I already had one and would I like to merge them! I forgot I'd set one up 5 years ago to attempt to get repeat prescriptions....I ended up using the phone in the end

So I logged in to book an appointment.

Showing nothing for 16 weeks and that's as far as it goes.

Tried again a few weeks later. Again no slots for the next 16 weeks

Fed up I walked into the GP "Yes we can see you in 4 days time".

What is the fucking point of having online booking if you can't actually book online.

Oh and to so how shit it is. If you want one in 8 days time, tough shit. Come back tomorrow as we only book 7 days in advance..

If the NHS was in any other sector, it would have been shut down years ago.

And lets not even start on dentistry.

[AndrueC]

Re: I went digital...

Our surgery website says that online booking has been disabled while they upgrade the systems - at the weekend. During the week it appears that online booking is working fine. Is it really too difficult for them to change the message and come to that why is it disabled at the weekend which is the one time when phone booking is also not available?

..could it be that 'online booking' just generates an email that the staff have to enter into their appointments system?

[Anonymous Coward]

I’m sure this will go the same way as the previous Sopra Sterio contract. Would have been more ideal to use a UK based business rather than sending more of our money to overseas companies.

[MTimC]

Who owns the architecture(s)?

How on earth is NHS coordinating the solutions (or even requirements)? Unless these are managed, there will just be a lot of point solutions and there will continue to be the comment that the 'systems don't talk to each other'.

It's not super-hard. But it's not trivial either and could well involve quite far-reaching process changes (and hence pushback/organised change management).

I see no evidence that NHS has understood what went wrong with NPrIT, nor got beyond the expectation that if you buy a bunch of systems, they will automatically conform to the mental model that you have of how they will work (and that everyone else shares that model).

[Ashto5]

NHS is massive

To try and get a single solution you get Birmingham council

Now add liability clauses and penalties and suddenly you get these suppliers running for the hills

We have masses of talent and we could spin up amazing teams in the UK to deliver this under the control of some exceptional managers

BUT

We will use the same failed suppliers yet again

[Stuclark]

At least it's not a FAX

It wasn't so long ago (less than 10 years) that the NHS still insisted on FAXING results / records from one trust to the next. Their excuse? ..."email isn't secure"

My wife, who's a nurse, whilst working in one of the richer London NHS trusts got told by an IT tech "no, Windows 10 doesn't work on computers, it is only for tablets" ... this was during their Trust-wide upgrade from WinXP to Win7... in 2016!

[Doctor Syntax]

Re: At least it's not a FAX

It actually works on tablets? Wow, that's something but not worth getting a tablet for.

[Nedly]

It still won't help

The trust I work at is spending over £100m on a new patient record system, it will link in with other nearby hospitals who will use the same system enabling 'seamless' patient data access across the region.

The only problem is that certain departments within the trust have been allowed to opt out.

It's this attitude that will ensure whatever framework is put in, the benefits of it are likely to be squandered regardless.

[Anonymous Coward]

Elastoplast for a borken back?

As other's have said above. They have bigger and more pressing problems. Namely, just being badly run, which results in poor morale, demotivated staff and lack of care. It's being held together (just) by a few stalwarts and eventually they will give up and we will be left with a useless husk of Soviet style system that still launders our taxes to corrupt pockets.

[Anonymous Coward]

The pros and cons of centralised digital patient records

> We've got to have fully digital patient records

There are both benefits and risks/negatives with centrally stored electronic patient records. Once such personal data is shared then it is basically impossible to ever "unshare" it in the future.

One of the main risks with centralised records is that they are available to an ever-increasing number of organisations (and departments/people within each of those orgs) that may or may not have a valid reason to access such records.

Here's a relevant example from Meeting Minutes showing Hospital Trusts apparently ignoring the ICO's strong advice regarding whether Trust Occupational Health staff should have access to the Northern Ireland Electronic Care Record (NIECR):

9th December 2022 Minutes:

"The Steering Group also noted that this matter had been discussed as part of a meeting with the Information Commissioners Office.

Members noted that previously the ICO had been strongly of the view that OH access to NIECR caused them some serious concerns....

The Steering Group agreed that given the clear advice from the ICO that Occupational Health access should cease, and the NIECR Team should examine the best way to engage with the Trusts to action this."

10th February 2023 Minutes:

"The Steering Group noted that a letter confirming that Occupational Health access would cease on 31st March was being drafted..."

31st March 2023 Minutes:

"After discussion, during which both sides of the argument were clearly expressed, it was agreed to extend the Occupational Health access to the NIECR as requested, during which time the NIECR Steering Group would seek guidance on the legal advice being provided to the Regional Occupation Health Group and any correspondence they have had with the ICO."

12th May 2023 Minutes:

"The Steering Group noted that system access for Occupational Health staff had been extended until the 30th of June.

During discussion [redacted] noted that if the matter could not be resolved between the Steering Group and the relevant Trusts it may be necessary to seek an opinion from the Information Commissioners Office."

23rd June 2023 Minutes:

"[redacted] informed the meeting that he had informed the relevant parties of the impending end to the extension of Occupational Health professionals to access the NIECR. 30th of June. This had in turn promoted a significant amount of correspondence by email which had included a request for a further 3-month extension.

...

[redacted] also expressed her concern to the requested extension. She argued that the legal advice which had been received by the Occupational Health clinicians seemed at first reading to support the idea that Occupational Health access would not be lawful.

...

After further discussion it was proposed that Occupational Health clinicians within Belfast Trust should have access to NIECR extended to 31 August. They were to be notified that there would be no further extensions, and the Steering Group would require very clear advice that further access had a clear legal basis before continued access to NIECR was allowed."

18th August 2023 Minutes:

"After brief discussion it was greed[sic] that the Steering Group should reaffirm its decision that a recommendation be made to the Trust SIROs that Occupational Health Doctors' access to NIECR should cease on 31 August."

28th September 2023 Minutes:

"The meeting was reminded that Occupational Health Doctors' access to NIECR had ceased with effect from 31 August. However, a request had been received for a single Belfast Trust Occupational Health Doctor to have their account access extended until the end of September. This had been agreed by the Belfast Trust SIRO. This access was due to expire on 30 September and at the time of the meeting there had been no further communication."

20th October 2023 Minutes:

"[redacted] reminded Members that the Belfast SIRO had approved further extension for 1 Occupational Health account for a further 30 days until 30th Oct 23.

Subsequently the NIECR Team had received a request from SE Trust for the reactivation/creation of several Occupational Health NIECR Accounts. This was for both Doctors and Nurses. The Trust had been notified that this would need the explicit agreement of the Trust SIRO.

The meeting noted that the Trust SIRO had confirmed this request....

The Steering Group was informed that discussions were ongoing about the precise start and finish dates for this temporary access."

8th December 2023 Minutes:

"[redacted] informed the Steering Group that a further Occupational Health extension for access to NIECR had been agreed to Jan 2024."

26th January 2024 Minutes:

"[redacted] said BHSCT have extended access until end of February 2024. WHSCT have extended access expiry date to be confirmed. NHSCT and SHSCT have extended access until April 2024"

[Doctor Syntax]

Re: The pros and cons of centralised digital patient records

That's OK, providing it's only temporary.

[Anonymous Coward]

Re: The pros and cons of centralised digital patient records

> That's OK, providing it's only temporary.

How would the temporary or non-temporary aspect make any difference as to whether such access was lawful? Especially when the "temporary" access was extended multiple times (to more than 1 year *after* access was supposed to have ceased).

Given that ICO had highlighted that OH access to NIECR was unlikely to be lawful in general (as OH stuff had other ways to access the information they wanted) then how would providing "temporary" NIECR access to OH staff magically make such access lawful?