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Much hot air been expended here by people who should know better. Its amazing how much gibberish the pairing of "NHS" and "IT" creates.

There are a number of underlying issues here, but the two main ones are due to the various goverment's fractionalising policies over the last 15 years which have led to reduction in size of organisational units, and the depletion of management skills. The worst of these was the dismembering of the PCTs and their replacement with GP-led CCGs. What did that achieve? The emasculation of any decent management within the NHS and its replacement by a bunch of empire-building ego-driven GPs, each with their own little private fiefdoms. There are several quality software suppliers to the NHS trying to bring order to the current chaos by offering upgrade routes, but finding themselves blocked by inept NHS management.

So why the delays in implementing Windows 7?

1) GP-led CCGs not seeing it as a priority. They prefer to spend their money on fancy offices

2) Fragmentation. There are too many contact points within the NHS to deal with, making finding someone to whom we can sell an upgrade solution damn difficult

3) Software issues. While most of the major clinical recording software packages will run on Windows 7, some will not, even now. Thats one of the reasons CSC left the GP market two years ago. Other suppliers have had a torrid time - one widely used package uses partly 8-bit CP/M code running in an emulator. Happily that package is now in the process of being killed off and replaced with a cloud solution, but its a hard job weaning the users off the old code.

Many other examples exist: a lot of plug-in software such as online test requests only work with Internet Explorer 7 or 8. IE9 or 10 kills the java routines. The NHS identity card software will only work with Java 6 v17. Anything newer kills it. The depreciation database used by a lot of Northwest trusts as a Citrix application will not work with a version of MSOffice newer than 2007.

The list goes on and on.......the problem is each trust has its own collection of software, much of it with a relatively small number of users on a national scale, but significantly locally. And many of these routines duplicate each other pointlessly. How many different labelling programs do you need? How many clinical systems do you need?

Its time for the government - or someone in authority to pull rank, knock heads together and order the CGGs what to do - with the threat of sanctions / sacking if they don't