Posts by Sir Sham Cad 727 publicly visible posts • joined 15 Jun 2009
Do they not have a fucking TEST domain? There is absolutely no reason whatsoever that I have ever encountered in nearly 25 years for the 3rd party provider to have access to non-test records.
My opinions on NHSE shall remain undisclosed because my cunning disguise is fairly thin, but do as I say not as I do at least feels apropos.
Many years ago at current place of ork but in a previous role I was due to leave the office for the local place of refreshment (also a great place to get actual work done) when suddenly the network monitoring software went nuts. We'd lost two VLANS across the whole network causing major network outage across large swathes of the estate in critical areas.
Now it took a while to understand what was going on but essentially the root bridge for the two VLANS was in chaos. Eventually managed to find the rogue edge switch responsible. Now a few things I must point out:
1) In this location there was no physical security to access the network cabinet. It was free standing in a hallway of a temporary building
2) Some of our 2nd line engineers were lazy and didn't think tidying up after themselves was important
3) This switch was very legacy and was configured by an idiot
Having identified the source of the issue we removed the cat5e cable that someone who worked in the building had helpfully "tidied" by plugging the loose end back into another port on the switch, looping across VLANS. This caused the switch to attempt to be the root bridge for both VLANS because nobody had told it that it wasn't god.
Completely agree.
However the issue is that we're using software created with private capital money and spending public money on subscriptions for the right to use the privately created software.
We should be taking a leaf out of the EU playbook and looking to in-source our software by way of open source software designed by and specifically for the public sector, owned by the public.
It's funny you should say that...
Actually, back in the day, when they were planning the Helipad and looking for approval, they ran exercises to ascertain the local impact of chopper noise. At the time I worked with an engineer who was learning to fly helicopters. He took one look at the 'copter used for the noise test and laughed. Aparently Air Ambulances are a hell of a lot bigger and noisier than the commercial helicopter they used for the test.
A lot of flat, high-sided buildings in the area so now you cannot tell WTF the chopper is by audio because it sounds like it's everywhere all at once.
Prior to the Helipad it used to land in the play park next to the hospital. Trees, dogs, kids be damned.
A few years ago (OK, about a decade - I'm old) we got the usual zero notice that some outpatient services were being moved to a local, new build GP surgery/residential flats building, close to the hospital.
No time to order and run in fibre so the only game in town was a laser link from the roof of the hospital wing opposite the GP building. The wing that houses our ED/Trauma/Resus services.
All worked well for a time and then the connection would intermittently drop and come back up. We began physically resetting the laser at the hospital end each time it happened and we'd see the connection come back.
Over time this got worse and worse and we just could not work out why. We did suspect that the trees between the hospital and the GP building were blocking the laser as they came back into leaf, maybe the blossom was having an effect.
We called in the company that originally fitted the kit to have a look and they ran some alignment checks at both ends. They discovered the root cause and implemented a fix.
On top of the roof of the ED/Trauma/Resus wing is the helipad for the Air Ambulance. Repeated heli-action vibrations had caused the laser head to slowly, slightly, lose alignment. The fix was a bigger mounting.
We ran in fibre soon after.
That's not completely true and is a bit of a myth. Procurement wound down, the name was changed to Connecting For Health and NHS Trusts are using the central Spine records which was the central part of NPfIT, and Digital patient record systems that integrate with it.
It's true that loads of potential EPR suppliers shit the bed and ran away (Fujitsu, looking at you) but the core aims of the NPfIT were achieved even if it was an absolute shitshow of running a National Programme that wasted billions.
I work in a place that is a permanent temporary building which is Modular so each floor is three separate modules with the only chance for air to mix between them is when someone opens the fire door to the stairwell.
The HVAC is set to maintain a pre set (but changeable) *average* temperature across the three floors. Not the same temp on each of the floors, just to maintain the average.
It works as well as you can expect.
The building was designed by and for a now defunct .gov.uk Department who never used it because they realised they needed a bigger boat.
Back in 2002 one of the first things I did was make our clunky, internally built, EPR system, securely available for local Primary Care (GPs) so they could access their patient's records from our Secondary/Tertiary work. Apparently and according to the emails and letters we received, it was a massive time saver for the GPs and their Admin team as well as the patients.
It's 2026 and I can confidently say that, across the wider patch that I'm involved with, we're, er, getting there with the joined up data sharing between Primary and Secondary/Tertiary Care orgs.
We can all share data but, to paraphrase Eric Morecambe, we're sharing all the right (patient) notes just not to all the right people.
Wow. I'm not sure how much more wrong you could be.
When we were going through the NPfIT (later changed to Connecting for Health because of the need to emphasise this was a Healthcare thing not an IT thing) almost every supplier pulled out including Fujitsu. BT were fronting Cerner (now Oracle HealthCare and soon to be not-Oracle) and the other was Epic.
There was no Union involvement or chatter. The issue was the .GOV procurement process which was fragmented and too open. One company created the Spine and all other bidders with their own proprietary and often non-existent EPR systems needed to talk to the National Spine for authentication and patient ID (not always successful). That was fatal for a lot of the bidders. This is why NPfIT/CfH was so delayed.
The whole point of it all was to improve Patient outcomes and reporting/accountability and it has worked very well compared to the pre-digital times.
By the way, the NHS is run for our patients. Not everyone agrees on how best to do that but I can promise you that it is and every day I see people run off their feet, pulling double shifts (24 hours) to ensure Safe Staffing levels. I see even IT people working all night in event of a P1 outage and then coming in the next morning because it matters. Because our clinicians matter because their care for our patients is everything.
I dunno if this was the rise to your bait that you were looking for but yep, I'm gonna bite.
From experience with some ex-Accenture people what will happen is those humans who are good at their job but get fired due to AI aversion but have good relationships with a portfolio of clients will form another company, let's call it CwP, and nick a lot of the customer base who are not wanting to trust ClippyPilot with their super important, legally required and deeply informative of their own investor happiness documentation.
Nose. Face. Spite.
I once (briefly, thank FSM) worked for a small, independent finance software company. The "IT Room" was a bunker in the basement full of boxes of old, knackered bits and cards. And the production server which was a tower unit. Situated next to the door. The power button sticking out nicely as if to say "press me!" It was not covered. I managed to hit that power button accidentally, downing the whole office, twice.
Despite my requests to be allowed to cover the button it remained prone when I departed several months later. Because they, er, didn't want me to make any changes to the server.
Slightly over a decade ago we were implementing a new Electronic Patient Record as part of the less than well managed NPfIT. All staff, regardless of role, were required to take a training session and pass a web-based test.
One right-click-view source later I noticed that the code for the options actually specified which of the options was "correct" when the test form was submitted. Yes I did tell the entire of my training cohort.
Of course it was such a well thought out and not at all rushed job that one of the required fields in the training environment for a Hospital EPR was "Species"
The part of TFA that I picked up as the main take-away was, basically, this:
!) Capita lost the contract because they were, er, Capita, and were replaced by MyCSP
2) MyCSP contract ended and a Public Procurement Exercise to find a new provider was undertaken.
3) Fuck it, Capita it is again, then. They've pinky sworn to be better this time.
The reason the same bastards keep getting these huge contracts is because they know how to complete a Public Procurement Tender rather than actually provide the service.
In my experience it's a couple of factors and this is deliberately simplified:
1) Beancounters and bosses don't see the financial benefit of taking the time and spending money on something that, at best, you won't notice the benefit of as opposed to shipping code or spending the money on something they can see.
2) The bad guys have to get lucky once, and they are trawling with a large net, and we have to get lucky all the time. Sheer weight of numbers means someone is going to run out of luck very frequently
3) Yes, I know this is one more than a couple but if it works in the pub... people who actually, properly understand infrastructure-to--code security are like hen's teeth and most places don't have 'em so the rest of us are following Principles and doing Audits and Learning Lessons.
Two problems really:
1) When we Procure via one of these Frameworks we don't get access to fixed pricing so any savings are either impossible to quantify or non-existent.
2) We don't have the money in the system to buy in anything like the theoretical value of the Framework. We're looking at this locally rather than nationally with more modest but realistic value ceiling.
Funnily enough, during the last Government, the husband of a sitting Cabinet member set up an IT Asset disposal company, fronted it with a separate company with an NHS-friendly face (we'll give you lots of money back or donate to your Hospital Charity if you give us exclusive access to all your stuff) and was aggressively selling those services to NHS vertical.
We all told them to fuck off once we spotted the scam and corruption.
The cutbacks are nothing to do with "AI" in the sense of a general GenAI CoClaudeGrokPilotGPT style LLM replacing desk jobs, it's because there's a lot of duplication of effort across different, non-clinical organisations (ICB's, NHS England, DHSC) which, aside from the duplicated costs in Pay, causes operational inefficiencies.
That said, everyone I deal with across the local ICB and NHSE are highly supportive, experienced, skilled, knowledgeable people who do not deserve to lose their jobs.
The irony is that, even if they are on the LTSC they show up as Windows 10 on an audit and count against us for DSPT compliance. Network segmentation for these devices is the best way to manage this problem (some of these devices can't even be patched, ever, because that would constitute the Registered Device being changed and, therefore, fall out of Registration compliance and cease to be a certified Medical Device).
Our fantastic Medical Devices team do work well with us and it drives them mad too.
We have this situation at the moment. Some of the manufacturers do have devices/software that can run on Windows 11/Server 2022 but they can't sell them to us/upgrade existing software until MHRA issue a Medical Device Registration and that can take years.
This is one of the reasons NHS England negotiated a roughly 50% discount with Microsoft on the Win 10 ESU at the last minute having previously said they wouldn't (wanting, instead, to push us to upgrade rather than be lazy and throw taxpayer's money at the ESU)
This is even more fun when there are two Vendors involved in the system. It's basically that meme of the three Spider-Man cartoon characters all pointing at each other.
Vendor 1: It's definitely an issue with Customer network
Vendor 2: No, we checked that, it's definitely an issue with Vendor 1 widget
Customer: It's definitely one of you two. Or if it isn't it's IT's fault
Me: Girls, girls, you're both ugly. Here's some evidence I gathered earlier (wireshark, netflow etc...) now let me know if I can help you with anything else.
Just call the bloody thing CopilotOS and save the marketing money.
Sorry but Keyboard/Mouse interface aren't going to be replaced by "I'm sorry, I didn't catch that" because life isn't an R&D lab. My work lappy is a hybrid touch screen laptop and very heavy "tablet" if you do the screen 360 flip thing. My previous laptop was the same. I have remembered that I could do touch things on the screen fewer times than I can count on my toes and I have the regulation 10 of those.
Windows RT is not a thing (and never really was) for a very good reason. As one commentard has already mentioned "those that cannot remember the past..." well they'll actually probably purchase a 3 year ESA and tell the C-suite that "We got that AI you wanted"
"Recovery" can't come soon enough.
