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BCS 'has not changed mind' about CfH review

Tags: A   Audit   BCS   BCS Health   CfH   Data   Granger   HIS   House of Commons   Informatics   iS   Office  

30 Aug 2006

The British Computer Society has denied changing its tack by backing the growing calls for a technical review of the health service’s £12.4bn IT programme.

Glyn Hayes, chair of the society’s Health Informatics Forum, has defended his position following a report in this week’s Computer Weekly, which detailed a private email from Dr Hayes to Martyn Thomas.

Thomas, a visiting professor at Oxford University, was one of 23 senior academics who wrote to the House of Commons Health Committee in April 2006 calling for an independent technical audit of the NPfIT.

The email was circulated privately among the 23 academics calling for the technical review. It was supplied to Computer Weekly by the BCS press office in a bid to clarify the society’s position.

In the email, Dr Hayes questions whether the national programme’s centralised approach and the electronic care record.

He says: “Obviously such a centralised system could be made to work technically, although they are having major problems doing so because of the scale and scope of the NHS.

“Our main concern [is] that a centralised system will not work in the complex organisational structure of the NHS. A distributed architecture would have been much more flexible.

“We also have major problems with the lack of architectural planning about the detailed structure of the Electronic Health Record. As you know, this is an entity which does not fit well with other technical IT methodologies and needs considerable thought.”

He goes on to say: “I do indeed support your proposal for a review of NPfIT.”

Computer Weekly’s report claims that these comments are “not consistent with public comments it [the BCS] had earlier made in defence of Connecting for Health”.

However, Dr Hayes told E-Health Insider: “Our position has not changed at all. We are wholly in support of NHS Connecting for Health and the national programme.”

The BCS has always had concerns about centralising data and the structure of the clinical record but had expressed these directly to NHS CfH, he added.

“We have acted as a critical friend,” he said.

On the question of a centralised versus a distributed architecture, he said: “There is an argument that says it would be better having [data stored in] individual systems as long as they could communicate with each other. We are not arguing for that but it is a question that needs discussing.”

He said the BCS was in favour of a technical review but that it must not hold up the project. He said: “If the politicians lose their nerve because of pressure from Computer Weekly then the health service is going to suffer.”

Professor Thomas admitted to being mystified by the furore. “I believe that Glyn Hayes, the BCS health informatics forum and the 23 academics are completely in agreement about what needs to be done to help the national programme,” he said.

Dr Thomas added: “I think the BCS is walking a very delicate line and believe that they can influence the national programme better by talking quietly with Richard Granger and his team and believe that the very public campaign that Computer Weekly is running is causing damage. I am not convinced that they are right.”

And Hayes says the BCS health forum has “major problems with the lack of architectural planning about the detailed structure of the electronic health record”.

The letter says, “Obviously such a centralised system could be made to work technically, although they are having major problems doing so because of the scale and scope of the NHS. 

© 2006 E-HEALTH-MEDIA LTD. ALL RIGHTS RESERVED.

Readers Comments
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1

Hasn't DH already ruled out a review?

30 Aug 06 09:40

The BCS may not have changed its mind, but buried in Appendix 1 of the recent NAO report is a note that the DH has no plans to commission an independent review of CfH as it remained confident that the programme's technical architecture was appropriate.


2

Stable door open, why has horse not bolted?

30 Aug 06 11:31

It is nearly three years into the project and nearly two years after basic elements of NCRS were supposed to have been delivered according to the OBS (P1R2 Dec 2004).

During 2004 many of us working for LSPs and contracted suppliers attended meetings (HL7, NHS consultation exercises etc) where plans for PSIS (effectively the centralised clinical record) and the Clinical Spine Application (a browser for the central record) seemed well advanced. Then it all went quiet. The NAO Report (in any extant version) barely mentions these specific NASP supplied components.

How come it is even possible (much less necessary) to hold discussions about the basic design and architecture of vital components of NCRS at this stage? This was all decided.. or wasn't it?


3

The necessity of a technical review

30 Aug 06 12:54

In response to the previous comment, if technical plans that were well-advanced in 2004 are still failing to materialise, then asking some fundamental questions about those plans does seem like a logical - and necessary - step.


4

Poor Requirements Analysis & Validation

04 Sep 06 13:37

As with many projects, the national programme was hindered by poorly specified, often unrealistic requirements supplied by an organisation without adequate end-user representation which were signed up to by the suppliers / system integrators without being adequately challenged. The alarming thing is that 2+ years into the programme we're still perpetuating the problems, just with different suppliers. The programme can still deliver and there are a great many people busting a gut to make sure it does, but it requires a more realistic, pragmatic approach to ensure the end users get systems that deliver real benefits.

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