Heading for the rocks


News and Comment from Roy Lilley.

With a combination of Google and YouTube I think I could tackle anything.  I’m up for it.  Surgery on the kitchen table, bring it on.  Build a moon rocket from three wheelie bins… oh yes.

Navigate by the stars, prune the roses, algebra.  Information, education, experiences… why bother with school?  What price three years at Uni when you have the world’s knowledge at your finger tips.  There’s nothing you might want to know that isn’t a couple of clicks away.

All you need to know is, what do you need to know.  Nineteen years ago a friend in the US told me about Google.  At the time I thought an Encarta CD was as good as it got.

Google is a revolution in learning, enquiry and the democratisation of knowledge.  I know… don’t write to me about their tax affairs.

And so it was, I turned to Google to try and figure out how the NHS’ use of technology for the management of its information is progressing…

I Googled ‘NHS IT strategy’.  Amongst the twenty gazillion search returns… every NHS nook and cranny has its own ‘strategy’, I found this; The NHS IT Strategy… tra-la!

It was written in September 2017 and promises a ‘tighter link’ to the 5 Year Forward View, published in 2014… of which there are about 100 weeks left.  You can see where this is going, can’t you?

There is nothing like a good strategy document and this is nothing like a good strategy document… boom, boom!  Strategy has to be timely, understandable and deliverable…

This strategy is based on a National Information Board report (a committee the size of a small country), that created 10 domains.  Ten to the power of ten, where things might not fit, go wrong or cost a fortune.

We are to be treated to a ‘narrative’ that ‘helps people understand where they fit into the programme’.  

Add to that a mission with a ‘triple aim’… really… and 5 deliverables… underpinned with four ambitions… plus five organisations with a finger in the pie… 

I make that three times 5, times four, times another five…opportunities to fall down the cracks, drop the ball, duplicate and screw up.

Add to that 150 odd Trusts, who can do what they like about IT and eight thousand GP practices with half a dozen systems, community services doing their own thing and social care working it all out with a pencil and you can see this is, frankly, drivel.

There’s a budget; £4.2m of which half is earmarked to prop up what we’ve got and the rest syphoned off to deal with the WannaCry panic and to deliver the DEL.  

The Bob Wachter Report put the tin-hat on the whole misbegotten enterprise when he helpfully pointed out there was insufficient funding to deliver the strategy!

As strategy goes, it’s a cave painting.

What do we need to do?  How about; find out who the people are, how many, what have they got wrong, who fixed it, with what, what did it cost and do we want to do it again?  

How do we do it?  Make a start…

  1. Understand this is not a bolt-on, it is a national imperative, meaning now! 
  1.  Lay the track.  Meaning; get wifi installed everywhere.  Make it a national procurement.  Just get on with it.  Start tomorrow.
  1. Implement the Newcastle Declaration.  It deals with interoperability… very important.  Stop people flogging stuff to the NHS unless it works with everything else.
  1. Don’t buy anything that needs staff training over and above a familiarisation walk through.  Base all the user interfaces on FaceBook, Twitter and Amazon Prime.
  1. Dump all the finger-in-the-pie people.  Have a department of no more than ten, with sweeping powers to sequester budgets and buy stuff.  Call them The Department of Getting IT Stuff Done, or Die.
  1.  Read this report from Newchurch on the state of play.  It was written a while ago but could have been written yesterday.

This is urgent work.

A health system without the proper management of data is like a ship with no engine; heading for the rocks.


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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.