Thursday, 27 December 2012

You don't need an IT system for every ill

Over the last few weeks I made some suggestions on how the NHS could reduce procurement costs through minor changes in the use of existing IT. Let's remember that GPs are central to the government's reform of the health service. Even at present, as I understand it, every time I have a visit to the hospital my GP receives a notification of who, what, why, where and when - it helps the GP take a more holistic approach to the patient. it also generally seems to work.

We also know that the NHS has not had a particularly exemplar approach to introducing 'all singing and dancing IT systems' - indeed just over a year ago I discussed how this could be improved.

Today we learn of the proposal for another 'all singing and dancing NHS IT system' - this time it will be used to identify potential cases of child abuse - £8.6m has been allocated for the development of the software.

In keeping with last week's blogs on reducing costs I think this is another opportunity for reducing procurement costs:  'just say no' to this proposed system and use existing records. By this I mean retain central role of the GP in seeing records of all hospital interventions and let the GP identify potential areas of risk - allocate more GP time to consultations and then perhaps they will be able to review the data.

The new system aims at safeguarding children. But I suspect that the introduction of such a reporting system may well lead to those abusive parents taking the precaution of avoiding the spotlight by merely avoiding taking their children to A&E - the abusers have in the past appeared to be quite sophisticated in getting under the radar. If that were the case the children we aim to protect may actually receive appropriate medical care.

Either way, if this system is to go ahead please make sure that the relevant procurement decisions are transparent, including reporting of robust gateway reviews at every stage. That way at least we may ensure all options are considered, including better use of existing systems, and also that we don't learn of another failed system being blamed for a potentially flawed but good idea.

So in summary:

  1. Explore all the options, including greater use of existing systems;
  2. Consider the potential disbenefits;
  3. Evaluate the risks;
  4. Adopt an ethos of transparent procurement decision making;
  5. Ensure robust use of gateway reviews.

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