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Criticism over the
National Programme for IT (NPfIT) have been frequent in the years
since its formation. In September 2006 it was reported
that over 110 major incident failures had been reported
by hospitals and GPs in a four-month period due to
faults with systems provided by NPfIT. Reportedly staff
found that the systems were often slow, impossible to
access or unavailable to them for a lengthy period of
time.
By the following year, a survey found that staff
already working in the health service were highly
critical of NPfIT. Some of the problems were connected
to failures with Pacs with health professionals not
having access to digital x-rays. There were also
reportedly occasions when Pacs failed to operate during
the course of an operation in which a clinician had
needed a copy of a digital x-ray to refer to. This led
to procedures having to be suspended until a hard copy
of an x-ray could be found. Worryingly this avenue may
not be open to surgeons in the future as digital x-rays
are set to completely replace ‘wet film’ images.
Various other problems have been cited since NPfIT
came in, notably trusts not being able to access patient
administration systems and staff losing access to their
systems. Problems in various parts of the country have
even led to an increase in patient waiting times with
national targets broken as a result.
Despite NPfIT being a centralised system designed to
have a uniformed network throughout the country,
localised problems have nevertheless occurred.
Vaccination rates fell by 19% in London alone following
failures in BT’s child health system and software errors
led to patient records disappearing at trusts in the
north-west region. Meanwhile
Birmingham Children’s
Hospital NHS Trust found that outpatient appointment
data for 800 children could not be accessed, again
because of a faulty software upgrade.
With apparent incompetence in some areas comes cost
and last year Andrew Way, Chief Executive of
Hampstead’s
Royal Free Hospital, claimed that the programme had cost
the trust an extra £10m with the result being that fewer
patients could be seen. The Royal Free began trialling
the system in the summer of 2008 but Mr Way said that
the hospital had spent an extra £4m getting the system
working and £6m was lost because of problems which meant
that the hospital was unable to bill other parts of the
NHS for work done.
Other criticisms commonly made by GPs are that they
feel that privacy and security issues are not
sufficiently well addressed within the Care Record
Service. Also, with NPfIT undoubtedly being a highly
sophisticated and technical system, there are many
working within the health service whose technical
expertise falls well below what is required to enable it
to work effectively. It has also been said that, with
staff relying on a centralised, automated system, NPfIT
is effectively dehumanizing the NHS; patients want the
reassurance of human contact and there are concerns that
this could be lost or certainly reduced along the way.
Richard Bacon, a member of the
Commons public
accounts committee, was highly critical of NPfIT and its
failures when saying: “There are serious and growing
problems with the whole NPfIT in the health service. In
many respects the NPfIT programme is making things worse
not better, while sowing distrust and disillusionment
across the health service.”
Such criticisms have led to many questioning the very
identity of NPfIT; the whole concept that only a highly
centralised NHS IT programme could deliver the
reliability of systems needed in the
NHS. With such
mistrust in the system’s reliability staff are
reportedly reluctant to trust the more modern ways and
many are showing a reluctance to discard old systems and
paper records as a result.
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