Independent Review of NHS and Social Care IT

The Hayes report is a critique of the current NHSIT programme in England; in 2002 this program was the largest IT effort ever undertaken and could be a useful resource when plans for new IT systems or existing systems are being considered.

The article in its entirity can be found at: http://www.e-health-insider.com/img/document_library0282/NHS_and_Social_Care_IT_Review%5B1%5D.pdf

Below are excerpts from the article as it is quite lengthy (Table of Contents, Executive Summary, Summary of Recommendations):

Independent Review of NHS and Social Care IT

Commissioned by Stephen O’Brien MP, Chaired by Dr Glyn Hayes August 2009

Table of Contents

Executive Summary ...........................................................8

Summary of Recommendations................................................. 14

1. Introduction............................................................. 24
2. Information Technology in the NHS........................................ 27
3. Lessons Learnt .......................................................... 57
4. Method and Structure of Evidence ........................................ 72
5. Strategy................................................................. 73

6 The capture and use of clinical data to support individual patient care ..87

8 Procurement .............................................................134

9 Health and Social Care.................................................. 143

10 Management of the Service.............................................. 150

11 Leadership and Human Resources ........................................ 158

12 Information Governance................................................. 170

13 Evaluation............................................................. 180

Evaluation ................................................................184

Final Recommendations .................................................... 185

Executive Summary

Since its inception in 2002, the Government’s National Programme for IT (NPfIT) has remained the largest civilian IT project in the world. Not only is it unrivalled in scale, the complexities of healthcare data and information mean that the use of IT poses an infinitely greater challenge in the NHS than in other sectors where information is more objective and absolute. Nevertheless, there is universal consensus that, if this challenge is met, the use of information systems in the NHS will bring about significant improvements to the delivery of patient care. Patients can also benefit from the enhanced communication channels that IT can forge between health and social care.

The National Programme for IT should not, therefore, be abandoned, as some are suggesting it should be. Rather, it must be adapted and recast to better meet the needs of patients. The Review Group has reached a number of conclusions as to how the National Programme for IT or a successor programme can best address the challenges posed by the NHS and deliver long-term improvements to patient care.

Part 1: Immediate Action

8 action points to bring about localisation in NHS IT:

1. The patient must be at the centre of all information systems; the provision of

patient-level operational data should form the foundation of NHS IT.

1. Subject to any applicable constraints, halt and renegotiate the Local Service

Provider contracts to save further inefficiencies with regard to cost and delivery.

1. Re-define the systems required for a national infrastructure, ensuring that all

functions that are amenable to localisation are decentralised; consider alternative solutions to one monolithic central spine of data. Health data will then be stored closer to the point of patient care.

1. Provide for standard setting and catalogue procurement centrally so that the patient can experience a joined-up approach to their care through information systems that are interoperable. The catalogue should encourage smaller providers to innovate and compete to create local solutions that better meet the needs of patients and the
2. Devolve all else to local Trusts, including choice of system. Allow local Trusts to purchase the system that they judge to be most appropriate for their patients and staff from the central catalogue.
3. Enable local health communities to join together and use integrators to manage the move from existing legacy systems to new systems. Integrators can help update, rather than abandon, successful legacy systems so that they are interoperable and conform to the national IT strategy.
4. Assess the cost effectiveness of the current National Programme for IT according to the benefits that can be derived for patients.
5. The NHS must take a long-term strategic view of IT. The delivery of information

systems should not be driven by political or bureaucratic timescales but by strategies that are focused on the care of the patient.

Submitted by (Kathleen Higginbotham)