Assist, an association of 1,800 IT professionals in the NHS, has called for the NHS to adopt "simple systems" which can be configured locally - not more sophisticated systems which it says bring rigidity.
But the government and the Department of Health plan the opposite. As part of the £12.7bn National Programme for IT [NPfIT] they are to roll out progressively more sophisticated standardized systems at trusts across England.
Assist, the association for informatics professionals in health and social care, says in a paper that a "one-size-fits-all" approach does not work.
"We observe that IT-imposed solutions have always tended to failure." It recommends a "focus on the basics before trying the ambitious" and adds that the emphasis should be on getting "clinical systems in hospitals working". It also says there should be a focus on standards, not the standardisation of systems - which was one of the original aims of the NPfIT.
Assist has submitted its comments to an Independent Review Group, set up by the Tory Shadow Health Minister Stephen O'Brien MP. The group's aim is to inform the Conservative's policy for the use of IT in the NHS, health and social care in England.
The Association's members are particularly concerned about the bad publicity over NHS IT. They say there have been "stunning" IT-related successes over the past 10 years. They praise the standards of IT in use in GP practices and say that the UK leads the world in the development of health information and IT standards. Thanks to the NPfIT, there is a "robust, secure IT network".
Assist's members observe that difficulties in meeting government targets such as Choose and Book and the 18-week initiative are failures of planning and policy rather than IT.
Choose and Book was set up to allow patients and doctors to book appointments online, but it is running several years late. The 18-week scheme is to enable patients to be treated for non-urgent conditions within 18 weeks of being referred by a GP. But hospital staff are struggling to implement systems to track each patient from the date of their referral to the 18-week deadline.
Assist says that although informatics is now fundamental to the delivery of national and local strategies it often remains an "afterthought in policy development and planning processes, at all levels". This lack of planning leads to "last-minute, ad hoc information demands and system changes at best miss opportunities for innovation through ICT and can only jeopardise delivery".
As core systems become integral to front-line care, an ad-hoc approach will "increasingly put patients at risk". The 18-week initiative and others have led to "substantial, avoidable demands on limited informatics resources and capacity".
The association calls for greater openness and transparency over learning from what has gone wrong.
"From an Assist perspective, no informatics professional would knowingly implement information and communications technologies that could jeopardise patient safety or their organisations. To do so would be totally unprofessional, as well as being at odds with the fundamental ethos of the healthcare professionals to "do no harm", an ethos that we as healthcare informaticians fully identify.
"We would, therefore, call for greater openness and transparency in learning from what has gone wrong. To do otherwise is not just a matter of seeking to avoid criticism patients' lives may be at risk if we do not heed them."
