Tim Kelsey, the NHS Commissioning Board’s first national director of patients and information, is to encourage doctors and nurses and other front-line staff to learn how to program.
I was in a hospital the other day with my wife. I watched a senior consultant try and find a printer in AD (because the one on his desk was broken). This was to print a request form. It was very hard for him. The form exists because they have two systems with a paper integration path between them. There is some ceremony involved as well, because there is a quota on how many outstanding forms they can be processing. There is also a restriction on when the appointment can be made resulting in a weird set of rules which are virtually impossible to deal with effectively. The staff are completely depressed at having to deal with this every day.
Instead of wasting more money on this shitty PR exercise, perhaps they should fire Kelsey and all quango-esque departments and middle management who bought this, fire the outsourced idiots who built pieces of crap like this and hire a software team (google style!!!) to build new software and infrastructure across the entire NHS from scratch on Open Source software.
The amount of money the NHS pisses up the wall on contractors and management could build a country-wide system from scratch which solves all of these issues. I mean firing five management consultants could hire people to build an open source active directory replacement which would save millions in license costs (OpenLDAP doesn't cut it so don't go there). Another five management consultants would create a standard desktop operating system country-wide based on a COTS Linux distribution. Another 20 management consultants would replace a big chunk of the 105-or-so disjoint software platforms.
In the mean time, they could surely afford some training for their staff, to fix a few printers and to clean up poor integration paths like this. Then we might get to see our consultants rather than watch them argue with Active Directory.
Note: I've worked for the NHS before - it's an IT disaster, bar Guys & St Thomas trust which actually have a clue stick.
Yah. I currently work for the NHS as a developer. Don't even get me started on this place - inefficiency upon inefficiency. Printers? holy cow, we've just installed "follow me printing" and because it was badly communicated and thought out, we now have several departments who can't print a damn thing because they are waiting on a pass code so they can set up their swipe card to allow them to print. Did I mention there is only 1 machine in the building that you can use to set up your card for printing? aiya.
Kelsey? I'll believe it when I see it - I tried to get hold of him informally a while ago about his coding4health...I got crickets.
Prescription only, I'm afraid. The doctor needs to check that you have a fully working conscience first before eliminating the crickets, ever since that messy business involving the wooden boy.
Using data smartly in the NHS is key to making it more effiecient.
I witnessed £1 million wasted on writing a piece of software that potentially could have saved the NHS millions but due to bad management and politics was eventually cancelled.
This despite the fact that a NHS board manager had already created a similair system, himself through self taught coding in an Access database
Agree about using data but the main problem is trust autonomy which allows them to develop incompatible systems. For example every damn A&E department in the country has a different software platform or configuration. There should just be one!
Oh that and NHS management, who should just be put up against a wall and shot. If you divide it across all trusts, each directorate member has pissed about 20 million of cash out of the window on stuff that hasn't delivered.
As a web developer within the NHS (though in Scotland) I can already tell you that the problem won't be that NHS staff can't code, but will be that they won't be allowed to code.
The main issue is always the archaic IT department who lock down computers, rendering them near useless. That would be the first place to start. Then we can start teaching our staff to do something other than create a Word document and visit their staff Intranet.
I met a senior NHS physician who built a very useful and simple mobile information service to improve access to certain services. My understanding was that he funded it himself with help from sponsors and had to do it entirely outside the NHS system.
It probably cost 1/10th of what it would have cost if it had been done through the NHS.
Not to mention that NHS computers are still running IE6 and heavily locked down, making it a poor development environment. Tim Kelsey can encourage NHS staff to code, but the infrastructure to do anything meaningful with that inside the system isn't there.
The biggest risk here would surely be that around PID (Patient Identifiable Data). Who is responsible for ensuring the safety of this data?
As it is right now, it's ultimately the trusts themselves (as is my understanding), but what safeguards will there (or could there) be in place to keep this data safe.
And what about that data? Do we force any new staff-written applications to create their own MPI etc. or do we let them access the main systems through some kind of API? In which case, that would need creating - and interfacing to a variety of different software is never simple. If it's all to stay on the internal network, then who hosts these apps - and where does that budget come from?
There are a lot of big questions and potential risks here and I'd be very interested to see what these eye-catching initiatives turn out to be. Until I see evidence to the contrary, I remain pessimistic about these being anything but trivial and largely pointless.
If this was a serious effort, why ask the doctors, nurses and other clinical staff to learn to code - and not reach out to the open-source development community and ask them for their help. I'm sure a great many developers have, or know someone, who has used the NHS and would love to have a part in making things better.
I have to agree with pretty much all of your points.
Securing Patient Identifiable Data should be near (if not at) the top of the list of priorities. Some API where data can be requested which only returns non-PID data would probably be the way forward, but there will certainly be cases where there is a need for certain data that will be identifiable.
I'd probably say that NHS staff don't need to learn how to code, but should instead work much closer with those who can.
As in an "insider" there is an endless list of services that could be improved with software if we could just open our doors slightly.
Well, at least this will give health professionals job security in the games industry if the government downsizes healthcare. Anyone up for a game of Sim-Hospital?
13 comments
[ 193 ms ] story [ 1455 ms ] threadInstead of wasting more money on this shitty PR exercise, perhaps they should fire Kelsey and all quango-esque departments and middle management who bought this, fire the outsourced idiots who built pieces of crap like this and hire a software team (google style!!!) to build new software and infrastructure across the entire NHS from scratch on Open Source software.
The amount of money the NHS pisses up the wall on contractors and management could build a country-wide system from scratch which solves all of these issues. I mean firing five management consultants could hire people to build an open source active directory replacement which would save millions in license costs (OpenLDAP doesn't cut it so don't go there). Another five management consultants would create a standard desktop operating system country-wide based on a COTS Linux distribution. Another 20 management consultants would replace a big chunk of the 105-or-so disjoint software platforms.
In the mean time, they could surely afford some training for their staff, to fix a few printers and to clean up poor integration paths like this. Then we might get to see our consultants rather than watch them argue with Active Directory.
Note: I've worked for the NHS before - it's an IT disaster, bar Guys & St Thomas trust which actually have a clue stick.
Kelsey? I'll believe it when I see it - I tried to get hold of him informally a while ago about his coding4health...I got crickets.
I think you can get a cream for that.
I witnessed £1 million wasted on writing a piece of software that potentially could have saved the NHS millions but due to bad management and politics was eventually cancelled.
This despite the fact that a NHS board manager had already created a similair system, himself through self taught coding in an Access database
Oh that and NHS management, who should just be put up against a wall and shot. If you divide it across all trusts, each directorate member has pissed about 20 million of cash out of the window on stuff that hasn't delivered.
The main issue is always the archaic IT department who lock down computers, rendering them near useless. That would be the first place to start. Then we can start teaching our staff to do something other than create a Word document and visit their staff Intranet.
I met a senior NHS physician who built a very useful and simple mobile information service to improve access to certain services. My understanding was that he funded it himself with help from sponsors and had to do it entirely outside the NHS system.
It probably cost 1/10th of what it would have cost if it had been done through the NHS.
Not to mention that NHS computers are still running IE6 and heavily locked down, making it a poor development environment. Tim Kelsey can encourage NHS staff to code, but the infrastructure to do anything meaningful with that inside the system isn't there.
This is the service: http://sxt.org.uk
As it is right now, it's ultimately the trusts themselves (as is my understanding), but what safeguards will there (or could there) be in place to keep this data safe.
And what about that data? Do we force any new staff-written applications to create their own MPI etc. or do we let them access the main systems through some kind of API? In which case, that would need creating - and interfacing to a variety of different software is never simple. If it's all to stay on the internal network, then who hosts these apps - and where does that budget come from?
There are a lot of big questions and potential risks here and I'd be very interested to see what these eye-catching initiatives turn out to be. Until I see evidence to the contrary, I remain pessimistic about these being anything but trivial and largely pointless.
If this was a serious effort, why ask the doctors, nurses and other clinical staff to learn to code - and not reach out to the open-source development community and ask them for their help. I'm sure a great many developers have, or know someone, who has used the NHS and would love to have a part in making things better.
Securing Patient Identifiable Data should be near (if not at) the top of the list of priorities. Some API where data can be requested which only returns non-PID data would probably be the way forward, but there will certainly be cases where there is a need for certain data that will be identifiable.
I'd probably say that NHS staff don't need to learn how to code, but should instead work much closer with those who can.
As in an "insider" there is an endless list of services that could be improved with software if we could just open our doors slightly.