Examination of Witnesses (Questions 80-99)
NORTHERN IRELAND
DEPARTMENT OF
HEALTH, SOCIAL
SERVICES AND
PUBLIC SAFETY
2 NOVEMBER 2004
Q80 Mr Allan: Do you publish those
business cases?
Mr Gowdy: No, we do not publish
them.
Q81 Mr Allan: You do not routinely
publish them?
Mr Hamilton: Not routinely. We
have never been asked before.
Q82 Mr Allan: Do you have anything
like the Gateway Review process?
Mr Hamilton: Yes.
Q83 Mr Allan: How does that operate?
Who does that for you?
Mr Hamilton: As I understand it,
it is done independently.
Mr Gowdy: We have a Directorate
of Information Systems within the Department which is responsible
for taking forward all of the ICT needs for the whole HPSS. They
work very closely with the trusts on the procurement process and
so on. They review the development at each stage of the process.
Q84 Mr Allan: You are not subject
to the Office of Government and Commerce Gateway Review process?
Mr Gowdy: We are subject to a
similar system through our Department of Finance and Personnel
which performs the Treasury function.
Mr Thomson: Chairman, if I can
comment on that. Yes, we do use the same approach as the OGC and,
indeed, until we have sufficient staff trained here it is OGC
who do the Gateway Reviews or lead the Gateway Reviews.
Q85 Mr Allan: This business case
we can expect to go to OGC and they will look at it and give a
traffic light indication as they would for anything else?
Mr Thomson: Exactly the same.
Q86 Mr Allan: How does that fit in
with the existing system? One of the recommendations of the Report
was that the ATICS Directorate system of the Royal Victoria Hospital
should be extended to other units, including some of the very
important ones like cardiology. Is that kind of work on hold?
Are you not advancing that recommendation until the outcome of
this large scale procurement process?
Mr Gowdy: They are proceeding
with that work but obviously in the knowledge of the development
of this other system. We do not want to hold them back. Their
system will be compatible with the system that we will have for
all the others. There are only a few suppliers who provide these
sorts of systems so we know the specification is going to be almost
identical.
Q87 Mr Allan: Giving credit where
it is due, I also notice in paragraph 220 on page 30, the Musgrave
Park was praised independently by the Birmingham University unit
for its system. Is that a different system again?
Mr Gowdy: It has different features,
yes. We will be expecting that they will take their system and
compare it to the specification that comes out of the Belfast
City Hospital model and we will see what additional needs we have
to put in place. We want compatibility in these systems.
Q88 Mr Allan: You would not necessarily
be telling them to get rid of their working system and to replace
it with a system that you are going to procure for everyone?
Mr Gowdy: There will be a couple
of decisions to be made. One is the functionality of their system
compared to this new one. Another issue would be the cost. It
may be that it would be more cost-effective for them to join in
the overall system.
Q89 Mr Allan: Who will actually buy
and own this? Will you, as the Department, be buying it for them
or will you be saying to each of the units, "You must buy
this new system out of your budget"?
Mr Gowdy: We will be saying to
the trusts that it is a cost that they will bear, but because
it is going to be done on a common procurement basis they will
all be making a contribution essentially to the purchase of a
system which they will all use.
Q90 Mr Allan: So you will not be
giving them additional funds for that?
Mr Gowdy: There will be a need
for us to secure some additional funds for this. Until the final
business case is with us we do not know what the final cost will
actually be. We have estimated it to be around £3 million
and we will need to take that through the usual process with our
Department of Finance and Personnel.
Q91 Mr Allan: These are the kinds
of projects we often end up looking at on this Committee.
Mr Gowdy: I am very conscious
of that.
Q92 Mr Allan: It is nice to be able
to learn a bit about it at this stage before the things are signed
and start going wrong sometimes. Is there an overall Northern
Irish IT strategy for the health service?
Mr Gowdy: Yes, there is.
Q93 Mr Allan: Was this in there or
have you somehow had to bolt it on?
Mr Gowdy: It is actually a priority
within that strategy which we published about a year ago.
Q94 Mr Allan: Was that in response
to this Report or did it predate the Report?
Mr Gowdy: We were conscious that
we needed to computerise. The Report was very helpful in terms
of defining some of the problems that were out there which gave
us the momentum to say we need a common, consistent approach to
this.
Q95 Mr Allan: Is there a relationship
between the Northern Irish strategy and the National Programme
for IT in England and Wales, which we know is the biggest IT project
in the world as I understand it from a government point of view
and presumably it is going to be buying similar kinds of systems
on a massive scale for England and Wales? How does that relationship
work?
Mr Gowdy: We work very closely
with them, and our Director of Information Systems folk work very
closely in terms of the specification of systems, the development
of new ideas and also the benefits of procurement. Yes, we would
want to make sure that we piggyback it where we can or that we
get into a similar relationship with suppliers on the back of
the developments that have taken place, or are taking place, in
England.
Q96 Mr Allan: A final word on the
professional buying. It is fine buying systems but the big question
is whether or not people end up using it and those are the kinds
of questions always that are raised around health service systems.
What are you doing to make sure that if you put in a new theatre
management system the people who are important, and I am thinking
particularly of consultants here, will want to use it rather than
prefer to do what they are doing already?
Mr Gowdy: We are saying that there
is a need for monitoring by us as well as by trusts of what is
happening in theatres. That is why we are saying a common specification
is required, so that we all operate on the basis of the same information
and then we can benchmark. We will be insisting that there is
a monitoring return made to us on an identical basis from each
trust.
Q97 Mr Allan: I am thinking not of
the monitoring side but the actual management side. The whole
point of this investment, £3 million, is not to get the figures
right, you can do that on the spreadsheet, it is to make sure
that you get this throughput figure right and that changes working
practices presumably.
Mr Hamilton: The infrastructure
is already in place, largely as a result of this Report, where
we looked at our Theatre User Committees and what they have been
doing and what information they get. Having been speaking to the
people in the trusts, we know that there is a great deal more
interest in the information that is being produced from the manual
systems. There is almost a desire amongst the theatre user communities
out there to have the computerised information available as soon
as possible.
Q98 Mr Allan: You have no sense of
resistance in the sense of if you improve the management system
then some of the issues that have been raised about timetabling
and freedom, whether or not to come in for a particular session,
that relationship will be changed if you have got a management
system that is really effective people are tied in on a longer
timescale than they have been to date. Is there any sense that
there is any resistance to that? Do you have clinicians leading
implementation in that area?
Dr Carson: There would be many
consultants who would have an interest in techie things and IT
solutions to some of the difficulties that they have. In fact,
many consultants, surgeons and anaesthetists would view the information
that comes out of a theatre management system would help them
demonstrate to the health service managers their particular needs
in certain areas. Another important driver which will add to the
acceptance of a computerised theatre information system is the
introduction of consultant appraisal where consultants now have
to demonstrate to their health service managers the areas of activity
which they are taking part in. There are strong drivers there
but they are drivers that by and large I think will be welcomed
by the profession.
Mr Gowdy: We do have in place
now a Theatre Managers' Forum and all of the theatre managers
across Northern Ireland, including those who operate in the private
hospitals, join into this forum. That is the opportunity for us
to give them some of these messages and to ensure that people
fully understand the importance of managing and using the new
systems effectively and we will be putting great emphasis on that.
Chairman: Thank you for that. Mr Jenkins?
Q99 Mr Jenkins: Thank you. Dr Carson,
earlier on you replied to one Member and said that the Report
was wrong insofar as it only took a 48 week working year for consultants,
therefore four weeks holiday, and they have more holiday than
that, is that correct?
Dr Carson: What I was suggesting
was the estimated availability of theatres was stacked around
48 working weeks a year for the theatre facility but, in fact,
individual consultants are only available 42 weeks per year.
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