Select Committee on Health Written Evidence


Evidence submitted by Dr Jon Orrell (EPR 53)

  I would like to address the question:

  Current progress on the development of the NHS Care Records Service and the National Data Spine and why delivery of the new systems is up to two years behind schedule.

  The reason is that NPFIT was designed by international "experts" with no knowledge of the complexities of medical informatics in the NHS. They started from the top down, dismissing existing systems as being legacy and intended to rip and replace with new monopoly suppliers.

  To the casual and uninformed IT management consultant it seemed obvious that the big multinationals had the answers and the little people doing the job on the ground were superfluous and irrelevant. One would have imagined from the outside that Hospital systems were the key and a national system would start with a spine, then Hospitals, then primary care and GPs later.

  In fact the truth is the reverse. The best integrated electronics are already held in primary care by GPs. We have already had the lifelong record, integrating summaries, medication, allergies, letters and tests for over a decade. The sensible thing would have been to build from the bottom up with this solid foundation as the basis.

  We tried the one size fits all approach in 2000 as part of an NHS pilot site. It failed twice and two years later we adopted integration with existing systems. It worked. CfH have exactly matched our timescales and conclusions. I warmly commend the excellent pragmatic work of Gillian Braunold, who has determindly bought the programme back from the brink of disaster (original centralised plan) and come up with good work around solutions. Keeping existing working GP systems being a brilliant example.

  There are examples of success in action with some ideas on consent. The key being to leave the GP as the custodian, editor and monitor for the NHS patient record.

  The key to success is to build on existing systems by integration. This is quick and incredibly cheap compared with the 12 billion rip and replace plan.

  There are examples of success in action. http://www.e-health-insider.com/news/item.cfm?ID=2506

  This Graphnet integration is the one we used in our pilot, It was also used in Hampshire (see below). It costs a fraction of the CfH rip off price and works in weeks.

  http://www.bmj.com/cgi/content/full/333/7559/146-a?maxtoshow=

  http://www.bmj.com/cgi/content/full/333/7557/39 <<Weymouth IT pilot site lessons for the NHS v2.rtf>>

Dr Jon Orrell GP

Weymouth

16 March 2007





 
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