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Monday, January 31, 2005

FOI request - Wells report on NHSU - no progress

On 1st Jan I submitted a request under the Freedom of Information Act to the Department of Health for publication of the report by Sir Willam Wells into the NHS University (NHSu)
The full text is available on this blog

It is now 20 working days since the request as allowed under the act and I have not received and response (email, telephone or snail mail) from the Department of Health or NHSu, although I did receive a postcard from my MP acknowledging receipt of his copy.

I have today looked at the Departments Freedom of Information complaints process
phined them. I was phoned back by Veronica Fraser (Head of Knowledge Management, Public Enquiries and Complaints Customer Service Centre) who had checked on my application - which had been stamped as being received on 12th Jan (although I posted it on 31st Dec) & suggested it had got delayed in the Xmas post - and that I should receive a response by 8th Feb.

It will be interesting to see whether this occurs.

Several people have complimented me on putting in this request, and asked me about my motivation for doing it...

I have had various dealings with the NHSu and have not been impressed with the experience.
As approx £50 Million of taxpayers money has been spent on this, I feel that there should be a public "right to know" more about what happened.

I have always been a believer that we need the NHS to be a "learning organisation" and have spent the last 20 years or so working on this either from within the NHS or higher education. I have also advocated elearning as a part of this development and felt that the NHSu had the potential to achieve this. I was writing about this sort of work nearly 10 years ago see:
Ward, R 1997 Implications of computer networking and the Internet for nurse education. Nurse Education Today 17, p178-183
Ward, R. 1997 NHSnet: a cost-effective medium for continuing professional education. British Journal of Health Care Computing & Information Management 14(8) p30-33

The formation of the NHSu was a surprise, as I had been at a conference presentation with NHS elearning people only a few weeks before & they were not expecting it - but it seemed to have ministerial clout behind it & therefore a serious budget. As soon as the first consultation came out I wrote 8 pages of comments, which were generally supportive of the concept, but queried some of the proposed delivery and seriously questioned whether trying to develop a "university" was an appropriate role for the NHS. I never received any acknowledgment or response to my comments.

I attended a "consultation" event in Birmingham (14.1.03 - my personal review ) and submitted comments on each consultation document. I also met with a representative of NHSu (after several rearranged dates) as NMAP project manager with colleagues from the BIOME hub of the RDN, and we were promised a further meeting with their curriculum development and IT managers - however this was never forthcoming.

I remained convinced that we need to improve both the learning culture and opportunities within the NHS, however I was always sceptical that the NHSu could achieve this.

When the announcement was made that the NHSu was to be wound up following the Arm's Length Bodies (ALB) review, I heard that the report by Sir William Wells investigating how it had spent £50 Million and achieved very little was produced in very limited numbers (? 7 copies) and restricted so that no one could copy it. I then wrote to my MP suggesting that a copy should be made public (and possibly investigated by the National Audit Office), and received a copy of a letter from John Hutton stating that their intention was to "publish their findings shortly".

I am hopeful that the Wells report will soon be in the public domain.

Thursday, January 27, 2005

NPfIT starts 2005

Guardian Unlimited | Online | A problem shared

Michael Cross writing in todays Guardian Online summarises the first month of 2005 for the National Programme for IT in the NHS and it can't make happy reading for those trying to put this raft of initiatives into place.

Particularly worrying must be the decision of 2 NHS Trusts to go their own way and procure IT systems on the open market rather than waiting for the National Programme to deliver.

Monday, January 24, 2005

National Occupational Standards For Health Informatics – Guidance Document

National Occupational Standards For Health Informatics – Guidance Document

National Occupational Standards in Health Informatics for the NHS have been developed as part of the Agenda for Change (A4C), Knowledge and Skills Framework (HSF).

The standards and accompanying documentsation can be downloaded from this page or you can request paper & CD copies.

Thursday, January 20, 2005

Lessons to be learned from failure of UKeU - WhatPC?

Lessons to be learned from failure of UKeU - WhatPC?

This article reports an investigation by MPs on the Education and Skills Committee into the failure of UKeU & suggests Sun's elearning platform could be made available to UK Higher & Further Education community.

Wednesday, January 19, 2005

Lords Hansard text for 18 Jan 2005 NHSU

Lords Hansard text for 18 Jan 2005 (250118-01)

In the House of Lords yesterday a debate took place about the NHSU. Lord Warner argued that the NHS Institute for Learning, Skills and Innovation, was the best way to "support people development, service improvement and technological innovation in the NHS".

Baroness Perry of Southwark led the challengers asking why the NHSU which has spent £50 million in 2 years was now "past its sell-by date"?

Questions included a request for specific figures for mthe number of staff helped by NHSU but no answer was given, although the parties exchanged claims about their respective proposals.

Parliamentary Questions on Choose & Book & GP involvement in NPfIT

House of Commons Hansard Debates for 18 Jan 2005 (pt 4)

Yesterday in the house of commons questions were asked about delays in Choose & Book, the security and confidentiality of electronic health records and the engagement of front line clinicians in the process (especially GPs & EMIS).

Further information can be obtained from the National Audit Office report Patient Choice at the Point of GP Referral, which is reported in the Guardian as NHS e-booking plan runs into trouble which suggests:
"GPs in practices which were supposed to be fully plugged-in to the network were expected to make online appointments for 205,000 patients by the end of last month. They managed only 63. There was also slippage in NHS hospitals, with only seven early implementers using the system instead of 22 as planned."

The BBC has a story in a similar vein
NHS choice target 'may be missed', perhaps the questions which should be asked are about why GPs do not seem enthusiastic for the Choose & Book system and whether the savings predicted to come from implementation are realistic. Perhaps there are lessons to be learnt from the (slower & more possibly more carefull thought out) Scottish experience with Electronic Clinical Communications Implementation

Tuesday, January 18, 2005

The Informatics Review

The Informatics Review

The latest edition of the informatics review (8:2) has just been published & includes a lead story on:

"Should Dentistry Be Part of the National Health Information

And news items on:

* Patients can stay off NHS database

* UK Hospital Explores Computer Modeling to Predict Cancer Treatment

* OsiriX: an open-source software for navigating in multidimensional
DICOM images

* 'Plug and Play' Connectivity Initiative Launched

* Healing rate of EMR-induced ulcer in relation to the duration of
treatment with omeprazole

NPfIT Benefits Timeline

NPfIT Benefits Timeline

This flyer, sets out potential benefits for both patients and clinicians, from the National Porgramme with dates from the beginning of 2004 to 2010.

Most of the specific targets eg PACS, HealthSpace, eprescribing etc are given the nebulous 2005-2206 dates which may still slip. The 2010 target is for the integration of care records with social care - & seems the most "aspirational".

It will be interesting to see whether this helps to convince clinicians (and patients) of the benefits, and whether the targets are met.

Monday, January 17, 2005 | Society | Patients can stay off NHS database | Society | Patients can stay off NHS database

This story, from Fridays Guardian, highlights responses to worries about the confidentiality and the NHS electronic database, and previews a public information campaign to be launched in the summer to convince people about the usefulness and security of the system.

Sunday, January 16, 2005

Relying on the computer is not the whole answer

An interesting report from the USA shows what we all know - simply putting in computers in not the answer.

A recent study found that medication errors associated with computer entry were growing steadily, and that 'mistakes associated with computer entry were the fourth leading cause of error in 2003, compared with the seventh leading cause in 2000'. See for the story.

The report is worth noting given that NPfIT now seem to be promoting patient safety as their number one reason for the whole programme.

As the report notes:
- simply automating processes does not automatically improve patient safety
- simply installing a computer entry system is not sufficient to reduce and prevent medical errors
- IT systems must be fully integrated throughout the clinical processes
- there must be enough time and resources to be devoted to staff training.
- all computer entry systems need to have extensive pilot testing to make sure that the systems do not perpetuate errors found in current systems.

Wednesday, January 12, 2005

Mobile Health Data | Exploring Barriers to Nurse Mobility

Mobile Health Data | Exploring Barriers to Nurse Mobility

This US based report on nurses use of mobile computing previews a presentation to be given in February about computers on wheels v pdas for nurses.

Managing Knowledge in Health Services

Managing Knowledge in Health Services

This book from Andrew Booth and Graham Walton is now available free online from the University of Sheffield. It covers a wide range of topics on library & information skills for those in health settings.

Saturday, January 08, 2005

Mercy for tsunami victims?

Mercy for tsunami victims?

A high tech US navy 1000 bed hospital ship (USNS Mercy) with advanced telehealth & communication systems may be deployed to help tsunami victoms.

This report from Federal Computer Week suggests how the technology on board could be used to treat the victims of the disaster.

Friday, January 07, 2005

Web-based Referral System Links European Doctors

Web-based Referral System Links European Doctors

This report from the NHS Health Informatics Community Web site describes work on the European Skeletal Dysplasia Network which illustrates some of the ways in which technology can provide real benefits for patient care.

The network enables international referrals and the coordination of expertise in the diagnosis and management of rare conditions. It is being led by the University of Manchester (with 8 European partners and seems to illustrate the potential highlighted by GRID computing and advocated by Healthgrid and others.

Wednesday, January 05, 2005 | Society | Patients at risk amid data protection fears | Society | Patients at risk amid data protection fears

This article in today's Guardian considers the removal of patient name boards on wards could be putting patients at risk. It appears to be based on a paper in the BMJ Data protection gone too far: questionnaire survey of patients' and visitors' views about having their names displayed in hospital which explored the views of patients and visitors to having their names etc displayed on a board on their hospital ward and bedhead - which managers had insisted were removed as it may be in contravention of the data protection act. Most felt it would be perfectly acceptable to use name boards.