One of the best known pioneers of IT in the NHS has issued an eloquent plea for trusts that make the running to be allowed to stay ahead while national standards are raised.
Frank Burns, chief executive of Wirral Hospital NHS Trust, Merseyside, and one of the principal authors of the 1998 NHS IT strategy, Information for Health (IfH), told an HC 2003 session, “I couldn’t handle the lethargy in my organisation if we were put in a siding while the rest catch up. We need to make sure the pioneers keep pioneering. We need to demonstrate to the doubters that these things are possible.”
He paid tribute to his trust’s staff who had, over the years, built up a commitment to using technology to support their day to day work and further the common cause. But he said they had been able to build up a huge momentum because they did not stand still.
He qualified his comments saying it was not good enough to have “half a dozen bright lights across the NHS and the rest in darkness.” But he made the case passionately for progressive trusts to be allowed to carry on making the running.
The session attracted a large audience eager to hear what Mr Burns thought of Delivering 21st Century IT to the NHS, the nationally-centred strategy that has succeeded the local model of implementation propounded by IfH.
He said of the 1998 strategy, “I have to regard success as limited.” Implementation on the ground had been slow because the strategy was not backed with enough cash and the cash allocated was diverted to other responsibilities.
Mr Burns said trust chief executives had expressed a discomfort with an approach based on local delivery and pushed for a centralised approach. They believed IT to be a high cost, high risk area of responsibility.
He claimed success for IfH, however, in ensuring that there was a proper focus for national strategy on the clinical process and in winning a high level of clinical support at both the political and practical levels. He also named local clinical support as one of the success factors contributing to Wirral’s achievements.
Yet Mr Burns had some high praise for the new approach which, he said, “had many positives” with the Integrated Clinical Record Service retaining the focus of earlier strategy.
“I’m really very happy to see the degree of strong central direction. Senior people have put their necks on the block,” he said, also praising the use of private sector skills and the degree of risk transfer associated with that. He also supported the ring fencing of money for the National IT Programme.
Mr Burns voiced concern, however, about the “hiatus” that he said had been caused throughout the country in the move from the IfH strategy to a more national approach.
He warned, too, of a continuing threat to the local IT spending needed over and above the National Programme money. “There’s a serious danger that the flow of local investment into IT will dry up. The NHS is still financially challenged.”
Clinical ownership, a strong theme in Mr Burns’ presentation, was also cited as a possible problem. “I’m not sure getting high levels of local clinical ownership is possible with procurement decisions that are covering half the country.”