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I was a software dev working in the NHS at the time of the National Programme for IT. They couldn't decide how they wanted authorisation to work, whether it was

I was a software dev working in the NHS at the time of the National Programme for IT. They couldn't decide how they wanted authorisation to work, whether it was role based or whatever else. We put a config flag in to switch between the two models they were going back and forth between and just twiddled it every week for months. There was some set charge every time they did it. They had the opposite problem with anything that actually mattered where they couldn't make a decision at all. Some of that software is still running in hospitals 10+ years later with apparently little change since the the NPfIT died. I moved out of the healthcare domain shortly after that. A few years ago I tried to sell some software for next to nothing to the NHS for a team my wife worked for. A simple webapp backed by a DB instead of spreadsheets on a shared drive. They took the idea and gave it to an in house employee who was running it as a side project (charging more for it than I was) and never finished building it. Speaking to someone in charge of innovation for a large part of the country recently, he said he couldn't even take some software I'd offered for a free trial. As he saw it the system was so broken he was warning everyone off. And his job was innovation. The NHS is ripe for improvement. I suspect its management haven't got a clue what they're doing though and fear the lure of big tech firms will be the only thing they can't resist.

TazeTSchnitzel 7y ago
Now living in Sweden which has what seem like very sophisticated e-health systems by comparison (at least on the user-facing side), I wonder why the UK couldn't have purchased and adapted an existing system that worked elsewhere.
- noir_lord 7y ago
  NIH combined with the optics of paying 'foreign' developers. Which is silly given who actually owns large parts of British infrastructure but... We have a confluence of shitty corrupt middle managers masquerading as politicians and a terrible press. I honestly have come to the conclusion that the UK is pretty fucked in the mid to long term.
- cs02rm0 7y ago
  You've reminded me of someone I know who also worked for an NHS body related to innovation/improvement who went to Amsterdam I think for an international healthcare conference. I said it must have been interesting, lots to learn about. She replied that the NHS was the best in the world and there was nothing to learn about from anyone else in any respect. Sadly, although I remain convinced many people must be slogging against the system, I suspect she isn't alone in that view.
- DanBC 7y ago
  It's not "the NHS". It's a bunch of GPs, hospital trusts, mental health trusts, community care trusts, and they're all independent competing non-profit businesses. The current Secretary of State at the Department of Health and Social Care is pushing open standards and interoperability, but has an idealogical attachment to private companies providing software after competitive tender.
- benmaraschino 7y ago
  Denmark's healthcare system tried to implement Epic nationally, and if this article is anything to go by, it didn't go so well: https://www.politico.com/story/2019/06/06/epic-denmark-health-1510223 https://www.politico.com/story/2019/06/06/epic-denmark-healt... Essentially, different healthcare systems have different needs which are reflected in how their electronic health record systems are architected. For example, EHRs in the US are optimized for billing, and if you're moving an US-centric EHR, like Epic, to a country like Denmark with universal healthcare, all that functionality becomes superfluous. Not to mention the language differences, as well, which are touched upon in the article. It's possible that similar concerns played into the NHS's decision to build their own system. Some NHS trusts are moving forward with their own Epic implementations, however. For example: https://www.digitalhealth.net/2018/06/royal-devon-exeter-nhs-foundation-trust-gets-epic/ https://www.digitalhealth.net/2018/06/royal-devon-exeter-nhs...

TazeTSchnitzel 7y ago

Now living in Sweden which has what seem like very sophisticated e-health systems by comparison (at least on the user-facing side), I wonder why the UK couldn't have purchased and adapted an existing system that worked elsewhere.

noir_lord 7y ago
NIH combined with the optics of paying 'foreign' developers. Which is silly given who actually owns large parts of British infrastructure but... We have a confluence of shitty corrupt middle managers masquerading as politicians and a terrible press. I honestly have come to the conclusion that the UK is pretty fucked in the mid to long term.
cs02rm0 7y ago
You've reminded me of someone I know who also worked for an NHS body related to innovation/improvement who went to Amsterdam I think for an international healthcare conference. I said it must have been interesting, lots to learn about. She replied that the NHS was the best in the world and there was nothing to learn about from anyone else in any respect. Sadly, although I remain convinced many people must be slogging against the system, I suspect she isn't alone in that view.
DanBC 7y ago
It's not "the NHS". It's a bunch of GPs, hospital trusts, mental health trusts, community care trusts, and they're all independent competing non-profit businesses. The current Secretary of State at the Department of Health and Social Care is pushing open standards and interoperability, but has an idealogical attachment to private companies providing software after competitive tender.
benmaraschino 7y ago
Denmark's healthcare system tried to implement Epic nationally, and if this article is anything to go by, it didn't go so well: https://www.politico.com/story/2019/06/06/epic-denmark-health-1510223 https://www.politico.com/story/2019/06/06/epic-denmark-healt... Essentially, different healthcare systems have different needs which are reflected in how their electronic health record systems are architected. For example, EHRs in the US are optimized for billing, and if you're moving an US-centric EHR, like Epic, to a country like Denmark with universal healthcare, all that functionality becomes superfluous. Not to mention the language differences, as well, which are touched upon in the article. It's possible that similar concerns played into the NHS's decision to build their own system. Some NHS trusts are moving forward with their own Epic implementations, however. For example: https://www.digitalhealth.net/2018/06/royal-devon-exeter-nhs-foundation-trust-gets-epic/ https://www.digitalhealth.net/2018/06/royal-devon-exeter-nhs...