As someone with a little first hand experience in the NHS IT (I develop medical imaging software) I saw how at the mercy of the vendors the NHS became in the wo

As someone with a little first hand experience in the NHS IT (I develop medical imaging software) I saw how at the mercy of the vendors the NHS became in the world of PACS (the systems used to store and retrieve medical images). Not only where they being charged vast amounts but the level of capability delivered was embarrassingly poor. I worked with many clinicians as a university researcher and again when I was working in clinical trials for a pharmaceutical company and they were continually amazed by what we could do with images; I heard the phrase "why can't we do that in the clinic" so often it was one of the reasons I moved into a medical imaging startup. I thought the limitations might be regulatory but after developing and successfully marketing an FDA cleared, CE marked piece of software we came to realise that the biggest obstacle in the UK NHS were the PACS vendors. Essentially they own connectivity to the images and made it almost impossible to integrate into their systems in a way that really addresses the clinical need. It doesn't help that the NHS seems to be filled with people only to eager to encounter a reason NOT to do something (in part I'm sure because everyone is too busy to add more to their plate). The technical competence of the senior folk was also often poor, they were usually senior clinical folk who relied on consultants for advice, often consultants provided by the vendors. The result was it got itself lumbered with long, expensive contracts that tied them into particular vendors which prohibited access to the wider ecosystem of solutions. Thankfully the NHS started to realise this and began rolling down many of these contracts. Hopefully a fresh start this year particularly with the cessation of the problematic Connecting for Health [http://www.connectingforhealth.nhs.uk/ http://www.connectingforhealth.nhs.uk/] program.