Submission to the PAC by Larry Benjamin (6 Nov 2006)

From Nhs It Info

Mr. Larry Benjamin
Consultant Ophthalmic Surgeon
Stoke Mandeville Hospital
Mandeville Road
HP21 8AL


Mark Etherton Esq
Clerk to the Committee of Public Accounts
House of Commons
London SW1A 0AA

Dear Mr. Etherton,

Re: The National Programme for IT in the NHS

I am a consultant ophthalmic surgeon working at Stoke Mandeville Hospital, Aylesbury.

I have a long-standing interest in IT and its use in Medicine and although a member of the Worshipful Company of Information Technologists, I am writing as an individual and a consultant in the NHS for the last 16 years.

I would like these comments to be included in the documents to be read by the Public Accounts Committee relating to NpfIT.

My worry regarding the implementation of NpfIT is that it has been introduced “backwards”. By this I mean that the national spine and its associated infra-structure has received much attention whilst very little effort has been put into useable local systems for day to day input of clinical data – the very life blood of any clinical system.

For a clinical system to be deemed useable by the staff using it, their involvement in its development is vital. Clinical systems have evolved over many years to allow the recording, storage, retrieval and analysis of data relevant to sometimes complex clinical situations. Although the time taken to input data into a new system does not necessarily have to be faster than the existing systems, if longer is required then there must be some added value. Data retrieval and analysis with plotting of trends would be an immediate benefit which would, I believe, stimulate staff to input meaningful information.

In my speciality, three or four software systems already exist in clinical use, which have been developed by and for ophthalmic units and their staff. All of these are already able to comply with the requirements of the national cataract dataset (which I helped to develop via the Royal College of Ophthalmologists). An interesting project recently took place between the 20 or so of the eye units who have installed one of these systems whereby details of 56,000 cataract operations performed recently were analysed. The data capture was input routinely and the retrieval near instantaneous.

It is highly unlikely that local service providers will achieve this level of detail and use-ability for at least 5 years. My suggestion is that more effort is put into interfacing between the national spine and local systems such as that mentioned above which are already fit for purpose. This will save time and money but most importantly, will gain user confidence very quickly.

Thank you for considering these comments.

Yours sincerely,

Larry Benjamin

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