…maybe Barbara Cartland lives-on and works at NHSE? It's a love affair with tech... and a total lack of reality.
The issues are well rehearsed.
The NHS is in a hopeless tangle of good intentions, snake-oil-salesmen, people who don't know the difference between machine learning and AI and senior management confused and beguiled.
Top of the shop from the report;
‘Our goal is for all ICSs and their constituent organisations to have all the attributes of digital maturity, including electronic records and other critical systems, by March 2025…’
Let’s ask some basic questions;
Why March 2025?
There is no operational justification, other than it's the year of the election…
Constituent organisations?
Do you know how many 'constituent organisations' there are in an ICS?
Systems, place neighbourhoods, collaborations, voluntary partnerships…
… for example, Bassetlaw ICS has five ‘neighbourhoods’ and 36 ‘places’.
If that’s typical, across 42 ICS', you’re probably looking at over 1,500 interfaces for data. Connecting everything from EPRs, to a pencil.
Digital maturity?
The last DM report I can find is an NHS self assessment from 2017… widely acknowledge to have been ‘gamed’ because there was the sniff of money in-the-air.
To get up-to-date, this report references another report, What Good Looks Like, which says;
‘[we will provide] an assessment framework which you will use to measure your level of digital maturity.’
… almost none of the ICS’ anywhere near ready to know where their pencil sharpeners are coming from, never mind interoperable healthcare systems, procurement, implementation and user engagement.
Plus… this research project, from Coventry University, revealing;
‘… a lack of sufficient skills and knowledge in leading digital transformation in the NHS…’.
Unabashed, Barbara Cartland ploughs on. It uses the words ‘we will’ sixty-nine times.
Who is we? I think it means ‘me’ [author] if all goes well and ‘you’ if it doesn’t.
As far as I can see, top-line, there are over 149 deliverables on the list, the sketchiest of time-lines and no clarity about who is responsible.
Readiness - ask people to be ready with an EPR by whatever date, tell them what to buy, give them the money to do it and the time to get up and running.
Normalisation - explain to people, mutualised access to data has to be normal.
Interoperability is too complex. ‘Normalisation’ is an industry standard procedure, quick, cheap and works.
Important but not urgent tasks are lower priorities, schedule for phase 2.
Urgent but not important tasks, park them.
Not urgent nor important tasks bin them.
NHS IT has been befuddled with complexity. This report makes it worse and worse still, it’s probably undeliverable and even worse, we won’t find out until it’s too late.
Complexity is fraud, it steals time and energy, persuades us we are clever and busy.
There is never a justification for complexity, if things can be simple…
>> I'm hearing - In April this year England had 677 fewer midwives than it did in April 2021.
>> I'm hearing - on Friday QA hospital Portsmouth had a queue of over 21 ambulances, roughly six hours waiting.
>> I'm hearing - from a Mum who has been giving her daughter, a community nurse, money to subsidise her petrol bills because what the Trust pay is not enough. They are waiting for a 'national line' to be agreed. Meanwhile we have community nurses subsidising through their own pockets.
>> I'm hearing - this from another Mum; My son graduated as a doctor this summer and is fortunate to have a job, 800 did not get posts.
The point system means over 50% of the places went to overseas doctors so students we have invested in, will not gain the vital development of F1&2 posts.
>> I'm hearing - QE Hospital at King's Lynn. It's literally falling to bits - massive props holding up the defective roof, buckets everywhere to catch rain. Is a fix on the cards?
>> I'm hearing - The GP workforce shrank by 116 doctors in May 2022. While appointments delivered in general practice rose by 3.6m compared with the previous month.
