NHS IT is, from my experience, a complete clusterf*ck. The NHS is sliced up in many different ways (e.g. by Trusts, which are regional, but also by field across trusts, e.g. radiology – there are many other 'dimensions' of slicing besides these two). All of these different dimensions of the NHS have at various times provisioned their own IT services from myriad suppliers, initially without much oversight. Interoperability ends up taking massively more resources than the actual implementation of any individual service. Attempts to unify the NHS's approach to IT are far too little far too late.
One of the contributing factors to the extent to which WannaCry affected NHS services was, afaik, the fact that the suppliers of some closed-source systems went out of business, so no updates could be provided for those systems.
I guess that's what happens when you give autonomy to trusts to commission/contract their IT as they see fit.
You could argue it is part of a political movement to create a free market around healthcare, which has seen healthcare trusts and CCGs (clinical commissioning groups) seek contracts for services that were previously provided by the NHS - car parking, waste disposal, laundry cleaning, cleaning services, sterile services, pharmacy, hospital buildings, payroll, finance, PET and MRI scanners etc etc..
There are relatively few things left that are commissioned on a national level. Nurses and doctors contracts, drugs (which gives huge purchasing power and very favourable prices for expensive drugs compared to small countries), clinical healthcare services which manage particular conditions. ok I'm struggling to think of more.
> The coalition government wanted to accelerate patient choice and competition, consistent with the wider belief that competition in public services drives improvement. The government’s critics recognised that competition was not new, but were concerned that the NHS reforms would result in much greater involvement of for-profit companies in the NHS.
-King's fund
There was previously a very expensive (~£10bn) project to implement a national IT patient notes system, which was abandoned.[1]
As someone else has mentioned (re NHSbuntu), it would be great of all that money had been put into something that could be developed further, even if it couldn't solve all the problems at the time.
Our local hospital (Queen Elizabeth, Birmingham) have a nice bit of software called 'PICS', which is one of the best I've used. It's fast, allows for electronic prescribing, note taking in clinic, ability to view results and viewing vital signs. But I don't think it has been sold to any other healthcare trusts, so it is essentially a stand-alone product at that trust.
Having worked at a place that lumps radiology PACS and RIS support into a more general ‘IT department’, it’s a disaster. The specific needs and requirements of a radiology department are poorly supported by a general IT department, no matter how good their wikis and documentation are.
There are models which work without dropping radiology’s RIS/PACS teams.
One of the contributing factors to the extent to which WannaCry affected NHS services was, afaik, the fact that the suppliers of some closed-source systems went out of business, so no updates could be provided for those systems.