Hear, hear.
General practice has evolved to have the only really effective IT in the
NHS. We are given a new contract which relies on our having systems we can
rely on. The government's NPfIT wants us to throw away our systems just so
the monolithic LSPs tasked with sorting out the mess that is secondary care
computing can male even more profit & there is no regard given to data loss,
functionality and training. We are not even allowed to see what is proposed
(or rather those who have been are not allowed to talk about it), which I
think is a scandal when we are talking about using public money to fund a
public service. We have enough work in front of us to make the new contract
work and I think we need to fight to keep the IT systems which have evolved
to meet our needs (we don't have time to cope with making new ones fit for
purpose) and we should insist that the HNS continue to support & pay for
them in keeping with the spirit of our new contract (it would be nice to
have at least one part which is not proving to be a disappointment).

Bill Westwood

-----Original Message-----
From: GP-UK [mailto:[log in to unmask]] On Behalf Of Simon Child
Sent: 14 February 2004 16:59
To: [log in to unmask]
Subject: "any change of IT requires a bit of investment up front"

http://www.guardian.co.uk/online/story/0,3605,1145668,00.html

"Rule one of reforming the NHS: don't load more work on to doctors. Rule
two: especially GPs. Rule three: never forget rules one and two.

"And there lies the single biggest obstacle to the government's
multi-billion-pound NHS IT upgrade. No matter how valuable the new systems
will be in the long run, any change of IT requires a bit of investment up
front, even if it's just a couple of days of frustration while getting used
to new screens. To an already over-stretched doctor, that looks like more
work."


Actually, that just doesn't *look* like more work, it *is* more work.

If we have to insert a couple of extra days training into our schedule, we
still have to do exactly the same amount of clinical work as well. It's not
a matter of being able to lengthen our waiting lists by a day or two (and
perhaps catch up later with a bit of waiting list initiative cash paying for
some extra sessions).

And those two extra days of training are just the beginning, more training
will be needed later, existing skills and software familiarity is discarded,
and so on. And meantime our workrate is slower as we use tools with which we
are not yet fully familiar, and we *still* have to do the same amount of
clinical work.

There are so few (?any) settings comparable to GP, with it's open-ended
commitment to deal with whatever arises on the day that it arises, that it
perhaps isn't surprising that people don't understand the special
circumstances, but it is still irritating.

[A/E is perhaps the nearest comparison, but even then A/E's can and do close
and divert to nearby hospitals if they get overloaded/understaffed]

Not to mention the issue of loss of data (perhaps not the actual data in
terms of bits and bytes, but likely some of the softer contextual and
semantic meaning in it) in any transfer of system.

--
Simon Child
www.GPUK.net
www.woodbanksurgery.nhs.uk