Chris Lancelot on...the disastrous qmas site

What happened when GPs in England and Scotland reported our quality framework achievements to the quality management and analysis system (QMAS) website? It crashed. It couldn’t cope with the amount of data submitted by 10,000 practices. Google takes an equal number of hits every second.

With decent organisation, programming and hardware the QMAS site should be able to absorb any message sent to it, display the results immediately and send a confirmation message to the originating practice within seconds. Yet from the start on 1 April the site was overwhelmed.

Although some uploads got through, it could take hours for results to appear and acknowledgements were no longer being sent out: all this caused consternation among practice managers and IT partners. The site eventually crashed completely the next day when practices logged on to check that their achievements had been uploaded properly.

The QMAS site is not only a disaster, but a metaphor for everything that is wrong with NHS computing. For a start, how many practices historically have failed to register their non-clinical achievements because they didn’t realise that there are two buried confirmation processes to go through, and no warnings if they try to exit in the middle of the process?

Why does the site display achievement figures as rounded-down whole numbers when some targets are worth 0.5 points? Why are some practices’ aspirations still set at 1,050 when only 1,000 points are available?

This is naïve, careless programming made all the worse because we depend upon its accuracy for a large proportion of our practice income. Is this really the standard by which the DoH treats primary care?

In any case the QMAS process is unnecessarily intrusive. Its function is to gather information about prevalence and achievement at the end of each year — so why the need for regular monthly input? No significant DoH or PCT decision will be made with 11/12ths of the data QMAS requires — so why waste time and effort gathering it?

And now for the bad news. The QMAS site is by far the easiest part of Connecting for Health to set up: it has a well-circumscribed function and is only needed on one day of the year for a tiny amount of data. If it can’t get QMAS right, what hope is there for the rest of the project?

Dr Lancelot is a GP from Lancashire.

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