I write on behalf of the iSOFT User Group (Primary care).
The group is appalled at the way in which the National Programme for IT (NPfIT) has been introduced.
As our members who have themselves developed medical software will testify, the secret of writing successful medical software is to integrate it with the way in which clinicians and staff actually work. User-friendliness is paramount: it must be easy for the clinicians to enter information, and just as easy for them to find it, without delay, when a patient is present.
But primary care is not just about patient-clinician interactions: practices have to call and recall patients for routine checks, identify those at risk of disease and report results to PCTs.
Good medical software depends greatly upon continuing discussions between programmers and users, yet NPfIT has chosen to do the exact opposite, planning its software behind closed doors.
Companies and individuals working for NPfIT operate under draconian confidentiality clauses.
Despite the fact that our organisation represents users of one of the three major primary care systems when NPfIT first began, we were never invited to discuss the new system. Indeed, we were told that the opposite applied: comment and criticism were not welcome.
It is generally reckoned that UK medical IT leads the world, and, of all the strands of medical IT, primary care is probably the most advanced.
It is interesting therefore that Richard Granger, head of NPfIT, has been quoted as saying that primary care software is the problem, not the solution.
Primary care uses a lot of ancillary software. The main system is only the beginning: we have scanning programs, analysis programs, appointments systems, third-party software to create insurance reports, analyse ECGs and so on. Yet the NPfIT software has been designed so that none of this software can interact with it.
The first release had no in-built scanning solution, was missing some of the additional functionality of the FrontDesk appointments system that many of us use, and wouldn't work with the analysis program Contract+ that many of us depend upon. Without a scanning solution, it was simply not fit for purpose. It is therefore no surprise that few practices wanted to change to it, and many of those that did felt they were being forced to by their PCT.
NPfIT has a reputation among our members for not listening, for not being in touch with the needs of primary care, and for producing cumbersome and time-wasting software.
This is before we have even touched upon the themes of confidentiality, security and the control of patient information: there are huge problems that have yet to be addressed.
One of our members recently demonstrated that the demographic information held about patients was not secure (this is held within the NHS Spine and used for Choose and Book, the online appointments system); and, to the best of our knowledge, no audit trail is in place, even though Choose and Book is now live.
In short, NPfIT is wasting large amounts of money on going backwards.
The iSOFT user group strongly supports the current call for an investigation into the fitness for purpose of NPfIT, and of its current working methods.
Dr John Lockley, Press officer, iSOFT User Group (Primary Care), Ampthill, Bedfordshire.