Procurement policies in the National Health Service are hindering the uptake of new technology and working practices, according to a new report.
The poor adoption of new technology was “one of the reasons our standards often fall below those of comparable countries", said the report titled All change please from think tank The Policy Exchange.
The study, based on detailed interviews with UK and US health care professionals, takes a swipe at the National Programme for IT (NPfIT) in the NHS, which is driving through a £12bn computerisation project.
It is not the core technology that is at fault, according to the authors, rather it is the basic approach.
The report is critical of the US health care system. For example, it states, “Compared with many other industrialised nations, the American healthcare system as a whole ranks near the bottom on important measures of performance. It lags behind other countries in the adoption of information technology that could improve quality and efficiency.
Nevertheless, it identifies the University of Pittsburgh Medical Centre as an example of best practice. Its technology supplier is Cerner, which is also the supplier of core systems for London where deployment has hit a number of problems.
The report states:
“The lesson (from University of Pittsburgh Medical Centre) is that IT has to adapt to clinical practice, rather than the other way round, a mistake made by the National Programme for Information Technology (NPfIT) in the UK, which has attempted to impose a standardised solution for every hospital in the NHS. In contrast, UPMC has developed different applications for its academic, community and paediatric hospitals to reflect their different needs.”
Although All change please is not principally about IT, its recommendations point to the need for high-quality IT-based procurement systems.
It takes to task the final report of Lord Darzi’s official review of the future of the NHS for not paying sufficient attention to the process of procurement.
Echoing National Audit Office reports from 2002 and earlier, the report identifies the lack of common descriptions and codes for items purchased across the NHS. It also highlights the large number of procurement systems used across trusts.
It claims that health trust and NHS supply bodies lack accurate data on costs, and claims better procurement could save between £800 and £2.1bn a year.
The NHS was an earlier pioneer of e-procurement, introducing EDI in the 1990s and it has a programme aimed at revitalising its e-procurement processes, which aims to deliver significant improvements within three years. However, notes from a meeting last autumn highlighted many potential barriers to success.
Even the initial strategy, published in the autumn of 2007, admitted, “classic e-business models do not fit health”.