there is no local, never mind grassroots, impetus for any IT in the NHS because ICRS/NCRS has caused a planning blight (in spite of what NPfIT - National Program for Information Technology- say) on local money to fund IT developments. Individual organisations are waiting to see what the LSPs (local service provider - a consortium of big IT companies who have been contracted to deliver to a geographical area.England -pop 56M - is split into 5 areas.) will offer as part of the centrally funded software. There seems to be little latitude for local initiative because to be officially adopted and funded it has to fit in with with the LSPs greater scheme of things is. As I understand it there is a regional Information Officer person who will liase with the LSPs. I suspect he has to commission streams of work within the overall scope of the NPfIT procurement.
Ive been to meetings where people have agreed that clinical input is essential for this to work, but there is agreement on how that clinical input is to be organised or more importantly who is paying for it.This is all within a very tight timescale. I suspect they wont get agreement re funding for clinicians and then will find some token clinician who they can blame if it doesnt actaully deliver what people need. If the LSPs (??via the regional Chief Information Officer) don't support something then it will effectively be frozen out and go in the bin. Richard Granger is quoted as wanting 'ruthless standardisation' as a means of sorting out NHS IT problems. Each LSP will offer the hospital some software. Equally the hospital doesnt have to use what is offered. The LSPs will get paid but no idea what will then happen to information flow then. The LSPs also have to manage 'legacy systems'. the working definition of this is 'stuff you are already using'. The LSPs version of integrating legacy systems may involve putting them in the bin and using what the LSP offers you. The problem is that if you raise the slightest doubt about how good an idea this is then you are labelled a ne'er-do-well and troublemaker nad clearly arent 'committed' to the project. There was an article published in 'Anaesthesia News' (from the Association of Anaesthetists of the UK & Ireland) which, for a slightly different problem, summarises the current position for any individual with an interest in these things. The original is in a pdf on the website ( www.aagbi.org.uk). I've copied it ( with permission) here http://aninfosys.dyndns.org/cgi-bin/wiki.pl?Lemmings
