Quote:
Originally Posted by OLD BOY
Tax havens, health insurance schemes....where are you picking this up from? That's not what I am advocating. You've been hallucinating again, it seems.
There are plenty of inefficiences in the NHS, and anyone who has visited a hospital on a few occasions can see that. Huge paper files being carted about, hospitals in one area unable to communicate or access your papers from your surgery if it's in a different area, trolleys with nothing on them being pushed in one direction, then another, with no obvious purpose - the list is endless.
We can do better than this.
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We tried, and failed - too much internal politics (between areas and trusts), disagreement on standards (as local systems had grown/been developed organically to meet local needs), incessant change outwith agreed contractual change, lack of suitably skilled staff (legal, compliance, IT business analysis and development), lack of additional staff to undertake the workload of those seconded to the Change Programme, political interference at local and national level leading to more unplanned change.
For comparison, I have worked on migrating the data from current systems and implementing an SAP ERP system in a University, which covered Finance, HR, and Education (about half the systems in use in the University at that time, but the rest had to integrate with the S4/HANA) - that took 3 years and about £30 million.
The NHS, with multiple times the complexity and organisational change required (you don’t just implement IT systems, you have to analyse the business processes required to support and drive the business forward, amend the systems to reflect the business processes, then redesign and train colleagues to be able to use the systems whilst doing their day jobs), would take decades and 10s of billions of pounds - we don’t plan or invest that long term in this country.
There are in England:
207 clinical commissioning groups
135 acute non-specialist trusts (including 84 foundation trusts)
17 acute specialist trusts (including 16 foundation trusts)
54 mental health trusts (including 42 foundation trusts)
35 community providers (11 NHS trusts, 6 foundation trusts, 17 social enterprises and 1 limited company)
10 ambulance trusts (including 5 foundation trusts)
7,454 GP practices
853 for-profit and not-for-profit independent sector organisations, providing care to NHS patients from 7,331 locations
How do you gain agreement with all these groups on a standard way of doing things?
tl:dr - it’s not that simple or easy