Big Brother alive and well at Heathcare Computing

“I just had a call from the National Programme [for IT] on what I could say. I looked at my notes and realised I couldn’t say anything.”  This was the quote from the Healthcare Computing 2004 conference that perhaps best summed up the national programme’s very strange approach to communications.

The unfortunate speaker was Andrew Haw, ICT and EPR Director at University Hospital Birmingham NHS Trust, who  was about to participate in a conference debate on NHS CRS. He had a last minute call from the national programme telling him what he could say based on a confidentiality agreement he had been required to sign to participate in the Best and Final Offer (BAFO) process. After working out he could say nothing he urged the national programme to start treating trusts and senior staff as grown ups.

Despite successfully securing billions in funding from the Treasury and completing an unprecedented procurement in record speed the National Programme for IT shows no sign of wanting to tell the world much about its activities.

While there are signs of improvement on internal communications – the figure of 20,000 clinicians variously involved was repeatedly mentioned by different national programme speakers – external communications to the media and other interested parties appears to be one-way traffic only.

The paranoia and secrecy surrounding the programme on external communications actually seems to have grown since last year, with only messages of unalloyed success permitted and any awkward questions or areas of concern largely airbrushed out of the official picture. 

Some members of the audience at the conference who asked questions on key points that remain unclear – such as concerns on data quality, change management, use of the NHS number or the position on legacy systems – often got responses from NPfIT officials that implied the questioner was wilfully putting up barriers to delivering benefits to patients.

Major exhibitors at HC2004 were also under explicit constraints on what they could say.  Many told EHI they were expressly forbidden by their local service provider and the national programme from talking to the press, and told refer any questions about their involvement in the national programme to the national programme’s press team.

And despite serried ranks of national programme media enforcers present at the show, their numbers were in inverse proportion to any press relations actually carried out.

A reliable source also reported that a further sign of Big Brother in action came when the national programme’s enforcers asked the British Computer Society, the organisers of the conference streams at Healthcare Computing, to hand over all tapes of the conference sessions involving national programme speakers.

In the actual conference presentations by NPfIT officers some new information was provided about how and what was actually being delivered but  EHI understands that in some cases more detailed presentations had been prepared for the conference but were filleted of content at the eleventh hour.

The huge irony is that when the veil did occasionally slip there were glimpses that different regions of the national programme are actually making great strides, and in the cases of London and the North East preparing to go live with the first live-e-booking sites within three months. 

Martyn Forest, regional implementation director for the North East cluster, for instance gave a presentation that suggested preparations are well underway.  He told the conference that early implementers have been identified, with final agreements with PCTs to be signed next week.  Forrest also gave details of the work being carried out with NHS organisations on their readiness for new systems.

In a debate on the national programme Stephen Elgar, team leader NPfIT for the London Information Governance Team provided a series of snapshots of progress in London: furious work is underway to prepare for e-booking to go live in three months; work is also well underway on integrating child health records into the NHS Care Records Service; chief executives have been attending a development programme called leading edge.

A few headline figures offered by Elgar were also striking: 5,000 new PCs have been procured in London and 2,000 smart cards are due to be issued to staff by Christmas.

But such glimpses of progress behind the scenes in presentations were the exception rather than the norm.  Similarly, many suppliers privately spoke of their frustration at not being allowed to publicise work they have underway or milestones already reached in delivering elements of the national programme.

EHI understands that one LSP had produced a sophisticated FAQ (frequently asked questions) website to answer NHS staff’s questions in its cluster but had been told by the national programme that it could not go live with the site.   

In his final conference presentation Richard Granger, NHS IT director general, once again promised a fresh approach to communications – just as he had 12 months ago.