Meet the suppliers: Ascribe

Linda Davidson

If you think that offices speak volumes about their owners you will be interested to learn that the boss of the expanding healthcare IT group, Ascribe, Stephen Critchlow, keeps his framed membership certificate from the Royal Pharmaceutical Society propped up
by his PC.

“I’m a clinician, a pharmacist,” he explains. “I decided to write a computer program because I didn’t like what was given to me. Like when you paint a room because you can’t afford a decorator. I couldn’t pay someone else to do it. I wasn’t a geek, but I could see a need.”

Ascribe Group is the company that developed from that rejection of software on offer in the hospital pharmacy departments where he worked in and around Manchester.

In addition to its market leading solution for medicines management, the group offers products for mental health, accident and emergency and general practice, plus patient administration systems from two new acquisitions, Barwick and HE Information Systems (HEIS).

Clinical safety

Critchlow comes across as a wiry, driven figure, much exercised by the problems that need to be solved to make healthcare safer. He apologises for getting emotional about the subject but says his work in IT is still informed by clinical experiences. “You would end up next to patients who had died because someone had given them the wrong dose of insulin.”

He points out that in the UK you are six times more likely to die of a medicines error than a road accident.

One of his early ventures centred on the problem of mixing total parenteral nutrition (intravenous feeding) doses for very sick children with serious gastro-intestinal conditions. The pharmacy machinery could only prepare enough doses for seven children and any more had to have their feed prepared by the nurses on the ward.

Critchlow found an academic paper which showed that this meant the first seven children had a one in ten chance of dying while the others, who had their feeds prepared on the ward, had a one in three chance of dying. Galvanized by the challenge, he says a team previously locked in a fairly uninspiring a nine-to-five routine, pulled together and solved the problem late one Christmas Eve.

“People in healthcare generally want to do the right thing,” he observes. “The hierarchy assumes this is not the case.”

The business moral Critchlow draws from all this is to “provide what the end user will buy.”

Having set off on the road of delivering improved hospital pharmacy software in the early 1990s, Ascribe received a shot in the arm when the Audit Commission’s Spoonful of Sugar 2001 report highlighted the relationship between improve healthcare IT and lives saved due to more accurate prescribing.

At the same time the company was also working on an integrated workstation to bring together orders and results in different hospital systems including pathology and radiology and manage the patient’s stay from the beginning of their care to discharge. Crucially it was web-based and built to sit on top of legacy systems so there was no requirement to rip-and-replace.

“It included all orders and all results and everybody had a pathway – not just the radiologists and so on but the porters and ambulance service,” explains Critchlow.

The first site went live in 2002 but it was bad timing – the National Programme for IT (NPfIT) was taking a very different strategic track.

“But medicines management was hot on the agenda: we realigned all our efforts to medicines management and grew 40% by implementing e-prescribing and medicines management solutions,” says Critchlow.

Consolidation

He is openly sceptical about the NHS’ capacity to absorb the amount of change management needed to embrace the NPfIT and even more doubtful about the amount of money being spent.

“I believe there’s more being spent by the NHS locally to provide all the [IT it needs], why spend another £6.2bn? It’s a complete waste.”

Critchlow points out that with 60% of UK hospitals using the firm’s pharmacy systems and other solutions installed in over 25% of mental health units, 30% of accident and emergency departments, 200 retail pharmacies and at 100 GPs’ desks, plus sales in Australia, New Zealand, Hong Kong and Malaysia, Ascribe’s annual turnover is in the low millions. Analysts predict revenues of £16.6m for 2006-7. How much do we need to spend?

With two recent acquisitions in the patient administration systems market – Barwick and HEIS – clearly the desire to be in the much wider market originally envisaged has not gone away.

Critchlow’s next plan is for a phase of consolidation – maybe a few months, maybe a year. “We need to get everyone aligned to the same aims,” he says, that aim being to get all Ascribe’s systems on a common architecture.

“Every one of our products can be integrated but we want to get a very consolidated approach – this is much more important than buying the next company.”

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