Why does an institution like the NHS that employs more managers than medics keep falling victim to computer glitches? - David Behrens
This had nothing to do with the global IT outage of last weekend; it was 15 months ago and a fiasco entirely of the NHS’s making.
The fact that it happened all over again last week, with even greater collateral damage, shows how little they learnt from it.
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Hide AdYou probably noticed last Monday that while airlines, banks and others recovered from the botched upgrade to a piece of software no-one had heard of, the health service remained in panic mode. It would take longer to recover and refresh, said managers. The waiting list for computer repairs, it seemed, was as long as the one for patients.


This was because EMIS, the medical information system used by more than half of England’s GP practices could not be simply turned off and on again. Fixes had to be deployed across hundreds of locations, said the IT people. They knew this to be the case because they’d got used to it. They don’t need a global outage.
Last time, EMIS blamed “human error” for the release of code that was supposed to fix a bug but instead shut down the whole system. It was what happened to the rest of us last weekend when an internet security firm called CrowdStrike managed to shut down half the world.
Perhaps that’s how civilisation will end; not by a deliberate press of the nuclear button but by a coding bug deployed in error to the PC at missile control. It hardly bears thinking about.
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Hide AdAs for the NHS, one has to ask why an institution that employs more managers than medics keeps falling victim to these glitches.
The answer is twofold. Firstly, it is in thrall to two software companies that have a duopoly in supplying most of England’s GP surgeries with their bookings systems – a business worth £77m a year at the last count. Secondly and more seriously, it doesn’t listen to anyone who tries to tell it where it’s going wrong.
EMIS, marginally the larger of the two systems, was developed in Leeds but was bought last year by an American multinational for £1.2bn, in spite of a warning from the government’s monopolies watchdog that reduced competition might degrade services for patients, taxpayers and the NHS itself
Its rival is the Phoenix Partnership, another Leeds outfit whose boss is the controversial Tory donor, Frank Hester. If his name sounds familiar it’s perhaps because he was in the papers just before the election for having made rude comments about Diane Abbott.
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Hide AdBoth systems are sanctioned for public funding in an incomprehensible and long-winded NHS ‘framework document’ written by managers with far too much time on their hands. But online staff forums reveal an undercurrent of discontent with EMIS because of its recent unreliability and general clunkiness.
It’s the people on those forums, those who deal with the day-to-day shortcomings of systems like these, who are best placed to say how they could be improved. But does anyone listen to their concerns? Not their managers, that’s for sure.
On Wednesday, the National Guardian’s Office, which campaigns for the right of staff to speak up on issues in the workplace, reported that the proportion of NHS workers who felt secure enough to speak out about unsafe and wasteful practices had declined to a five-year low. Fear of retribution from managers was cited as the main reason for wanting to keep quiet.
In a sector whose common currency is life and death, IT problems are at the low end of the critical list – but the reluctance to draw attention to inefficiencies and potential hazards goes right across the board.
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Hide AdThe most serious manifestation of this silent culture is the case of Lucy Letby, the former NHS nurse serving 15 life sentences for murdering seven babies and attempting to kill seven more. Not only were whistleblowers on her wards ignored but those who thought she’d been made a scapegoat for institutional bad practice were prevented from coming forward in her defence.
This week the East Yorkshire MP David Davis set out to get parliament to examine the chance that there had been a mistrial. It’s a complex and harrowing case that has two contentions – and NHS culture is on the wrong side of both of them.
It would cost nothing for the non-medics who run the health service to open their ears to constructive criticism. What else has to go wrong before they can be made to do so?
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