A Welsh Assembly committee has warned that a national programme to digitise patient records is already outdated, prone to crashing and places patients at risk.
The Pubic Accounts Committee has raised the alert in a report, Informatics Systems in NHS Wales, which says staff are still struggling with archaic and fragile IT systems which don’t deliver on their promises.
This is despite the NHS Wales Informatics Service (NWIS) having spent an estimated £484 million on developing and rolling out new systems up to 2016.
The report says NWIS also spends only 10% of its budget on innovation while allocating considerably more to repairing and maintaining systems long past their sell by date. It could find little evidence of where the money would come from for further developments.
The committee is particularly concerned at the fragility of CaNISC, the system used to track the treatment and wellbeing of cancer patients in Wales. It is based on software not supported by Microsoft since 2014 and a replacement still has not been found.
Systems failures
Cardiff and Vale Health Board reported the system was down for three days during August of this year, and in total, systems across NHS Wales failed on average once every nine days in the first six months of 2018.
The committee was given assurances that no patients were at risk during the outages, but NWIS’s own serious incident log stated there was so and that some patients needed repeat diagnostics due to an inability to process some pathology examples.
The committee said concerned about “overly positive” reports of progress from senior managers, with the chief executive responsible for hosting NWIS describing its ambitions as “world leading”. This is despite projects either running well behind schedule, or in some cases, only on schedule because the schedule had been changed.
“In 2003 the iPhone was yet to be invented and Gmail and Skype were yet to take off,” said Nick Ramsey (pictured), chair of the Public Accounts Committee. “It was in this same year that the Informing Healthcare strategy was launched, with an electronic patient record for in Wales at its heart.
“The other technological innovations of that year have not only been realised, but leapfrogged several times, and yet NHS Wales remains far away from a seamless electronic portal for patient records.
"Our inquiry has raised serious question marks about the competence, capability and capacity across the health system to deliver a digital transformation in Welsh healthcare. And yet we discovered a culture of self-censorship and denial amongst those charged with taking the agenda forward – in NWIS itself, as well as its partners in the health boards and the Welsh Government.”
Recommendations
The committee makes five recommendations in its report:
- The Welsh Government should set out a clear timetable for putting the digital infrastructure of NHS Wales on a stable footing.
- There should be a review of the senior leadership capacity in terms of skillset and governance within both NWIS and the wider NHS Digital Team.,
- Any additional funding apportioned to NWIS needs to be tied to reorganisation to achieve the improvements that are required.
- The Welsh Government should provide the committee with six-monthly updates on progress.
- NWIS should work more closely with other public bodies, including the UK’s Government Digital Service.
The report will now be considered by the Welsh Government.
Image from Welsh Assembly, CCA 2.0
