NHS National Programme for IT

NHS National Programme for IT

 

What is Information System?

            Information system is a set of interrelated components that connect or retrieve, process, store, and distribute information to support decision making and control in an organization. Data is composed of raw facts representing events such as business transactions. Information is composed of clusters of facts that are meaningful top human beings in the processes such as making decisions.

 

National Programme for IT

            The NHS National Programme for It aims to introduce new computer systems and services that will enhance how information is stored and shared in NHS. The new information technology (IT) provides opportunities for the health service to make changes and deliver better, safer care for patients.

 

Benefits of the National Programme for IT

Benefits for Patients

            The information systems that are being used in the national programme for IT are seen as beneficial to patients. Information systems provide opportunities for NHS organizations to make significant changes that make a big impact for patients, enabling choice, faster diagnoses and reduced waiting times.

 

Savings and Efficiency Gains

            One of the goals of the National Programme is to afford the NHS with savings. Based on evidence, the information systems have caused significant savings for the NHS. The National Programme was also reported to provide efficiency gains. Time savings for staff and patients are one of the considered efficiency gains that the National Programme affords.

 

Benefits from New Infrastructure

            The National Network for the NHS (N3) provides efficient, secure, high quality network and broadband connectivity for NHS computer systems and services. N3 was recorded to brought £192 million of savings to the NHS. Intangible benefits include the support of the frontline applications such as the electronic transmission of prescription messages from GP surgeries to pharmacies, as well as the transfer of patient’s complete GP record from one practice to another more quickly and efficiently. The system also enables the fast and efficient sharing of digital E-rays and scans between NHS hospitals in a healthcare community.

 

Benefits from National Systems and Services

            Since the implementation of Choose and Book a number of sites have reported huge reductions in the time taken to process a GP referral. The system has also resulted in the drop of number of patients who fail to attend a booked appointment.

 

Benefits from Local Systems and Services

            Local NHS organizations are reporting a mix of benefits from the implementation of the National Programme. These benefits are a mixture of monetary and intangible benefits. Example of intangible benefits is enabling someone to choose, or for a carer to understand and participate in a care plan, do however support improvements in quality, safety and the patient experience and so they underpin NHS reform.

 

Glitches and Failures of the NHS National Programme for IT

            The controversial NHS National Programme for IT became an issue because of the reported glitches and problems months after the new Connecting for Health technology was first used. The failures are said to have affected dozens of hospitals in England and in several hospitals in the Midlands. Most of the reported failures were related to the systems for viewing digitized X-rays on screens in wards and operating theatres. Software for organizing patient appointments was also filled with problems. There have been around 20 incidents that affected multiple NHS sites. Some hospitals that reported glitches with the system were Birmingham Women’s Hospital, Birmingham Children’s Hospital, University Hospital Birmingham, the Royal Orthopedic Hospital in Northfield, and Worcestershire Acute Hospitals NHS Trust. Most of the glitches involved the Patient Admissions System (PAS), which contains details of appointments and treatments (Birmingham Post 2006).

 

Management Challenges

            The NHS National Programme for IT is considered a strategic move that will cause long-term benefits. However there are management challenges that must be dealt with in order to make the programme a success. One of the challenges of the programme is determining benefits and costs of a system. The total benefits, savings and costs of the programme are hard to quantify. The programme provides intangible benefits that are hard to measure. Another challenge is determining the complexity of large-scale systems projects.

 

Financial Models

1. Payback Method – one of the most popular and most easily understood financial measurement methods. It is essentially an expression of how long it will take to recover the initial cash outlay on an investment form the investment’s cash flow returns (Mcmenamin 1999). Payback period is the number of years required to return the original investment from the net cash flows.

2. Return on Investment (ROI) – is one of the widely used measurements. ROI approximates the accounting earned by the investment.

3. Net Present Value Method (NPV) – is the method of evaluating project that recognizes the money received immediately is preferable to money received at some future date. This approach finds the present value of expected net cash flows of an investment, discounted at cost of capital and subtract from it the initial cash outlay of the project. If the present value is positive the project will be accepted; it its negative, the project should be rejected.

 

            The problem with the economic models is they have limited applications and they require financial data as input. Economic models ignore the intangible benefits that the project produces. In order to measure the intangible benefits of the project, other measurement techniques must be utilized.

 

1. Benefit Measurement Models

            Benefit measurement models require a well-informed respondent or group to provide subjective information regarding characteristics of the project under consideration. Such methods typically avoid conventional economic data, such as projected sales, profit margins, and costs, but rely more on subjective assessments of strategic variables, such as fit with corporate objectives, competitive advantage, and market attractiveness. Included in this category are checklists and their extension, scoring models (Cooper 1993, p.170). Benefit measurement techniques rely on the subjective inputs of characteristics that are likely to be known. Benefit measurement techniques recognize the lack of concrete financial data at earlier stages of the project and the fact that financial analysis is likely to yield unreliable results. Because of limited information and because only a tentative commitment is required during the early stages of the project, benefit methods are the most logical evaluation tool.

 

Management Information System

            A management information system is a system or process that provides the information necessary to manage an organization effectively. MIS and the information it generate are generally considered essential components of prudent and reasonable business decisions. An institution’s MIS should be designed to achieve the following goals:

• Enhance communication among employees


• Deliver complex material throughout the institution


• Provide an objective system for recording and aggregating information


• Reduce expenses related to labor-intensive manual activities


• Support the organization’s strategic goal’s and direction

 

Because MIS supplies decision makers with facts, it supports and enhances the overall decision-making process. MIS also enhances job performance throughout an institution. At the most senior levels, it provides the data and information to help the board and management make strategic decisions. At other levels, MIS provides the means through which the institution’s activities are monitored and information is distributed to management, employees and customers.

 

Reasons for the Failure of the National Programme for IT

1. Excessive Expenditure

            Large projects cost large amounts of money. The National Programme for IT was originally costed at around £ 6 billion whereas a report estimated that the programme costs £ 12 billion. Many IT projects cost a little more than originally budgeted. The characteristic of large IT projects seems to be that they go over budget by a very large factor. Then, the fact that their budget is already very high, means that the additional cost will be newsworthy. Since this cost over-run will normally happen before the original schedule has run its course, it will normally be the need for the suppliers to renegotiate their contract that is the first indication that a project is failing. As we shall see, it is the realisation that the requirements apparently agreed in the initial contract cannot be delivered for the initially quoted price that kicks off this renegotiation.

 

2. High Level of Complexity

            Complexity usually means that the separability of the components of a product are severely constrained. Changes to one component induce changes in many others.

 

Managing Change

            Management of change is described as a structured approach to individual, team, organization and society transitions that move the target from a current state to a desired state. Change management in organizations is a process for managing the people-side of change. It is the integration and adaptation of a new business model into an organization to transform the organizational relationships with all its constituents.  It is important that the management asses the current condition of the employees in order to identify the changes that the organization needs. It is also important to estimate the effect of management change on the employee behavior patterns, work processes, technological requirements and motivation. Management of change must be continuously monitored for effectiveness and must be implemented throughout the organization and must be adjusted in order achieve the desired goals.    

 

Planned Change

            The aim of planned or market-induced change is to gain competitive advantage in a fast-changing world. Planned change involves the organization of work processes, development of the skills of the organization’s people and alignment and commitment of key stakeholders. The values of planned change are embedded in economic approaches and organizational behavior (Buelens and Devos 2004). Through the economic perspective, the shareholders and customers are viewed as the most important stakeholders. In order to achieve success, the organization needs to improve its performance. The organization behavior perspective on the other hand view human resources as the key to the success of the planned change. The aim of planned change is to create economic value. Planned change constitutes a deliberate and premeditated intervention designed to alter some aspect of organizational life. The aims of a planned change are achieved through some methodology. Planned change usually involves some methodological approach or set of steps (Stickland 1998).

 

 

The Change Process

1. Analyze the Organization and its Need for Change

            The manager of change must first have a clear idea of the organization’s current situation. The manager must conduct any one of the following:

• A full financial audit of the organization


• A structural survey in which different departments and their staff are identified


• A skills audit of the organization’s personnel


• A marketing analysis of the business within the industry

The organization’s operations including the way it functions in its environment, its strengths and weaknesses must be studied before planning for change.

2. Create a Shared Vision and Common Direction

            It is important to engage every member of the organization to make the planned change successful. According to Jick and Peiperl (2003), uniting the entire organization behind a central vision is important to the success of the planned change. The vision should reflect the philosophy and values of the organization and should help it to articulate what it hopes to become. A successful vision aims to guide behavior and to aid an organization to achieve goals (cited in Randall 2004, p. 138).

3. Create a Sense of Urgency

            The manager must create a sense of urgency and appeal to employees’ self-interests by clearly explaining that their future well-being is at stake.

4. Support a Strong Leader Role

            The transformational leader must turn employee compliance to commitment.

5. Craft an Implementation Plan

            For change to become successful, the manager must embark on a programme of involvement precisely at the point where decisions are to be made about what is to happen and how it is to take place.

6. Communicate and Involve People

            Real Communication requires a dialogue among the different change roles. By listening and responding to concerns, resistance and feedback from all levels, implementers gain a broader understanding of what the change means to different parts of the organization and how it will affect them.

7. Reinforce and Institutionalize Change

            Throughout the pursuit of change, managers and leaders should make it a top priority to prove their commitment to the transformation process, to reward risk taking and to incorporate new behaviours into the day-to-day operations of the organization. By reinforcing the new culture, they affirm its importance and hasten its acceptance.

 

 

References

Buelens, M & Devons, G 2004, ‘Art and Wisdom in Choosing Change Atrategies: A Critical Reflection’, in J J Boonstra (ed.), J J Boonstra (ed.), Dynamics of Organizational Change and Learning, Wiley, Chichester.  

 

 

Cooper, R 1993, Winning at New Products: Accelerating the Process from Idea to Launch, Perseus Books, Cambridge MA.

 

Stickland, F 1998, The Dynamics of Change: Insights into Organisational Transition from the Natural World, Routledge, London.

 

 

Jick, T D and Peiperl, M A 2003, Managing Change: Cases and Concepts, McGraw Hill, New York.

 

Mcmenamin, J 1999, Financial Management: An Introduction, Routledge, London.

 

Randall, J 2004, Managing Change, Changing Managers, Routledge, New York.

 

 

Upgrade to IT in NHS Needs Rethink 2006, The Birmingham Post, p. 4.

 

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