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The National Programme for IT in the NHS Report

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Updated: Jun 30th, 2020

Introduction

The National Programme for IT was launched in 2002 by the National Health Service to reform how NHS used information (Burr 2008, p. 2). According to Nieuwenhuizen and Erasmus (2007, p. 45), information is very critical at institutions of health. Cases where doctors repeat medications that a patient has already received are common when the concerned doctors are not able to share data. It is also common to find cases where attending to a patient’s need takes long because or re-diagnosis. The National Health Service realised that a lot of effort was going into waste because of the poor information management system at most of the public health institution. As Levine (2002, p. 74) notes, in most of the cases, patients were forced to register afresh every time they visited public hospitals. This was not only a waste of time for both the patient and the concerned health officers but also a waste of resources. Successful referrals were also hindered because of the poor information management system that largely depended on handwritten records. When handing over a patient from one health officer to another, patient data must be part of the handover process. However, this was not the cases. This meant that the receiving doctor had to start the process anew, a fact that was reducing efficiency in delivering quality services to the clients.

It is upon this background that the NHS realised that a time had come to revolutionise its information management system at all public healthcare facilities. In 2002, it developed this programme to help integrate its communication system to increase coordination between offices and medical officers in all public health facilities. The introduction of the electronic care records was meant to ensure that patient’s data was always available and easily accessible within the database at all the healthcare centres within the country. In this report, the researcher will critically review this program using relevant methodologies and concepts to determine if the best possible results were achieved from it.

Analysis of the Project Using Relevant Methodologies and Tools

The National Programme for IT was a major project for NHS that was meant to transform the communication system at the firm. To analyse this project, it will be important to start by using some of the project management theories to determine if the right procedures were followed by people concerned. According to Kendrick (2011, p. 28), Four Stages Theory of project management is one of the simplest and most commonly used theories of project management. This theory simply outlines the four main stages in a project and defining what should be done at each stage for it to be considered a success. According to this theory, the first stage is the start-up. This is the most important stage in project management. This is because it involves the identification of needs. It is the justification for why the project is necessary. This was done in 2001 by NHS officials in the public healthcare facilities in England. Their review revealed that it was necessary to have an integrated communication system that will enhance communication among departments within a hospital and different hospitals within the country.

It was established that this could only be achieved by establishing electronic health records within all public healthcare facilities. This stage was conducted successfully. The second stage is the planning of the project. Once a problem has been identified and a decision made to address it through a given project, the next important stage in the planning process. According to Levy (2009, p. 78), to achieve success, it is necessary to have a comprehensive plan that details what should be done at various stages, the stakeholders involved in the execution, the time needed for the execution, and the resources. This can properly be done by using a Gantt chart. The report does not have a record of the events that took place other than a rough explanation of when major events took place. This can be summarised in the Gantt chart below.

Gantt-Chart for the Timeline for Activities in the Plan
Figure 1: Gantt-Chart for the Timeline for Activities in the Plan

Completion and Review

Although not presented in the report, the Gantt chart is one of the main tools used in the planning process. When using this tool, the planners will need to break down the entire project into individual tasks. It enables the planners to determine the timeline when various activities within the project should be completed. This way, it will be easy to determine if the project is progressing as per the plans. Another important tool that is used in project planning is the Project Control System which helps in defining project controls. According to Heldman (2011, p. 72), defining project control for this project is very important in enhancing the success of this project. The figure below shows the specific activities that should be addressed in the project control system when using this project management tool.

Project Control System
Figure 2: Project Control System

Source (Kerzner 2010, p. 39)The project control system defines the estimates, budgeting, contract management, cost control, scheduling, and management of finance. These activities have been defined in the sections above. The top management of the National Health Service should be responsible for the controls in this project. When this has been done successfully, the next important stage in project management as per this theory is the execution.

In this stage, the project members will be putting into practice what has been planned and approved by the relevant authority. This process is very critical because it involves bringing to a reality what has been visualised at previous stages. This will need the application of the right technologies and the use of the right workforce. The implementation of the National Programme for IT in the NHS was expected to take eight years, from 2002 to 2010. The specific activities in this project were broken down into for phases. The first phase was scheduled for completion in 2006, the second phase in 2007, the third phase in 2008, while the last phase was scheduled for 2010 (Burr 2008, p. 28). The management enrolled a detailed plan to change the data management records. In the first phase, the NHS replaced manual care records with electronic care records. This was to reduce work when recording the details of the patients. The system made it possible for the officers involved to take all the details of the patients and put it into a departmental database where all the relevant authorities within the department could access it. This meant that at every stage of medication, the relevant officer would only need the identification of the patient to access all the historical health records of the patient.

In the second phase, the system was advance to make it possible for the relevant departments to share a patient’s health records. The interdepartmental transfers of health records were considered appropriate because it allowed medical officers in one department can access the details of a patient in a comprehensive manner (Davida 2008, p. 51). This is very important when dealing with a patient suffering from more than one health problems that need the attention of health officers in different departments (Chin 2004, p. 45). For instance, a pregnant mother who is visiting a health facility because of a wound that needs treatment cannot be given specific types of medicine. This is so because some medicines have a serious negative effect on features. In many cases, a doctor may make prescription without inquiring if the patient is expectant. If the patient receives the wrong medication, then a more serious health problem may arise.

To avoid such unfortunate scenarios, the new system was meant to provide the doctor or nurse with a full description of the health status of a patient before the process of treatment can begin. This made it necessary to have interdepartmental data transfers. The fourth stage went a step higher. The National Programme for IT was meant to go beyond institutions to a regional setting. The authority developed regions within the country that would share their data. This move was informed by the fact that sometimes a patient may visit a different healthcare centre when seeking medication. Through this integrated communication system, it became possible for different centres within a given region to share their patient’s data for efficiency in delivering quality care. The last phase that was scheduled for 2010 would see NHS integrate the communication system for all the public healthcare centres in this country. The patients would be able to access medical data at any part of the country as long as they were attended to in a public hospital in the country.

With a large online database that was shared by various hospitals, a patient in London would have no problems accessing the historical data that was collected in a hospital in Manchester because they will be available in a common database that can be accessed online. The report by NHS dated May 2008 indicates that the first three phases of this project have been completed (Burr 2008, p. 31). The information in this report does not indicate the level of success of the last phase of the project because as the time of its publication, there were two more years to the date scheduled for project completion.

The last stage of a project as defined by this model is the evaluation and closure. As Schmidt (2009, p. 47) says, this involves reviewing what has been achieved and comparing it with the objectives. The aim will be to determine if the intended objectives have been realised by the time the project is brought into completion. If it is determined that some areas need to be addressed, then the project manager will need to lead the project members in addressing the identified gap. If it is proven that the system effectively meets the set objectives, then the system will be put into use, and the project declared completed.

Program Evaluation and Review Technique (PERT)

According to Berkun (2005, p. 54), one of the common concepts in critical review of major projects is PERT. This tool is specifically important in planning and coordination of megaproject such as the National Programme for IT that was initiated by NHS. When using this method, the first stage is always to identify all the elements are identified, and their interrelationship determined. As Carroll (2008, p. 131) observes, this means identifying these elements and establishing how one element would lead to the other or affect others. For instance, in the NHS project, it will start by identifying the elements of the integrated communication system. Once this is identified, the next step will be to establish how each of the elements will be responsible for the construction of the entire system. As Pandey (2009, p. 71) notes, it is like building a roadmap using individual components of the entire structure. To achieve success in the planning process, a network diagram is always necessary. This diagram offers a visual representation of the events and activities involved in the process of completing the project. As Kousholt (2007, p. 118) notes, when using this tool, it is necessary to use arrows to demonstrate the path that will be taken towards achieving the intended goal. The NHS project is an ambitious mega project that involves various components which include hardware, software, people, and equipment to bring it to successful completion.

Fish Borne Diagram Showing Components of the NHS Project
Figure 3: Fish Borne Diagram Showing Components of the NHS Project

This network diagram identifies the major elements in this project. The first element is the hardware. To develop the new integrated data recording and sharing system, the NHS had to purchase the necessary hardware. At the individual offices, the health workers needed personal computers as their workstation. These computers will enable the officers to enter and retrieve data whenever it is necessary. To support all the data within a given centre, it will be necessary to have minicomputers, also known as mid-range computers. They can sustain data within a centre (Coulter 2009, p. 137). In large centres, it may be necessary to have mainframe computers. At the regional and level, NHS will need supercomputers to manage the large data at the required speed. Other components of the hardware include the cables, wireless connection device, a router, among others.

The software also forms a major component in this diagram. As Murch (2004, p. 12) notes, a communication system may use software depending on the needs of the system. At the workstation, the health officers will need various forms of software in their computers to enable them to perform their duties efficiently. The database will also need software to make communication between departments possible. It will also need a firewall to protect it from intrusion and viruses. The labour used in the development of the system is another component. The process will need skilled labour to handle various tasks in putting up the system. Semi-skilled labour may also be necessary when addressing physical tasks such as transportation within the centres. The last component, as identified in the diagram above, is the equipment needed to develop the system. These are the tools and machines needed to put various components of software together to form the system (Brigham & Ehrhardt 2013, p. 70). All these elements are needed to complete the system. The report was given by NHS demonstrates the importance of various elements discussed above in coming up with this new system. It is also important to note that each of these elements come at a cost. National Health Services had to purchase the software and hardware needed for the system. The fee charged by the consulting firm that was responsible for the new system included labour and equipment costs.

Conclusion

The National Programme for IT was an ambitious project that was initiated by the National Health Service to help improve patients’ data management at all the public health facilities in England. Launched in 2002, the project was meant to create a new system that will eliminate the manual system that was in use at most of the public healthcare facilities. The project had four phases, with each phase having specific activities to be addressed. The critical review of this project demonstrates that NHS followed fundamental processes in this project that led to the success witnessed in the first three phases of the project. The methodologies and concepts used to identify specific elements of the project that worked together to help achieve success. The report was drawn in 2008, two years before the scheduled date of completion. However, the project was a great success because of the planning and execution strategies that were used.

List of References

Berkun, S 2005, The art of project management, OŔ eilly, Beijing.

Brigham, E & Ehrhardt, M 2013, Financial management: Theory and practice, South- Western, Mason.

Burr, T 2008, The National Programme for IT in the NHS: Progress Since 2006, The National Audit Office, vol. 484. no. I, pp. 1-54.

Carroll, N 2008, Project management: A decision-making approach, Lippincott Williams & Wilkins, Baltimore.

Chin, G 2004, Agile project management: How to succeed in the face of changing project requirements, AMACOM, New York.

Coulter, M 2009, Strategic Management in Action, Pearson Higher Education, New York.

Davida, F 2008, Strategic Management: Concepts, Pearson Higher Education, New York.

Heldman, K 2011, Project management jumpstart, Wiley, Hoboken.

Kendrick, T 2011, 101 project management problems and how to solve them: Practical advice for handling real-world project challenges, American Management Association, New York.

Kerzner, H 2010, Project Management Case Studies, John Wiley & Sons, Chichester. Kousholt, B 2007, Project management: Theory and practice, Nyt Teknisk Forlag, New York.

Levine, H 2002, Practical Project Management: Tips, Tactics, and Tools, John Wiley & Sons, Hoboken.

Critical Review of the National Programme for IT in the NHS 14

Levy, S 2009, Legal project management: Control, costs, meet schedules, manage risks, and maintain sanity, DayPack Books, Seattle.

Murch, R 2004, Project management: Best practices for IT professionals, Prentice Hall PTR, Upper Saddle River.

Nieuwenhuizen, C & Erasmus, B 2007, Business management for entrepreneurs, Juta, Cape Town.

Pandey, I 2009, Project management, Vikas Publishing House, Delhi.

Schmidt, T 2009, Strategic project management made simple: Practical tools for leaders and teams, John Wiley & Sons, Hoboken.

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