Managing IT to deliver information in the NHS in Scotland – podcast transcript

Simon:  We’re here today to talk about Audit Scotland’s latest report on the Management of Information Technology in the NHS in Scotland – to talk to us is Rhona Jack who led the team that produced the report. So Rhona, what is this report about?

Rhona:  It’s about the arrangements in the NHS in Scotland for providing information through IT in order to deliver better care and what we want to see is whether there’s clear and unambiguous leadership there, whether the stakeholders, that’s information users are properly involved and it’s about ensuring that programme and project management is working properly.  

Simon: So what have you found?

Rhona:  The good news is that there’s now a much more corporate approach to IMNT in the health service and that should help the delivery of care in future because clinicians will be able to share information where it’s appropriate to do so.  But on the down side there’s confusion about who’s in charge of IMNT strategy and implementation and there’s also more work to be done on developing the IMNT strategy so it’s driven by a clear information strategy that covers things like the quality and cost as well as activity.  We also think that there’s a need to improve the funding arrangements so that money is allocated based on specific goals so that full costs are known and so that decisions about future investments can be made on the basis of cost benefit analysis.  Another finding is that stakeholders need to be much more closely involved to make sure that their needs are met and that the expected benefits are delivered.  

Simon:  What does this mean for patients?

Rhona:  Effective IMNT can be a very effective tool to support patient care.  For example, it can provide clinicians quick access to clinical information to inform their decisions about patient care, even in emergency situations.  It can also provide clinicians and patients with access to specialist advice from remote locations through the use of tele-medicine and it can speed up diagnostic reporting from things like radiology and laboratory systems.

Simon: You said earlier there is confusion about who’s in charge and that there seemed to be a lack of a national strategy.  Are these small minor problems or is it a bit of a shambles in Scotland?

Rhona:  The current situation arises from the history where under the previous regime, boards and trusts had autonomy to buy and implement their own systems and that led to a more fragmented approach.  What’s happening now is a more corporate approach basically it will take a while for that corporate approach to deliver.  

Simon: You suggest there that the Scottish Executive has already started some sort of work on a more corporate approach.  Are we seeing any benefits yet of that?

Rhona:  I think it’s fair to say that we are.  For example the emergency care summary contains key information from GP records such as current medication and details about allergies and so on and that can be accessed if the patient needs out of hours services.  Another example would be the picture archiving computer system which allows digital x-rays to be sent between clinicians and that means that somebody in a remote location, perhaps an elderly person who’s got a suspected fractured neck or femur could be x-rayed at the remote location rather than having to be sent into specialist services.

Simon:  We’ve heard quite a lot in recent years about what’s been happening with the IT programme down in England and it’s generally portrayed as quite chaotic.  Is the situation in Scotland better or worse than in England?  

Rhona:   We didn’t set out to compare the two.  The two countries are only part-way through their implementation process so it would be really inappropriate to make judgements about who is better at this point in time.  I’m sure England’s ahead in some areas and Scotland may well be ahead in others.  

Simon: What would you like to see happen as a result of this report?

Rhona:  We want the Scottish Executive to follow through on the good work that they’ve already begun to implement changes in line with good practice.  We want them to make sure that funding arrangements are improved, that information drives the technology, that project management – the good practice that’s already there – is spread throughout the whole of the service and that users are properly involved.  

Simon: Rhona, thanks very much for your time.