NHS and Government waste

[GridGirl]

I think Apple launching the iCloud will give people more of an idea what the cloud is. My other half works in a network department for the NHS. His team have been taking phonecall's for some time from people wanting to be on the cloud. Sadly when questioned as to what the cloud was the reponse has often been 'Errrrr'. Maybe they've just heard it as a buzzword and dont quite inderstand the concept. I don't think the cloud will take off in the NHS anytime soon.

[Mark]

The cloud can mean different things to different people. In the consumer context it often means things such as data storage and processing that you would normally do on your local PC e.g spreadsheets, word processors.

However where I work cloud is very specifically on-demand provisioning of virtual machines, and has nowt do to with what Apple is up to.

[Daniel]

I think Apple launching the iCloud will give people more of an idea what the cloud is. My other half works in a network department for the NHS. His team have been taking phonecall's for some time from people wanting to be on the cloud. Sadly when questioned as to what the cloud was the reponse has often been 'Errrrr'. Maybe they've just heard it as a buzzword and dont quite inderstand the concept. I don't think the cloud will take off in the NHS anytime soon.

That's completely normal. People hear about a new technology and ask an IT department what that new technology could do for them. That's the way it should be, it's not for the customer to explain what the technology is or what it can do, it's for IT to find a possible use. It's nice to see that we've got some fantastically progressive and visionary people working for the NHS in their IT department :laugh:

[Dave B]

Off the top of my head, within the NHS the Cloud *could* mean patient records available anywhere by any clinician, rather than a phonebook sized folder having to be physically carried around the country. If I get hit by a bus in Cornwall next week I want (the relevant part of) my records available to the paramedics on the scene - not having to be couriered down the A303.

Although given the history of government IT projects... :s

[Mark]

Off the top of my head, within the NHS the Cloud *could* mean patient records available anywhere by any clinician, rather than a phonebook sized folder having to be physically carried around the country. If I get hit by a bus in Cornwall next week I want (the relevant part of) my records available to the paramedics on the scene - not having to be couriered down the A303.

Although given the history of government IT projects... :s

Quite so. I find it completely crazy that Karen has to carry her maternity notes around to the doctors and hospital with her, and recently she's been told to have them on her at all times in case she goes into labour! I mean seriously, how hard would having them online really be?! Too hard apparently..

[GridGirl]

Daniel, this is not a commercial environment but a government entity with budget cuts. You think of a good reason to use the cloud and you might possibly get some money towards it. Sadly, I very much doubt that budget cuts go hand in hand with investing in technology. The NHS is already spending more than enough on IT as part of the break up of PCT's.

Dave there is already a national system where patient records are kept. :)

[Dave B]

Dave there is already a national system where patient records are kept. :)
AFAIK it's only for archival, not for day-to-day usage. I've been transferred between hospitals and had to have my notes couriered - I offered to carry them myself but that's a Data Protection risk :s

[Daniel]

Daniel, this is not a commercial environment but a government entity with budget cuts. You think of a good reason to use the cloud and you might possibly get some money towards it. Sadly, I very much doubt that budget cuts go hand in hand with investing in technology. The NHS is already spending more than enough on IT as part of the break up of PCT's.

Dave there is already a national system where patient records are kept. :)

But it's not the customer's job to explain what it does.

If I walk into a Fiat dealership and say "What are the positives of me buying a Twinair 500" should I have to explain what it is and how it works before he sells me one? F**k no, that's the salesperson's job. Of course if one of my requirements is to carry my family of 7 then of course it's not suitable for me and it's the salesperson's job to advise me that it's not suitable.

The attitude which was shown to the users was both unprofessional and unproductive. If it were me I'd try to explain how other departments have used to their advantage, I'll also explain the concept which will usually give the person calling an idea of whether it's going to possibly be of use for them or will be a waste of time. Anything further than that would have to be dealt with by a business analyst. Again, it's not for users to go out and educate themselves as to how something works......

[MrJan]

The NHS is already spending more than enough on IT as part of the break up of PCT's.


Spending? More like wasting. Did a job recently for a PCT and all the construction stuff was stupidly high spec for what they actually needed. The system is so un-streamlined that it's shameful. It's not confined to the NHS either, schools and councils are exactly the same with money being thrown at things that it shouldn't be. And then you get the end of year budget surplus that is thrown at something that no one cares about, purely so the budget can be used up and they'll get another decent wedge of cash the next year.

[Daniel]

Spending? More like wasting. Did a job recently for a PCT and all the construction stuff was stupidly high spec for what they actually needed. The system is so un-streamlined that it's shameful. It's not confined to the NHS either, schools and councils are exactly the same with money being thrown at things that it shouldn't be. And then you get the end of year budget surplus that is thrown at something that no one cares about, purely so the budget can be used up and they'll get another decent wedge of cash the next year.

:up:

There's no incentive for departments to save money...... if you save money then that money merely gets taken off you next year. If however people got a small bonus for saving money then there would at least be an incentive to save money and also to avoid the end of year spending splurge where crap which isn't needed gets purchased just because. This is from someone who spent a year working for a local government authority.

[MrJan]

:up:

There's no incentive for departments to save money...... if you save money then that money merely gets taken off you next year. If however people got a small bonus for saving money then there would at least be an incentive to save money and also to avoid the end of year spending splurge where crap which isn't needed gets purchased just because. This is from someone who spent a year working for a local government authority.

It's not just that, more often than not the person desigining the work hasn't actually spoken properly to the people that use it. So you get a load of things which are either not used or just don't carry out their function well. We had to build a reception desk for a job recently and I really had to hassle the architect for a drawing that properly showed what it looked like. Thank god I did, because speaking to the people that actually use the building now it seems that it is pretty much useless.

You also get materials that are silly. It's amazing the amount of times I contact a sub-contractor to hear "are you sure you want that? Because x product does pretty much the same but is £x cheaper". So then you go back to the architect and tell them that you have found a product alternative that will show a cost saving. The architect then asks for data sheets and product samples, takes a few days to think about it and then tells you to go ahead with the expensive version that he specified :rolleyes: It's properly stupid, but I guess working for an LA you have seen it all first hand anyway.

[GridGirl]

But it's not the customer's job to explain what it does.

If I walk into a Fiat dealership and say "What are the positives of me buying a Twinair 500" should I have to explain what it is and how it works before he sells me one? F**k no, that's the salesperson's job. Of course if one of my requirements is to carry my family of 7 then of course it's not suitable for me and it's the salesperson's job to advise me that it's not suitable.

The attitude which was shown to the users was both unprofessional and unproductive. If it were me I'd try to explain how other departments have used to their advantage, I'll also explain the concept which will usually give the person calling an idea of whether it's going to possibly be of use for them or will be a waste of time. Anything further than that would have to be dealt with by a business analyst. Again, it's not for users to go out and educate themselves as to how something works......

They are team of 6 looking after the networks of around 1million end users. They are not salesmen. :s They dont have business analysts either. :laugh: With the break up of the PCT's the cloud would only really work if it was implemented at a national level for the benefits already outlined by Mark and Dave B and even then it would need to be authorised by the government before the breakup. It's just not going to happen anytime soon.

[Daniel]

They are team of 6 looking after the networks of around 1million end users not salesmen. :s They dont have business analysts. :laugh: With the break up of the PCT's the cloud would only really work if it was implemented at a national level and authorised by the government before the breakup.

That's a shortsighted way of looking at things. I wasn't suggesting that they become salespeople, it was merely the example. It's shortsighted thinking like that which means that the NHS will always be well behind.

[GridGirl]

Well tell us how it works with local authorities then? How are they more progressive?

[Daniel]

Well tell us how it works with local authorities then? How are they more progressive?

They're not, however some local authorities are better than others. Two wrongs don't make a right though.

[MrJan]

That's a shortsighted way of looking at things. I wasn't suggesting that they become salespeople, it was merely the example. It's shortsighted thinking like that which means that the NHS will always be well behind.

Not necessarily short-sighted but it certainly sounds a bit too "not my job". Too many of these large companies and government run stuff have people with slopey shoulders. It may not be your 'job' to do something, but for the sake of a minute or two it's probably worth it to the company. That's sort of how I end up being tech support for my company.

[Malbec]

:up:

There's no incentive for departments to save money...... if you save money then that money merely gets taken off you next year. If however people got a small bonus for saving money then there would at least be an incentive to save money and also to avoid the end of year spending splurge where crap which isn't needed gets purchased just because. This is from someone who spent a year working for a local government authority.

This is not correct. There are incentives for departments to save money, for example our department has been given a 10% budget cut in line with the rest of the organisation. How that cut is made is up to us, and as a consultant we get a large say in how this happens. Ultimately if there is a large budget shortfall jobs will have to be axed. There aren't many incentives that are greater than keeping your own job in the current climate.

[Malbec]

I mean seriously, how hard would having them online really be?! Too hard apparently..

Its really easy to keep them online. Its almost impossible to keep them secure while allowing so many people involved in your care to access them. That is why the NHS connecting for health project was scrapped after £20 billion was spent on it.

We use a local version of the software developed for the NHS spine which requires the user to slot in an id card to activate the system. The idea is that when you've finished with it you pull out your id card to deactivate the system. Sounds great but that depends on around 1 million users all using the system securely 100% of the time. The security of the system is utterly dependent on the lowest common denominator, ie the staff using the system. Thats why it failed.

[GridGirl]

Not necessarily short-sighted but it certainly sounds a bit too "not my job". Too many of these large companies and government run stuff have people with slopey shoulders. It may not be your 'job' to do something, but for the sake of a minute or two it's probably worth it to the company. That's sort of how I end up being tech support for my company.

This is a prime example of people working for government departments getting away with wasteing money because of a lack of accountability. If the person you speak to doesn't authorise a cheaper product do you really think the s**t is going to hit the fan further up the management chain? Probably not and this is not a good thing. :( By the time someone is bothered about a tangible result it is probably far too late for them to have any influence.

[Daniel]

This is not correct. There are incentives for departments to save money, for example our department has been given a 10% budget cut in line with the rest of the organisation. How that cut is made is up to us, and as a consultant we get a large say in how this happens. Ultimately if there is a large budget shortfall jobs will have to be axed. There aren't many incentives that are greater than keeping your own job in the current climate.

OK, but tell me why in all forms of the public sector you have a budget for the financial year and come March when there's money left in the budget, people start splurging on things which are not necessarily needed? Also, this idiotic form of budgeting means that the pace of public works is not consistent and a lot of things tend to get done just before the end of the financial year. Then there's the fact that this spending splurge means that money doesn't necessarily get spent in the best way, for instance I was working for the local authority till the end of the financial year and just before the year end there was money left so they made an order of PC's, as it wasn't a large order they weren't able to negotiate a discount or anything...... Stupid. Also, we only order Dell's, the moronic leadership don't seem to feel the need to play big OEM's off against each other for business and save money because there is no incentive, if a PC costs £250 it costs the department who gets the PC £250, if it costs £300 then it costs them £300.

in the private sector if Barryfullalove saved his employer £50 per PC and there were 400 employees then his boss is going to be pretty fricking pleased.

I understand your argument that it's people's jobs, but if you save £10k then all that happens next year is that £10k gets taken off your department and distributed to other departments. So there really is little incentive to spend less than your budget.

[Malbec]

OK, but tell me why in all forms of the public sector you have a budget for the financial year and come March when there's money left in the budget, people start splurging on things which are not necessarily needed? Also, this idiotic form of budgeting means that the pace of public works is not consistent and a lot of things tend to get done just before the end of the financial year. Then there's the fact that this spending splurge means that money doesn't necessarily get spent in the best way, for instance I was working for the local authority till the end of the financial year and just before the year end there was money left so they made an order of PC's, as it wasn't a large order they weren't able to negotiate a discount or anything...... Stupid. Also, we only order Dell's, the moronic leadership don't seem to feel the need to play big OEM's off against each other for business and save money because there is no incentive, if a PC costs £250 it costs the department who gets the PC £250, if it costs £300 then it costs them £300.

in the private sector if Barryfullalove saved his employer £50 per PC and there were 400 employees then his boss is going to be pretty fricking pleased.

I understand your argument that it's people's jobs, but if you save £10k then all that happens next year is that £10k gets taken off your department and distributed to other departments. So there really is little incentive to spend less than your budget.

You're talking about local government. Many nhs organizations don't work like that. Surplus money is ploughed back into the system and since the nhs is run on a competitive basis hospitals cannot afford to waste money on things that don't improve care and attract more custom. Ultimately those that are inefficient get pruned down in size and/ or are shut down

[Daniel]

You're talking about local government. Many nhs organizations don't work like that. Surplus money is ploughed back into the system and since the nhs is run on a competitive basis hospitals cannot afford to waste money on things that don't improve care and attract more custom. Ultimately those that are inefficient get pruned down in size and/ or are shut down

Fair enough then. But if a department has a surplus is that surplus not automatically taken out of their budget the next year?

[Malbec]

Fair enough then. But if a department has a surplus is that surplus not automatically taken out of their budget the next year?

No. Budgets are adjusted according to projected demand, investment requirements and service development. Removing the surplus from next years budget is only possible if demand and spending art expected to be stable. That is rarely the case in the nhs.

[Daniel]

No. Budgets are adjusted according to projected demand, investment requirements and service development. Removing the surplus from next years budget is only possible if demand and spending art expected to be stable. That is rarely the case in the nhs.

I guess it's different to local government, I guess you can hardly turn away someone with a broken arm, like you can put off fixing a pothole.

[MrJan]

I guess it's different to local government, I guess you can hardly turn away someone with a broken arm, like you can put off fixing a pothole.

Don't get me started on potholes. We've currently got roads round here being resurfaced that were done in the last 18 months, while others have just had patch repairs for years.