[These opinions are my own and not those of NHS Orkney]

Have a look at this announcement from e-health insider:

Scotland and Northern Ireland have issued a joint tender to purchase a patient management system, with rich clinical functionality, worth between £30-120m over four years.

Scotland and NI tender for patient management system

So here we go again. The development is being commissioned in the same way as usual: spec a tender for a monolithic and very complex system; go to tender; give the work to a 3rd-party software consultancy; wait a few years; take delivery of the software; attempt to roll it out, only to discover it’s not fit for purpose. We’ve seen this pattern time and time again in the NHS and other public sector organisations. Isn’t it time we learned that this approach doesn’t work? Increasing the scope of the project and throwing more money at it – as has apparently happened in this case – is not going to fix the problem. Not that I have a solution, but surely the consistent failures of the last decade should be a clue that this traditional approach  to software development doesn’t work for the NHS. We need something more iterative and agile, with developers – physically and psychologically – closer to the end-users. My recipe for a new approach would be something along the lines of: systems analysts with proven NHS success and preferably employed directly by the NHS + iterative design + programmers distributed among the various health-boards + open-source software within the NHS network. What would we lose in at least trying something different?