Why so many different NHS logins and systems?

[FlyingIsEasy]

Can anyone explain why there isn't one NHS system rather than lots of different ones?

I've got a chronic condition which means I'm at the hospital every few months with GP checkups in between.

The hospital uses something called Patients Know Best, unless I want to book a blood test and then it's a different system I've forgotten the name of.

If I want to see my GP I have to log in to System Online and that's where they put my results.

The two systems don't speak so I have to take my hospital tests to my GP and vice versa. It seems bonkers.

And then all the Covid stuff is a separate login as well. Why? Is there hope it''ll all get joined up one day?

Because there is no interoperability between NHS systems. And despite what some people would have you believe about the ‘nanny state’ there is no truly centralised system or organisation truly running things. Also it’s just so incredibly difficult to develop and implement these systems. I work in digital health developing apps for the NHS. It literally takes like a decade to get something to market. And by then everything has changed anyway so it’s a constant losing battle.

Ha ha good question indeed. I work at a trust where I need logins for 8 different systems to do my job. It's just ridiculous! Let alone have access to anything from other hospitals or local GPs.

Apparently It should be possible to have an authentication service that links to systems. However - this has not even been implemented for staff let alone patients. I think the .gov service seems to be trying to do this. Maybe eventually it will get to nhs…

gds.blog.gov.uk/2021/12/01/one-login-for-government-december-2021-update/

Haha try working for them. I have about 25 different log ins 😭

Because there is no such thing as the NHS. There are different trusts, GP practices, services contacted out to private providers, etc as infinitum. There's no one overarching body that would set such a thing up.

DH worked in the National Programme for IT. It was a disaster, despite everyone's best efforts. As above pp, too many individual fiefdoms, all wanting slightly different solutions, because they didn't want to cede power to a central system. Cost 10 billion and was abandoned.

Depends where you work. I work across 3 Trusts & one Trust uses a system named EPIC (used almost worldwide) which is like, the ONLY system. It’s mind blowing.

Another Trust I work at uses (off the top of my head):
ICE
SPICE
CURRENT HEALTH
EPMA
BADGERNET
EUROKING
HEALTH ROSTER
NIVS
ESR
SYSTM ONE
CLARITY
ASTRAIA
TEAMS
SOLITON
REDCAP
ATTEND ANYWHERE

The mind boggles.

They did try coming up with one NHS computer system. 10 billion later they gave up.

The arrogance of the Dept of Health/NHS is that they can produce something superior to what already exists.

They won’t just buy a system used worldwide. Nope. Have to try to fudge their own.

Personally I think that nhs is big enough to properly make a system that is tailored to them. In the long run it will be cheaper - but they don’t want to pay for the upfront cost of hiring good engineers to do this. It’s like PFI - cheaper in the long term for govt to build hospitals like they did post war - but they want things now even at a high recurring cost - making it the problem of future generations.

I live in an area where they have 2 prominent hospitals close together (some staff work across both sites and some complex patients may need care in both) - they chose different computer systems for each hospital… then had to make an integration so that they could talk to each other…

@Namenic they spent £10billion trying before they gave up!

@AgathaMystery

The arrogance of the Dept of Health/NHS is that they can produce something superior to what already exists.

They won’t just buy a system used worldwide. Nope. Have to try to fudge their own.

What "worldwide" system are you talking about? There are lots of different EMR systems currently. I only know of a couple in the part of the world I work in and they are shockingly bad! I actually don't think it IS arrogance for something as big as the NHS to write their own specifically fit for purpose design rather than trying to make another system work for them. It's a bafflingly difficult area of work and I'm not at all surprised there's no one central system!!

Try working there . I need six different systems all the time to do my job, and another five or six about once a week or so. None of these have the same username/password combination. I have five different usernames without even factoring passwords.

It amuses me that IT get stroppy if they find out that you write these all down. They seem to be unaware that the NHS isn’t staffed by robots (although to be fair, they are not the only group under this apprehension). It is not possible for a human to remember all these combinations.

I’m guessing with the £10billion they didn’t do small chunks at a time. DH has been in software for a long time and thinks that they can split the project into smaller but significant pieces - and do it gradually. For example - they could start by getting an identity management system that works across the nhs - they kind of already have to have one - because .nhs.uk emails are used.

The pandemic has shown that when there is enough focus, expertise and funding, a lot can be achieved - not just in IT, but science too

Changing passwords every 120 days is also stupid and less secure as people will write these down or pick something insecure.

@vastgrandupgrade

Try working there . I need six different systems all the time to do my job, and another five or six about once a week or so. None of these have the same username/password combination. I have five different usernames without even factoring passwords.

It amuses me that IT get stroppy if they find out that you write these all down. They seem to be unaware that the NHS isn’t staffed by robots (although to be fair, they are not the only group under this apprehension). It is not possible for a human to remember all these combinations.

Can’t your computer save them, surely no one re enters passwords every time

Patient held records are the way to go. But guess what? They don't want you and I to have them because, you know, information is power, and it's not really your record, it theirs.