By Tony Collins
[This is the final part of a 3-part series on how Trafford Healthcare NHS Trust’s IM&T team achieves much on a small budget]
Trafford General Hospital bought its main systems outside of the £11.4bn the National Programme for IT [NPfIT]. The hospital, though, is one of the most technologically-advanced in the UK.
Part one of our series on Trafford Healthcare NHS Trust covered the clinical support for IM&T, integrated systems, and the openness that’s required of the trust’s suppliers.
Part two covered the trust’s control of its data, how NPfIT could ever have worked, how patients benefit from the IM&T, why doctors keep their smartcards on them at all times, links between hospital and GP systems, the real-time view of free beds, why duplicated patient records are rare, board support for integrated electronic patient record systems, and some of the remaining challenges.
Some of Trafford’s further challenges include:
– Securing the agreement of all GPs in the area to share a synopsis of their records. About half have agreed so far.
– Scanning in all paper notes to the EPR. At present about 50% of patient notes have been scanned and are available to clinical staff as “PDF” files, normally with chapter headings. They include diagrams, charts and handwritten text.
– Dealing with any uncertainties that arise when the Trust is acquired – in all probability by Central Manchester Foundation Trust .
– Maximising the IM&T opportunities that the acquisition will bring both Trusts in terms of modernising systems and extending the concept of the shared electronic patient record across a wide area of Manchester.
Trafford has 14 people working on IM&T and IT infrastructure related matters who handle support, infrastructure and integration. The total yearly cost, including salaries, is about £1.5m in capital and revenue which covers the spend with all of Trafford’s IM&T suppliers.
This compares with costs of between £23m and £31m for each NPfIT installation at acute trusts in London and the South – and these sums do not include the costs of running a hospital’s IM&T and associated infrastructure. Neither do the NPfIT costs include the salaries for an acute hospital’s IT and IM&T staff.
Steve Parsons, Head of IM&T, says of his hospital’s technology: “This is bargain stuff”.
If Trafford can do so much for so little, can centrally-bought NPfIT systems costing many times more – for less – still be justified? The Department of Health argues that NPfIT systems offer more than non-NPfIT. But how much more could Trafford offer its clinical staff, in terms of proven technologies and integration?
Asked where he’d put Trafford in a league table of UK hospitals with systems that clinicians need and want to use, Peter Large, Director of Planning, pauses and says with a slight smile: “Let’s be modest – in the top 10%.”
He’s probably not joking.
• Since writing this article Parsons and his team have been short-listed by the eHealth Insider Awards for the trust’s electronic whiteboard project, in the category of “innovation in healthcare interoperability”.