Why the NHS needs to upgrade its systems so the rest of us can innovate

head in handsIt’s times like these where I feel like the only logical course of action is to bang my head against the wall. Desperate? Maybe, but often it feels utterly futile trying to combat the elephant in the room: the NHS’ insistence on using outdated systems for their day-to-day work.

We recently updated the Network Locum site with a fresh design and user-interface. For a company such as ours the work of designer Peter Larkin is hugely important because we have to stay relevant to current technology trends. Ease of use and functionality are essential to making us effective at delivering our service.

However when we receive calls from Practice Managers telling us that our site keeps ‘breaking’ it is a major cause for concern: a lot of time and effort went into the site and the feedback from locums has been extremely positive.

Unfortunately the blame doesn’t lie in our hands. While we have been striving to stay at the front of the curve when it comes to using modern technology, we’re dealing with people using browsers that are up to 13 years old. Dated browsers, like Internet Explorer 6 and 7, are unable to execute widely used modern browser components like HTML5 and javascript. The job calendar page on Network Locum, which allows Practice Managers to post jobs online, is completely inoperable on IE6 and cripplingly slow on IE7.

This is based o Gavin Jamie's sample analysis
This is based on Gavin Jamie’s sample analysis

Our lead developer Craig stresses, “Older web browsers are less secure, slower, and have less features than modern browsers. If our customers use them, they can’t make the most of the site.”

So what choices do we have? Either we commit a large amount of resources making the site compatible with outmoded users or we try and get our customers to update their systems. Sensibly we chose the latter, although the prospect of selling two products to potential clients is slightly more difficult but in the long term it will make their lives easier.

Our own naivety led us to believe that the use of old browsers was a choice by GP practices, but the truth is that many practices want to upgrade but are being held back simply because necessary applications such as Choose and Book will not work with newer browsers.

These sentiments were echoed by Kenny Kennington, IT Operations Manager at Torbay & Southern Devon Health and Care NHS Trust. He said, “It is the central systems [like Choose and Book] we all have to use that are holding back any progress.” It has to be a cause for concern if IT specialists within the NHS are aware of issues but unable to enact changes.

Companies like ours, whose aim is to help streamline the mammoth task the NHS has, are being stunted by the technological stagnation festering in the administrative branch of the NHS. It makes our lives difficult, but far more importantly it is holding back our customers from providing the best service they possibly can to the people who matter most in this chain, patients.

Fortunately we’re not alone in our quest to get the NHS to join us in this decade. Handi Health and NHS Hack Day are two organisations trying to change the pace at which the NHS adopts new tech.

Dr Damian Rowland, an NHR Doctoral Research Fellow based at Leicester University and a member of the NHS Hack Day clan says, “efficiency saving in itself in moving from IE6/7 is huge.”

It’s important we keep pushing government organisations to embrace new technology because it is designed to make life easier for the people using it. Ed Bott, a prominent technology writer for ZDNet, was most damning with his criticism of companies who insist on using IE6, “Any IT professional who is still allowing IE6 to be used in a corporate setting is guilty of malpractice.” That was written in 2010, three years later and not much has changed in the NHS. After our experiences with how it affects our business I can’t help but feel Mr Bott is right.

 

Any comments please get in touch

Melssa. morris@networklocum.com

www.networklocum.com

 

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Peter Morris

Couldn’t agree more. Someone in the NHS needs to grab this with both hands and force a change that wouldn’t be that difficult or expensive to implement but would make a real difference!

February 4, 2013 at 6:03 pm Reply

Jane

Superb -Companies like Network Locum make a difference …. this sort of exposure is just what the NHS needs in order to move forwards.

February 4, 2013 at 7:07 pm Reply

Amy B

Here, here! Couldn’t agree more. The NHS is backwards with regards to IT. It makes day-to-day work as a doctor incredibly tedious, we waste time daily battling against archaic IT systems.

February 4, 2013 at 9:37 pm Reply

JP

Why the government should handover our country’s health and wellness to professionals…

February 5, 2013 at 2:28 pm Reply

Jon

I’m a GP and have yet find a practice using windows 7. I am writing software using EPR demos from vision that can only run on xp virtual machines!?!

Given that all microsoft support for xp finishes next year, I wonder how upgrading will be facilitated…gulp

February 6, 2013 at 11:48 am Reply

    kenni39

    Jon, I feel your frustration. I would love to swap out all the XP instances in GP Land for Windows 7, unfortunately 3rd party apps are the problem. Despite GPSOC mandating a software whitelist, lots of practices still rely on software that will not run on Windows 7. We are making progress, but until the CFH tech office fully warrant the use of Windows 7, we are being held back by bureaucracy, that has largely stagnated due to ongoing changes in the NHS. It is however encouraging that the new regime seems to be doing something toward this. The new CQRS training tool will work on any browser, but does recommend IE8 and above (Although not IE10)!! I raised the IE6 issue with John Coulthard, when he was still at Microsoft, in 2007! Perhaps now that he works for Tim Kelsey we will see things change! I live. In hope

    February 9, 2013 at 11:24 am

imran najmi

HI I THINK THE NHS IS WAY BEHIND MOST OTHER INDUSTRIES IN TERMS OF TECHNOLOGY…HOW MANY USE IE6? I THOUGHT THAT ONE IS WAY OLD!

Date: Mon, 4 Feb 2013 16:57:00 +0000 To: imrannajmi@hotmail.com

February 7, 2013 at 5:53 pm Reply

    networklocum

    If you look at the chart in the blog it will tell you that more than 50% use IE6/7 #ridiculous

    February 8, 2013 at 3:45 pm

Jack

I think anyone still trying to make arguments justifying why the NHS needs to upgrade its browsers is completely missing the point.

EVERYONE in the world, including most of the NHS I.T., know the Standard Operating Environment (SOE), along with its browser (IE6), is horribly out of date.

EVERYONE knows there are numerous technical ways to obviate the backwards compatibility issue for IE6 dependent web apps (e.g. Virtualization).

The real question is: what are the organizational and systemic issues that have created a paralysed and unresponsive I.T within the NHS. (Hint: It is not a technical limitation). To keep going over and over why XP/IE6 is shit is pointless. It’s stating the obvious.

The people in charge of I.T. have good reasons for behaving the way they do (otherwise they wouldn’t do it). The way the system is set-up CAUSES the situation we are in. All efforts need to be directed to analysing the system, reasoning about the incentives of individuals and groups which cause them to act the way they do, and trying to come up with solutions.

If you think that once the XP/IE6 challenge is overcome, then NHS I.T. will be a panacea of productivity, you are wrong. There will be complicated technical dependencies well into the future, and overcoming this specific one, without tackling the underlying root cause will doom the NHS to repeating this debacle.

February 8, 2013 at 3:41 pm Reply

    Ryan Maginn

    Can’t they just use Opera?

    It’s free.

    I install it whenever I work in a new practice.

    I worked somewhere yesterday and found IE almost unusable.

    I also feel there should be easy accessibility to Athens considering it has massive resources quickly accessible like eBNF/Medicines Complete.

    The problem I encounter with IE is that IE forgets that you have just logged into Athens for BNF about 15 mins after you have, so eBNF has to be relogged into.

    Plus it just doesn’t work well and silts up really quickly.

    February 23, 2013 at 5:07 am

Trista

Useful info. Fortunate me I discovered your site accidentally, and I’m shocked why this accident did not happened in advance! I bookmarked it.

April 7, 2013 at 11:37 pm Reply

Healthcare Software

I completely agree with this article. I work for a company that provides software to Dispensing Doctors Surgeries. We have found over 60% of our sites still use Internet Explorer 6.

We recently developed a new modern website but had to downgrade it’s appearance so that they could still load the page. It limits what we were able to do with our website and means we aren’t able to take full advantage of HTML5 until everyone had upgraded their browsers. It also meant our developers had to spend more time testing compatibility with older browsers.

IE6 is very insecure, unstable and completely outdated. If IE6 is required, I recommend people download Mozilla Firefox or Google Chrome and use it side-by-side with Internet Explorer. Use only use IE 6 for the NHS websites that need it and for all other websites use the modern browsers. That way everyone can take full advantage of the additional speed and security that modern browsers have to offer.

October 7, 2013 at 10:40 am Reply