NHS patients are getting “precious little” from the NHS electronic care records system in England, the National Audit Office (NAO) has found.
The £7bn system to replace paper files is falling further behind schedule and in places where it has been introduced it is not working as it should.

The National Audit Office also said some patients would not even get one as large chunks of the NHS had pulled out.

In conclusion, the NAO said the system was not providing value for money – something the government rejected.

The Electronic care records are the key part of the overall £12.4bn NHS IT project.

The scheme was launched in 2002 by Tony Bliar with the aim of revolutionising the way the health service uses technology and also includes developments such as digital x-rays and fast internet connections.

It is the third time the NAO has looked at electronic records – and each time the findings have been more damning.

The report from the NAO presents a depressing account of delays, contractual wrangling and technical glitches.

The original vision for the scheme was compelling – a national network connecting hospitals, GP practices, ambulance services and mental health trusts, and an end to the tortuous paper trails that have caused frustration and misery for doctors and patients alike.

But the complexity and cost of the scheme meant it was always seen by many as a high risk strategy. And when it ran into trouble the plans were scaled back, and the original vision set aside.

Many GPs and hospitals are now working with different systems, prompting the NAO to question whether further investment in the national programme would be pouring good money after bad.

The latest report details a range of problems that the programme is struggling with.

In London, all GP practices and more than half of hospital trusts have pulled out, while in the south three-quarters have. However, this has not been accompanied by a proportionate drop in cost.

Meanwhile, the contract covering the rest of country is currently being renegotiated. Even after such a scaling back, roll out in places that remain part of the system is still proving difficult.

The NAO said it doubted the final deadline of 2016 – which is already six years later than originally envisaged – would be met.

And even in those trusts that have electronic records, there are problems. For example, some hospitals have struggled to introduce electronic prescriptions.

The NAO said the difficulties were caused by a range of factors, including the government being too ambitious, difficulties with technology and the complexity of the NHS.

The problems have prompted some critics to call for the entire scheme to be scrapped – although this is something the NAO stopped short of suggesting.

The government has already announced there will be a review of the project. This is due to start next week.

Tory MP Richard Bacon, a member of the House of Commons’ Public Accounts Committee and long-standing critic of the plans, said: “It is perfectly clear that throwing more money at the problem will not work.

“This turkey will never fly and it is time the Department of Health faced reality and channelled the remaining funds into something useful that will actually benefit patients. The largest civilian IT project in the world has failed.”

But the Department of Health said while the original vision “was flawed”, the project still had the potential to deliver value for money.

Dr Chaand Nagpaul, of the British Medical Association, said: “We cannot turn the clock back, but this report provides useful lessons on how best to use resources in the future.”

From: http://www.bbc.co.uk/news/health-13430375

Health authorities should stop wasting money on “ineffective” operations like tonsil removals and wisdom teeth extractions, according to the quango Audit Commission.
It has calculated that the NHS could save £500 million a year by doing so, that could be put towards more worthwhile treatments.

Its briefing, Reducing expenditure on low clinical value treatments, found that a clearer approach among primary care trusts (PCTs) to what it called “ineffective or inefficient treatments” would ensure more consistency across the country.

It came as another report, by the health think-tank The King’s Fund, criticised “persistent and widespread variations across England in patients’ chances of undergoing surgery for common medical problems”.

Both reports, by coincidence issued on the same day, agreed that some patients were undergoing operations “that do not benefit them”, in the words of The King’s Fund.

However, while the Audit Commission report focused on the potential cost savings of reducing operations, The King’s Fund called for an end to the “unfair” and “inefficient” variations in accessing worthwhile surgery.

The former identified tonsil removals as “relatively ineffective” and hysterectomies in cases of heavy menstrual bleeding as less cost-effective than alternatives.

Wisdom teeth extraction was often not worthwhile, because of a “close benefit and risk balance”, while some procedures, such as orthodontics, were nothing more than “potentially cosmetic”.

Some PCTs, of which there are about 150 in England, could save more than £12 million a year by reducing such operations, the soon-to-be-abolished spending watchdog calculated.

Andy McKeon, its managing director of health, said: “PCTs across the country are currently paying for treatments that cost the taxpayer money, and according to clinical experts have little or no real value to patients. This needs to change.”

The King’s Fund report – Variations in Health Care: the good, the bad and the inexplicable – found that tonsil removal operations in children were 10 times more common in Coventry than in Kingston, even though the procedure “has been queried since the 1930s”.

But it concentrated on lack of access to operations that did work.

For example, it found that rates of admission for hip and knee replacement varied by up to 400 per cent, with people in poorer areas much less likely to receive one.

Rates of coronary artery bypass grafts varied from 34 per 100,000 in Westminster to 197 per 100,000 in Berkshire.

John Appleby, chief economist at The King’s Fund, said: “This report confirms research over decades, both in the UK and internationally, which has shown persistent and unwarranted variations in use of and access to even the most common surgical procedures. This is unfair to patients and inefficient for the NHS.

“Remedying this is urgent given the need to improve quality of care while the NHS grapples with the biggest financial challenge in its history.”

From: http://www.telegraph.co.uk/Tonsil-removals-and-other-ineffective-operations-cost-NHS-500m-a-year

A hospital trust will save £14million after becoming the first in the country to buy its way out of a Private Finance Initiative (PFI) deal.
The NHS body was due to pay £2m a year for the next two decades to the private firm that built West Park Hospital in Darlington, County Durham.

But after reviewing the costs, Tees, Esk and Wear Valleys Mental Health Foundation Trust decided to take advantage of a break clause in the deal.

It paid £18m upfront to get out of the PFI contract 23 years early, but it now owns the hospital outright and expects to save £14m over the course of the deal once maintenance and inflation is taken into account.

The move, disclosed in the Health Service Journal, comes after The Daily Telegraph uncovered evidence that hospitals are closing accident and emergency departments in order to pay the interest on PFI deals for new buildings.

Some PFI hospitals – built and run by private firms and effectively rented back to the state – will end up costing taxpayers more than 10 times their capital value.

“We concluded that the best option was to exercise what exists in the PFI projects, which is a clause called ‘voluntary termination’,” said Colin Martin, Director of Finance at the Tees, Esk and Wear Valleys trust.

“It effectively means we pay off the mortgage early.”

However he added that the trust – which runs mental health services in County Durham, the Tees Valley and along the North Yorkshire coast – did not regret the original deal and was committed to two other PFI deals.

“We wouldn’t have had the hospital if we’d waited for the traditional financing route,” Mr Martin said.

PFI deals became the preferred way of paying for public sector infrastructure projects under Labour, as they allowed new buildings to be constructed while avoiding large initial outlays of money.

Under the complex deals, private contractors carry out the building work then own the structure for up to 35 years, while the public sector body gives them annual interest and repays the capital sum as well as paying for maintenance.

However because of the length of the deals and the amount of interest involved, taxpayers end up paying several times the original value of the project.

In the first known example of an NHS hospital buying its way out of a PFI deal, the North-East mental health trust decided to purchase West Park Hospital outright.

It had agreed a 32-year deal with Norwich Union Public Private Partnership Fund to build the 116-bed facility, which opened its doors in 2004.

The hospital – which is also home to the trust’s headquarters – cost £16m to build but under the deal, the trust was paying the contractors £1.4m a year in interest payments and a further £600,000 in maintenance and paying back the principal.

In 2009, the trust reviewed its PFI deals and decided it had enough cash in the bank to pay the £18m break clause and so buy West Park outright. It gave the project company the required statutory notice and after the legal process was completed, the deal ended in December.

Treasury figures suggest it would have the remainder of the deal would have cost a further £32m, so it has saved £14m by getting out of it.

However it is unlikely the pioneering move will be copied by many other trusts, as most PFI deals are so large as to make early repayment impractical.

Aviva, the company that now runs the PFI firm that built West Park, was unavailable for comment.

From: http://www.telegraph.co.uk/Hospital-saves-14m-by-getting-out-of-PFI-deal

NHS Hospitals are wasting up to £500 million a year by paying too much for basic supplies, according to Britain’s spending watchdog.
The National Audit Office found that some health bodies are paying twice as much as others around the country for dressings, clothing and medical equipment.

In some areas, individual hospitals are purchasing 177 different types of surgical glove and putting in hundreds of small orders for A4 paper.

It comes even though the National Health Service is under orders to make £20  billion in efficiency savings over the next four years.

The NAO recommends that the Department of Health make it easier for trusts to compare the prices of products they buy, and that hospitals collaborate with each other to buy in bulk and so save money.

Because local trusts are independent of Whitehall control, the NAO says they should be held to account by Parliament to improve on the “poor value for money” they provide in procurement.

Margaret Hodge, the chairman of the powerful Public Accounts Committee, said: “It is simply unacceptable that so many hospital trusts are currently paying more than they need for basic supplies. Even for some of the commonest items, the price hospitals pay varies by more than 100 per cent.

“Too much purchasing is still done through multiple, low-value orders, which incur high admin costs.

“And the range of similar products that trusts buy is sometimes so wide as to appear ridiculous: how can it be, for instance, that while one trust does its work with just 13 different types of surgical glove, another requires 177?

“These are well-known recipes for poor value for money that really ought to have been addressed by now.”

The NAO report states that England’s 165 NHS hospital trusts spend about £4.6bn a year – a tenth of their total expenditure – on “consumables”, such as surgical dressings, drinks, staff uniforms, pacemakers and replacement hip joints.

Because there is no central system for buying these products, managers in individual hospitals make deals with 17,000 different suppliers. One trust employed 45 people in its procurement team.

Although it is “standard practice” in the private sector, health bodies are not required to give each product they buy an individual code, which would help them analyse data and reduce errors.

As hospitals do not know how much others are paying for products, and they buy items in different quantities at different times, price variation is common and the NAO estimates that up to £150m could be saved if it were eliminated. In some cases the amount paid varied by as much as 183 per cent.

In addition, NHS bodies are putting in on average 4,501 order for surgical gloves a year, and could potentially save £7m a year in admin costs just by reducing orders.

Further savings could be made by buying in bulk or joining regional “hubs” with other hospitals to make economies of scale and improve their bargaining power with suppliers.

Hospitals are also encouraged to standardise the products they use – one trust used 287 different types of tubes known as cannulas, while another bought 15 variations of A4 paper.

Amyas Morse, head of the National Audit Office, said: “At least 10 per cent of hospitals’ spending on consumables, amounting to some £500 million a year, could be saved if trusts got together to buy products in a more collaborative way.

“In the new NHS of constrained budgets, trust chief executives should consider procurement as a strategic priority. Given the scale of the potential savings which the NHS is currently failing to capture, we believe it is important to find effective ways to hold trusts directly to account to Parliament for their procurement practices.”

The Health Secretary, Andrew Lansley, said: “We welcome the publication of this report. The more efficient the NHS becomes, the more we can invest back into patient care. That is why it’s so important for hospitals to deal with wasteful procurement.

“While it is up to local hospitals to decide how they purchase products, Government has a role in providing support and robust information. We are therefore considering launching a review to help hospitals get better value for money from procurement, drawing on the expertise of Government advisers.”

From: http://www.telegraph.co.uk/Hospitals-wasting-500m-a-year-on-basic-supplies

Whilst Health Direct applauds the NAO’s research, we know that they are under quoting the waste.

On January 11, 2011 we piublished: NHS wasting £1 billion a year on supplies when we found that the NHS is wasting more than £1 billion of taxpayers’ money a year as managers spend vastly differing amounts on the same supplies, the head of a government backed healthcare efficiency drive has claimed.

Labour’s Private Finance Initiative- NHS hospitals will cost taxpayers 60 years of pain.
Under Private Finance Initiative schemes, British taxpayers are committed to pay £229 billion for new hospitals, schools and other projects with a capital value of just £56 billion.

Official figures show that, under Private Finance Initiative (PFI) schemes, British taxpayers are committed to pay £229 billion for new hospitals, schools and other projects with a capital value of just £56 billion.

Several contracts are due to run for 60 years, documents released under freedom of information requests show, meaning taxpayers will be paying for the projects for generations to come.

Private contractors who agreed PFI deals with the Government are set to make billions of pounds in profit, with some due to see returns of up to 71 per cent.

In a series of reports, UK media lines disclose the heavy costs and administrative burdens caused by PFIs. The deals are a way of building large public projects using private finance, which were relied upon by the Labour government. The disclosures will lend weight to MPs calling on PFI companies to refund a share of their profits to the taxpayer.

The PFI deals include:
• A hospital which charged £52,000 for a job that cost £750. Demolishing a shelter for smokers resulted in the PFI contractor charging £2,600 a year for the additional work .
• A hospital in Bromley, south London, which will cost the NHS £1.2billion, more than 10 times what it is worth.
• An empty school which will cost taxpayers £370,000 a year until 2027. Another school had to pay £302 for a socket, five times the cost of the equipment it wanted to plug in.
• Military dog kennels which would have ended up costing more per night than a room in the Park Lane Hilton, London. The deal to replace facilities at the Defence Animal Centre in Melton Mowbray resulted in the sacking of the contractor and the scrapping of the contract.
Under a PFI, a private contractor builds a school, hospital or other asset, then owns it for typically between 25 and 35 years, effectively renting it to the taxpayer for that time. In exchange, the contractor has responsibility for maintenance.

Treasury papers suggest that payments on PFI contracts already signed run until 2048. The Daily Telegraph (a UK daily broadsheet) has uncovered deals, signed in the late 1990s, which include special clauses meaning that they last for up to six decades.

So a 21 year-old leaving university this year will pay taxes for the PFI until they are almost 70.

By then, some of the facilities will have been obsolete for years. Political pressure on the PFIs, introduced by John Major but greatly expanded when Gordon Brown was chancellor, was mounting last night after The Telegraph established the scale of profit-making by some of those involved.

An almost unknown City company, Innisfree, with only 14 staff, is the largest single player in the PFI market, owning or co-owning 269 PFI schools and 28 hospitals.

According to accounts filed at Companies House, Innisfree’s profit margin was 53 per cent last year. A successful FTSE 100 company makes margins of around 6 per cent. David Metter, the founder and chief executive of Innisfree, owns almost three-quarters of the company and collected pay and dividends of £8.6 million last year.

Jesse Norman, the Conservative MP for Hereford has been quoted as saying that Innisfree have made money like it is going out of style, and that a tiny number of individuals have made more money for less work than any other group of people he can think of. Innisfree said its directors were at a conference abroad yesterday and unable to comment, although there is no suggestion that Innisfree has done anything improper or illegal.

Mr Norman heads a new cross-party group of MPs demanding that Innisfree and other PFI beneficiaries return a portion of their profits to the taxpayer, saying that it’s scandal.

Labour’s last health secretary, Andy Burnham, who was in charge of 221 PFI projects, admitted last year that mistakes were made. Innisfree co-owns the Princess Royal University Hospital in Bromley, opened in 2003, which cost an estimated £118million to build and equip according to Treasury figures.

However, Treasury calculations indicate the NHS will have paid Innisfree and its PFI partners a total of £1,210 million for the hospital over the 35-year life of the contract, but this does include support services. The National Audit Office says the deal will produce a return for the PFI contractors of around 70 per cent.

From: http://www.telegraph.co.uk/Private-Finance-Initiative-hospitals-will-bring-taxpayers-60-years-of-pain

NHS trusts are closing accident and emergency departments to help pay for hospitals built under Labour’s Private Finance Initiative (PFI) an investigation by The Daily Telegraph has found.
Since 2007, more than a fifth of England’s hospital trusts with active PFI hospitals have closed casualty departments, or published proposals to do so. In the same period, only four per cent of trusts without PFI hospitals have closed, or proposed to close, A&E units.

Fewer than a quarter of England’s 168 NHS hospital trusts have significant PFI hospitals in operation. But these trusts account for almost two-thirds of A&E closures or proposed closures.

Health campaigners said there was a “clear connection” between the “inflated” costs of the PFI and the cuts in A&E.

Most trusts insisted there was no connection — not all A&E closures are necessarily done on financial grounds and some are supported by local clinicians.

In recent days, The Daily Telegraph has disclosed how some PFI hospitals – built and operated by the private sector, and effectively rented back to the taxpayer – will end up costing the public purse more than 10 times their capital value.

The new Princess Royal University Hospital in Bromley, south London, cost £118million to build. It will end up costing taxpayers £1.2billion, including facilities management. South London Healthcare, the NHS trust responsible for the Princess Royal, has a second PFI hospital, the Queen Elizabeth in Woolwich.

The trust’s annual deficit was raised to £100million by the two deals. It has closed the A&E unit at one of its non-PFI hospitals, Queen Mary’s in Sidcup.

In internal documents seen by The Daily Telegraph, the trust stated that the “occupation costs” of the PFI hospitals were roughly double those of its non-PFI hospital.

A spokesman admitted that its PFI contracts placed “some undeniable restrictions on our flexibility”. But she insisted that the decision to close A&E at Sidcup was “entirely unrelated” to PFI.

Other trusts closing A&E units include Coventry and Warwickshire NHS Trust, which recently opened a new PFI hospital and plans to shut the full A&E unit at its non-PFI hospital in Rugby.

Barking, Havering and Redbridge Trust, which opened a new PFI hospital in Romford, wants to close the A&E unit King George’s Hospital in Ilford.

East Lancashire Trust has closed A&E at its Burnley hospital to help pay for a new PFI hospital at Blackburn. In Nottinghamshire, Sherwood Forest NHS Trust has downgraded A&E services at Newark after opening a new PFI hospital in Mansfield. At least four other trusts with PFI hospitals have similar plans.

Under its PFI contract, Queen Elizabeth Hospital, Woolwich, must have 64 visits a year from pest controllers, even when there are no pests to control. When there are pests, the hospital must pay for further visits, which it did 10 times last year.

Food served at the Queen Alexandra PFI hospital in Portsmouth is cooked in south Wales, then driven 100 miles to Hampshire.

Early PFI hospitals had on average 20 per cent fewer beds than the hospitals they replaced, according to research. Because of high service charges, several PFI hospitals cannot afford to keep even these reduced numbers of beds fully open.

In an effort to disguise their private ownership, a number of PFI hospitals have changed their names to include a royal connection. Greenwich District Hospital became Queen Elizabeth Hospital. Salford Hope Hospital is now Salford Royal. Oldchurch Hospital, Romford, became Queen’s Hospital. Farnborough Hospital, in Bromley, was renamed after Princess Anne.

From: http://www.telegraph.co.uk/Casualty-units-shut-to-pay-for-private-finance-hospital-contracts

The NHS is wasting more than £1 billion of taxpayers’ money a year as managers spend vastly differing amounts on the same supplies, the head of a government backed healthcare efficiency drive has claimed.
John Neilson, managing director of NHS Shared Business Services (NHS SBS), said cash was being needlessly squandered by health trusts who are paying multiple prices for identical equipment – ranging from stationery to surgical instruments.

He also claimed that millions could be saved by outsourcing more NHS administration overseas to countries such as India.

In an interview with The Times, Mr Neilson said: “It’s scary. We actually have multiple prices being paid for the same item in the same trust, in the same month.”

He claimed that NHS trusts were routinely paying as many as 19 different prices for the same pacemaker, wasting up to £750 a time.

And he said a host of other equipment such as computers were being bought at needlessly high prices – wasting around 12% of the NHS’s purchasing budget.

Mr Neilson said the offenders ranged from family doctors to elite foundation hospitals and that trusts across the country were also buying a “bewildering” amount of different equipment to do the same jobs.

The health service spends around £13 billion a year on buying equipment.

“If you talk about 12% of that, it takes us into the low billions,” added Mr Neilson. “They haven’t got their purchasing under control at all.”

Statistics showed that 18 NHS trusts paid 22 different prices for a J&J Linear Cutter surgical tool, with the cost ranging from an average £403, to a minimum £289.

There were also 10 different prices paid for Huntleigh flowtron boots – which prevent DVT – with 17 trusts forking out an average of £2,002. However the lowest price paid was just £482.

Mr Neilson said vast amounts of money could be saved if health managers worked together to standardise equipment and exploit the bulk buying power of the NHS.

“Out of 130 trusts we work with, only 30 of them buy the most commonly bought item. And that item is a Dell PC. Even if they all bought the same PC, just think of the savings that would produce.”

He also said moving some NHS services overseas would help in the drive to save £20 billion by 2014.

Call centres in India already handle invoices and other administration for some trusts at a fraction of what it would cost in the UK.

But the health chief said there was a “UK sensitivity issue” preventing more outsourcing.

NHS SBS is a joint public-private venture set up in 2005 to get the the best value-for-money by outsourcing NHS administrative functions such as finance, accounting and payroll.

It is tracking the finances of a third of NHS trusts, who are spending £31 billion annually.

A Department of Health spokesperson said NHS SBS initiatives had so far delivered savings of over £50 million, which had been reinvested in frontline patient care.

A spokesman said: “As elsewhere across Government, we are working to use purchasing power to get the best possible deal for the taxpayer. NHS Trusts and Foundation Trusts are seeking substantial procurement savings in their planned efficiency savings of up to £20bn over the next four years.”

From: http://www.independent.co.uk/nhs-wasting-1-billion-a-year-on-supplies

A service set up to enable millions of patients to email their GPs and access their Summary Care Records online has proved to be unwanted by the vast majority of potential users, according to a major new study.Academics from London found that instead of the 5-10% of the population that Connecting for Health predicted would sign up to the HealthSpace service, developed as part of the National Programme for IT, only 0.13% of those invited to take part got as far as activating the full functionality of their personal health record.

It was also predicted that patients would access use the HealthSpace service to access their Summary Care Records and notify their GP of errors, thereby driving up data quality in NHS medical records.

In fact, only 2,913 of 2.24 million patients invited to open an advanced HealthSpace account actually did so, and the research team did not find a single person who had accessed their Summary Care Record.

Research into trials of the service, published on BMJ.com, comes as the Government promises an ‘information revolution’ which will offer patients much more control over their records.

Professor Trisha Greenhalgh, from Barts and the London School of Medicine and Dentistry, who led the research covering uptake of HealthSpace from its release in 2007 until mid-2010, concludes in the report: ‘Unless personal electronic health records align closely with people’s attitudes, self-management practices, identified information needs and the wider care package, the risk that they will be abandoned or not adopted at all is substantial.’

She adds: ‘The findings raise questions about how eHealth programmes in England are developed and approved at policy level.’

Problems with HealthSpace uncovered by the researched included a complex registration process, a ‘clunky’ user interface and low levels of knowledge about, or interest in, the product from GPs and other healthcare staff.

HealthSpace’s future is already under review by the Treasury, with the Government increasingly looking for patients’ IT services to be developed by private providers.

Researchers said the recent emergence of rival products from commercial IT giants including Microsoft and Google raised serious questions about the place of a standard-issue personal health organiser from the NHS.

A Department of Health spokesman said: ‘Healthspace gives patients access to their Summary Care Record online and enables secure communication between clinicians and patients.

‘The UCL research has produced a historical snapshot, rather than insight into patients’ needs and expectations. Healthspace continues to be developed in response to those aspirations and the commitment to give patients, as well as clinicians, access to their Summary Care Record.’

From: http://www.pulsetoday.co.uk/story.asp?sectioncode=23&storycode=4127785

A new study to better understand what prevents people from using information technology to help them manage their health and care has found that few people have even heard of the three major NHS health information websites.
The study commissioned by Connecting for Health, looked at how social groups who may be excluded from electronic health information services used websites including health information website, NHS Choices, online health record, HealthSpace and health advice for those with learning disabilities, Easyhealth.

The report titled ‘Including Everyone in Electronic Health Information Services,’ states: “One of the most important findings of this study was that people had not heard of NHS Choices, HealthSpace and Easyhealth. This was even the case for people who had searched online for health information previously.”

The quantitative study by Raft, which interviewed 50 older people, people on low incomes and those with a learning disability from Bolton, Salford, Bury and Manchester, found that although few people had heard of NHS Choices and Easyhealth, participants were positive about the services when they were demonstrated to them.

However, some felt NHS Choices in particular was aimed at people that were newly diagnosed and could not help those who had had a condition for many years.

Others said that fear of health information, puts them off searching for health information “as a computer can’t reassure you if you’re frightened.”

In relation to HealthSpace, again, few participants had heard of the service including those in Bolton and Bury which are early adopters for the summary care record.

The reaction was mixed and found that it was “clear that most people would only wish to used certain functions of the website” such as the calendar function to help them remember hospitals appointments and the communicator.

Several added that they saw no advantage of seeing a record of medications or allergies when they already knew that they had them.

The report concludes that there is a high degree of trust in the information from the NHS websites which could usefully be used to promote the websites for effectively.

“Most people felt that leaflets and posters in GP surgeries and hospitals clinics would be suitable. Several people suggested the idea of TV advertising.”

The study also aimed to address those who had never accessed the internet, which amounts to 9.2 million people across England. It found that those who would consider learning wanted to do it as possible to home as possible in such as at home, community group they attended, GP surgery or hospital clinic.

Another finding was that although many people did not have access to computers or did not know how to use them, family members were able access the websites and provide the information.

The report recommends that “By promoting NHS websites to all computer uses, we can indirectly improve access to electronic health information for those people who do not use a computer.”

Marlene Winfield OBE, director for patient and public at CfH said: “This report is already helping CfH in the design and delivery of its products and services.

“It will we hope, contribute to the wider digital inclusion discussions taking place as a result of the current health whitepaper and the information strategy consultation that followed it.”

From: http://www.e-health-insider.com/major_nhs_public_websites_unheard_of

The NHS spends up to £86m a year on thousands of websites that are difficult to find, confusing for patients and which do not meet their needs, according to research commissioned for a Department of Health report.
Research for the NHS Digital Communications Review, conducted by communications agency Precedent and leaked to the Health Service Journal, found 2,873 nhs.uk websites that were in use and more than 1,000 other nhs.uk sites that were no longer active. A total of 287,300 web pages were accessible and Google listed 56 million pages within the nhs.uk domain.

The researchers concluded that the public would appreciate fewer contact points online but the digital communications review said there was not sufficiently strong evidence that there were too many NHS domains.

Instead the review said there was a need for a digital brand strategy with standards for all NHS sites. It said a central information role was “sound in principle but its adoption requires a general acceptance that it is the role of the centre to perform this organising function.”

EHI understands that the researchers suggested that the NHS may be spending too little on too many websites rather than too much.

The Precedent researchers said that two of most recognised health service websites, NHS Choices and NHS Direct, were often competing for attention and although NHS Choices focuses on health information and local service data and NHS Direct offers online diagnostic tools the differences in content between the two was not clear to patients.

They added: “NHS Choices and NHS Direct are both established as national sites with similarities of positioning, brand and audience. This confuses users about the ‘definitive’ access point for NHS information and the roles of each site.”

Research for the review also concluded that GP practices websites were also the weakest of the health service’s online offerings.

It added: “GP surgeries have by far and away the poorest sites, in that they have the largest percentage of problems identified. GP sites failed to provide the means to allow interaction with users.”

The researchers found that overall the NHS was failing to meet patients’ needs for online functionality such as online appointment booking, repeat prescription requesting, test result reporting and contact via email. Only 50.3% of sites included email addresses. “The NHS is not making itself easy to do business with,” the report said.

The research is also critical of the accessibility of websites and said that vulnerable members of the public were not been catered for with 30% of sites exhibiting at least one “notable deficit in standards” which might cover poor quality content, lack of NHS branding, poor navigation or out of date content.

The researchers said it was very difficult to estimate the cost to the NHS of the websites with responses to information on usage and cost received from only 188 out of 4,121 sites. However it estimated that the cost of running the sites “could be as high as £86m per year” and said costs could be higher as those figures did not include set up costs.

The digital review, however, said no broad conclusions could be drawn about value for money “given the relatively low cost of establishing and operating small, focused websites.”

The researchers claimed the public “struggled to locate the NHS online with a Google search” when searching on health-related terms and said the scale and depth of information on offer was daunting to many. It said patients also often ended up going to information offered by Wikipaedia, the charity sector and websites such as NetDoctor and PatientUK rather than the NHS.

The researchers said interviews with users revealed that the public wanted to see “one NHS” online which would tally with their perception that they were receiving care from “one NHS”.

The Department of Health said the white paper had outlined the government’s plan to being about an NHS information revolution to give people access to comprehensive, trustworthy and easy to understand information. Information on how this will be achieved is to be set out in the DH’s information strategy, due to be published in the autumn.

From: http://www.e-health-insider.com/nhs_%C3%82%C2%A386m_website_spend_confusing