How open source can bring NHS IT back to the future

Open source has the power to revolutionise the NHS, but it's an issue of confidence

In many respects open source software is not really understood within healthcare. A lot of people hear about it and imagine a teenager who downloaded a piece of code off the Internet. The lack of control and ownership of the code is seen as a risk to clinical safety. And they would be right if that were the case.

But the open source approach in the NHS is not new. In the 80s and early 90s, the health service used to write its own software, just as open source programmers are doing now. In-house programmers spoke to clinical and administrative colleagues, and developed software that would help them deliver more efficient care.

Back then, teams ran a fully-integrated suite of systems. These were well-received, and are still used today by some organisations. I recall the South West Information Team writing a patient administration system (PAS) for the whole of the South West of England imagine the time, effort and cost associated with that type of project today.

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Somewhere along the line the NHS lost confidence and belief that it could do this in-house and began contracting out IT development. The start of the 21st century saw software suppliers working alongside clinicians but this approach had its limitations. Any IT functionality developed would be sold back to individual trust by suppliers rather than shared for the wider benefit of the NHS. The result? IT costs soar and trusts are unable to combine or promote best practice of technology projects.

Same problems, different solutions

As a taxpayer and an NHS employee I realise that every penny is precious. Healthier lifestyles and better drugs means our population lives longer, and we do not have sufficient funding to help manage long-term complex conditions. We either need more investment, or have to make better use of current resources.

IT is just one area of healthcare that needs more money. What can we do as an IT department to overcome this challenge? Think outside the box. PAS systems from the mid-90s worked for a fraction of the cost compared with todays market. They were affordable systems that delivered results. How can we achieve this now?

Funding bids can help with purchasing technology, but the recent Integrated Care Digital Record bid process highlighted some downsides. Having been through a bidding process and advised that the open source programme was one of the key priorities for the NHS, we then heard nothing for months which makes it very hard for trusts to plan their finances in already difficult circumstances. But thanks to the affordability of open source, we can still press ahead with our open source EPR project.

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How open source can bring NHS IT back to the future