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NPfIT ignored NHS culture, says Halligan

Leadership and teamwork needed

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One of the founders of the NHS National Programme for IT has told HC2010 that it failed to understand that "culture eats strategy for breakfast".

Professor Aidan Halligan, who now works in senior roles at University College London Hospitals (UCLH) and Brighton and Sussex University Hospitals, said that the programme has been too top-down, ignoring the views of doctors and nurses.

"Those people run our health service. We did not engage with front line staff," he told a keynote session at the conference in Birmingham on 28 April 2010.

When asked by SmartHealthcare.com what he would do if the next prime minister put him in charge of informatics in England, Halligan replied: "I'd say, the culture eats strategy for breakfast, prime minister, and unless we start from the bottom-up rather than the top-down this time, it will not work. And by the way, prime minister, it needs to work."

He added that there were three things the health service required: "Leadership, leadership and leadership," adding that the two trusts he works for are learning from the military how to build this quality in their managers.

Halligan said that the NHS had received too much money in the last decade. "Bring on the recession, is what I say. We've had too much of it," with high levels of funding allowing the introduction of new projects without fundamental rethinks of how things work. "There will be more change in healthcare in the next five years than in the last 10," he said, adding: "IT will be at the heart of it."

Information will be vital due to the explosion in knowledge, meaning no single person can know everything relevant, Halligan told the audience. When he was trained, senior professionals were taught to be self-reliant and trust only themselves: "We weren't trained to work in teams. We weren't trained to lead." But in future, this will be essential.

Halligan described a technique which UCLH and Brighton are using to improve team working. Staff undergo simulations in mocked-up wards equipped with CCTV cameras, letting them review and analyse the way they work together. 1,500 staff from the two trusts having used the facility so far.

"Good teamwork reduces mortality in surgery by 40 per cent," he said. "Bullying and harassment have been managed out" among the 750 surgery staff who have gone through the programme.

This article was originally published at Kable.

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