Intended for healthcare professionals

Rapid response to:


Failing IT infrastructure is undermining safe healthcare in the NHS

BMJ 2022; 379 doi: (Published 09 November 2022) Cite this as: BMJ 2022;379:e073166

Rapid Response:

A self-respecting software engineer wouldn’t go near this mess

Dear Editor

Zhang et al do a good job of identifying the causes of NHS IT failures - chronic lack of investment and a growing disconnect between government ambitions and reality. The solutions they offer however miss the point, the biggest issue is the ugly patchwork of software packages, local hardware and departments with overlapping and duplicated responsibilities. No technology company would structure its infrastructure the way the NHS does, and no number of quality improvement cycles or “carrot and stick” targets can convert what we currently have into a coherent system.

What’s needed is some more joined-up thinking - consolidating IT services regionally instead of per-hospital would be a start. This would allow trusts to share staff and resources, expand the most reliable systems and processes across multiple sites, and ultimately make the NHS a more attractive place for IT professionals to work. I know for sure I wouldn’t want to in its current state.

Competing interests: No competing interests

23 November 2022
Duncan White
Former Software Engineer and Doctor in General Medicine