CfH to fund NHS clinician trips to India and USA

NHS Connecting for Health is urgently looking for experienced NHS clinicians, interested in ensuring that NHS IT systems are fit for purpose, to be flown out and work on assignment with clinical software developers in India or the United States.

Both of the brand new clinical systems that Connecting for Health has contracted to be delivered, Lorenzo from iSOFT and Carecast from IDX, are being written from scratch overseas by software developers with little or no immediate experience of the English NHS.

The hope is that the inevitable problems that arise in remotely developing these systems to meet the particular requirements of the NHS can be more quickly overcome if NHS clinicians are on hand to advise. CfH says that it plans to fund a permanent presence of NHS clinicians at the two software development sites on a rotating basis.

In a note last week to staff involved in the project Dr Gillian Braunold, CfH clinical lead, says: "There is an immediate need by NHS Connecting for Health to find experienced NHS clinicians (open to all Clinicians, not just Doctors) to travel to Hyderabad in India and Seattle in the USA for several weeks."

Dr Braunold told EHI that she did not have a number of clinicians in mind, but it would be "less than 100". Only a few clinicians would be taken over at a time, she added, and the requirement was mostly for clinicians "other than GPs".

She stressed that it was a requirement in the contracts that suppliers "make sure their product is fit for purpose". Dr Braunold added that the contracts also say "CfH will supply NHS experience. It’s a contractual requirement".

She said the note, seen by EHI, was sent out to 600 clinical staff who had expressed an interest in becoming involved in the project. In it Dr Braunold explains that the intention is that clinicians will be able to advise software developers in Seattle, home of IDX; and Hyderabad, home of iSOFT’s development team, "on the workings of the NHS and to resolve misunderstandings if they arise".

Additional guidance provided says that the aim is to shorten the time taken for development. "Such a presence will enable the Authority [CfH] to provide NHS knowledge and understanding and help inform the software development and defect resolution and speed up information flows back to CfH."

Initial commitments of two weeks, followed by another two weeks within a few months are being sought. The CfH guidance says that it is expected that clinicians will work with the software provider their local service provider has contracted with, though individual preferences will be catered for.

There is no mention of volunteers being sought from the South of England to guide software development in Kansas City, home of Cerner, which is expected to provide its Millennium software to LSP Fujitsu for the South of England.

Dr Braunold told EHI that she had recently returned from a visit to iSOFT’s development centre in Chennai, India. Asked how the GP component of iSOFT’s Lorenzo product was shaping up she said: "It’s a big product that we’ve got to get right".

Pressed to expand on how close Lorenzo was to being ready, she added: "I’ve seen a product in development that has a lot of promise, but it’s in development and lots of work will be needed before its ready for GPs desktops."

The CfH guidance says that one of the jobs the volunteers will perform, will be "to gain an understanding of progress in each of the locations and during their assignment provide CfH with an objective assessment of progress, problems and issues".

Problems with remotely trying to develop or rewrite clinical software to meet the needs of the NHS have often been experienced in previous NHS IT projects. Anglicising IDX’s Carecast system from Seattle was identified by University College London Hospitals NHS Foundation Trust (UCLH) as contributing to delays in its deployment of the system. UCLH successfully went live with the first phase of Carecast in June.