Rethinking NHS networking

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Abstract
The government white paper The New NHS , published in December 1997,1 reaffirmed the NHS Executive's commitment to an NHS-wide electronic network. The network was originally conceived in essentially administrative terms, but it is now to be used to support clinical work. Now is therefore a good time to consider the future direction of NHS networking. This article focuses on the economic and political issues of electronic networks in primary care and considers two questions. Firstly, can the benefits of networks outweigh the costs, or are they simply poor investments? Secondly, if a case can be made, then what problems will need to be addressed in the new networking strategy? #### Summary points The NHS computer network, NHSnet, was originally oriented towards administration but is now to be designed to support clinical work It is possible to construct a positive case for a large scale network for healthcare settings, based mainly on economic arguments It is also possible to identify conditions that need to be met before the positive case can be translated into reality Some of these conditions could be met in the near future, but others will require changes in attitudes and values that will have to be tackled in the longer term Assessment of the chances of success of an NHS-wide network is hampered by a lack of empirical evidence about the costs and benefits of networks in health care Implementation of the 1992 information management and technology strategy2 was slower than the NHS Executive originally hoped. 3 4 Concern has been expressed about elements of the strategy, notably about data security5 and the failure to show that the investments made to date have been worth while.6 It has been claimed that the strategy will save £100m a year,7 but after five years there is …