NHS trusts rule out outsourcing and shared services options

Originally published in Kable government computing

Investigation for St George’s and Kingston NHS trusts finds their in-house IT services are more efficient than outsourcing.

A study commissioned by St George’s healthcare NHS trust and Kingston hospital NHS trust has found that outsourcing or adopting shared services for their IT services would not be beneficial.

The joint cost and performance benchmarking study was intended to identify opportunities for efficiency and performance improvement in the IT operations of the two trusts, which shared the same south London demographic community and work closely as part of a strategic partnership.

It was also designed to assess whether there was a case for outsourcing some or all of their information management and technology functions.

Anthony Brewer, the IT director at Kingston, said: “We needed to know if we were running as ‘lean and mean’ as we could be – both in our overall operations and within the various service teams and departments.

“We also felt it was time to revisit the outsourcing question, having concluded three years ago that it wasn’t cost-effective. According to the benchmark report this remains the case.”

The study, by ImprovIT, found that IT operations at both St George’s and Kingston were about 15% more efficient than the average for comparable trusts. In addition, it found that the two IT operations were considerably more efficient than an outsourcing alternative.

John-Jo Campbell, the director of IT at St George’s, said: “This kind of third party evidence was important in reassuring management that IT is delivering value for money. But I was also interested in having an external pair of eyes identify inefficiencies where they existed in the different departments and to offer advice on improvements.”

One area of improvement which the study recommends for St George’s is rationalisation of “incident categories”. The document says that narrowing the list down to fewer categories would streamline response management and reporting processes. According to the study, this would lead to an increase in efficiency and reduced costs.

With regard to shared services, the study says that although this could bring efficiencies in some areas, there were numerous complexities which makes benefits difficult to either determine or achieve.

It says that for shared services to be effective there needs to be a degree of similarity in the systems, processes, priorities and time scales. Although the trusts use the same e-patient record platform, Cerner Millenniun, there are also significant differences in the way systems have been implemented and are managed and maintained, which reduces the level of benefit that might be achieved.

“Take IT maintenance in clinics; St George’s provides clinic support from within its operational divisions, whereas Kingston has a central team,” said Brewer.

“It would require a large upfront investment to reconfigure our infrastructures and methodologies in order to share this service. So, at least in the short term, it isn’t worth it.”

In a statement to Government Computing, Brewer said that Kingston is using the results of the study to put together service improvement plans, which it is currently working on.

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