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The National Health Service IT Programme

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Describe about a local sociotechnical design approach to exploiting the potential of The National Health Service IT Programme NHSIP?


1. Introduction:

The article which is reviewed in present assignment deals with analysis of NPfIT (national program for Information Technology for national health services). Health ministry of the UK government undertook NPfIT with the intention of increasing use of different computer applications in all sectors of health services (, 2011). The assignment also contains critical evaluation of the theories   which are suggested by author in article.

2. Overview of the article:

In first part of the article author discussed the nature of NPfIT. The first part also deals with analysis of the background for this program. The whole project was completed by consortia. Members of these consortia were responsible for different tasks in the programs including project management IT supply consultancy services etc. Before implementation of the program, hospitals of UK were responsible for purchasing their own computer systems. However these organizations fail to share data among them as there was no centralized system for data sharing.  It increased the complexity in heath care management, Due to absence of any centralized system; the consistency of health care service quality was also being hampered (Hackett, 2009). Thus the Government felt more difficulty while providing health services to people.  The project primarily aimed at creation of a centralized system in the health sector of UK. While   initiating the   project, it was   considered as one of the major IT infrastructure development project of UK. However, completion of this task leads to significant changes in socio technological practices. Although the task of implementing a centralized process in health sector of UK as not easy, the project was successfully completed. After completion of the project the Government of UK succeeded to standardize the heath care practices. Organizations in Healthcare sector also become able to share data among them. As the process of data sharing became easy, overall quality of health care related services improved significantly.

Execution of the project was challenging as it opposed the conventional theories of socio technological practices. In case of this project, the traditional heath care organizations required adapting the new IT infrastructure.

Second part of the article deals with analysis of the approaches which were adapted by UK government for bringing change in health care sector of the country. In this article   implementation of new IT infrastructure   in health services are described as an implementation of Push strategy for socio technological changes. The author discussed on Pull strategy while describing use of new systems in hospitals. On basis of the analysis, the author suggested a local design approach of implementing socio technological changes. Last part of the   article deals with analysis of this hybrid strategy and its effectiveness for implementing major changes.


4. Critical Evaluation of theories:

According to Lyonnet and Toscano, (2012) implementation of push strategy for bringing changes in a system sometimes fails to meet requirements of each part of the system. Mano, (2014) also  opines that modification of a large system  using Push approach is  not effective  as  the  users of new  system  do not get  opportunity  of getting  involved with the strategy development process.  However Hackett (2009) opines that use of push approach while changing social systems ensures delivery of standardized outcomes.   It indicates that  use of  Push strategy  for implementing  IT  system in  health sector  can enable the government  to  standardize the services However use of this approach is not effective for meeting the requirements of each hospital and thus its effectiveness   reduces.

Use of push strategy can lead to partial use of systems by health care organizations as all parts of the new system may not be required by a hospital (Pires, 2015). Such problems can be minimized by using pull strategy. Use of pull strategy ensures that   the requirement of each udders of the new system is fulfilled (Lyonnet and Toscano, 2012). However it may not be effective in case of health care sector as meeting   all requirements of each hospital in UK will lead to significant increase in cost of system implementation.  According to the author development of a hybrid approach combining push and pull strategy can be beneficial for healthcare systems. Use of local designing approach will engage local planning groups for developing their strategies required for implementing new infrastructure (Eason, 2005). Thus the new system will be able to meet requirements of each stakeholder. The    proposed approach will allow   the new system for being implemented in phases. It enables the stakeholders to understand whether the system is suitable for organization or not.

5. Conclusion:

Analysis of the theories mentioned in current article indicates that implementation of local designing approach can reduce the problems regarding partial use of new system. This approach is also effective for modifying the new system according to the need of each stake holder. However, in UK needs of  hospitals are  almost similar  but  the process of  implementation  of new  system  requires  being  different. It indicates that the local designing approach can be modified further.



Eason K. D. (2005)‘Exploiting the potential of the NPfIT: a local design approach’ British

Journal of Healthcare Computing and & Information Management ,22 (7) ,14 -16., (2011). Dismantling the NHS National Programme for IT - Press releases - GOV.UK. [online] Available at: [Accessed 13 Mar. 2015].

Hackett, J. (2009). Is NPfIT for purpose?. Bulletin of The Royal College of Surgeons of England, 91(1), pp.16-17.

Lyonnet, B. and Toscano, R. (2012). Towards an adapted lean system – a push-pull manufacturing strategy. Production Planning & Control, 25(4), pp.346-354.

Mano, R. (2014). Online health information, situational effects and health changes among e-patients in Israel: A ‘push/pull’ perspective. Health Expectations, p.n/a-n/a.

Pires, S. (2015). Promising Approaches for Behavioral Health Services to Children and Adolescents and Their Families in Managed Care Systems. [online] Available at: [Accessed 13 Mar. 2015].


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