Microsoft’s decision to end support for Windows XP in April next year looks set to cause significant problems for the NHS, which still has 85% of its desktops running on the obsolete operating system.
The scale of the XP challenge is revealed today in a report from EHI’s research arm, EHI Intelligence, which calculates that there are 677,000 computers across the health service that work on the OS, which was launched in October 2001.
By contrast, just 14% of the computers covered by the research (or 110,000) are running the Windows 7 OS that Microsoft introduced in October 2009, and just 1% (10,600) are using the newer Windows 8.
The report, which examines servers, networks, hardware, and mobile devices, finds that the NHS has a generally dated infrastructure, and a surprisingly large fleet of PCs for an organisation whose staff need to work on wards and across the community. But it has a particularly large problem with XP.
Senior analyst SA Mathieson suggested that this could be attributed to trusts investing in hardware in the early years of the National Programme for IT, the support provided by Microsoft’s Enterprise-wide Agreement with the NHS until 2010, and the large number of health applications that only run on the OS.
“This report shows that most NHS organisations invest in infrastructure and devices when times are good or they have a specific reason to do so, such as a new building or EPR project,” he said.
“In other circumstances, they tend to stick with what they have got. That certainly seems to be the case with XP, and it means many trusts are now facing a major headache given that Microsoft insists that it is going to end support for the system on 8 April next year.”
The problem facing the NHS is not, primarily, a licensing issue. In an interview with EHI, Neil Jordan, general manager, worldwide health for Microsoft, confirmed that the server, desktop and Office licences that the NHS bought under the EwA between 2001 and 2010 are perpetual licences.
They also entitle trusts to upgrade to the latest versions of Windows and Office covered by the deal at any time. However, trusts are likely to find the move expensive, since many will want to replace their PCs at the same time, and a big drain on their IT departments.
Some NHS IT directors interviewed for the Intelligence report seem to be hoping that Microsoft will change its mind or that a national solution will be found for the NHS.
However, Jordan emphasised to EHI that while trusts will be able to buy “bespoke” support packages from Microsoft, the company will stop producing security patches for the OS, potentially exposing its users to serious risk.
Jordan added that Microsoft is adopting a “stick and carrot” approach to shifting the NHS – and other major XP users – off the OS, with the carrots coming in the form of support for systems that work on the more modern versions of Windows and that support mobile working.
Mathieson said the ‘NHS IT infrastructure’ report showed there were similar opportunities for trusts and suppliers across the infrastructure, hardware and mobile market, with companies that can offer trusts compelling hardware management, mobile and data solutions likely to do well over the next few years.
“Politicians are focusing on improving the NHS’s electronic patient records, but these will only realise their potential with excellent IT infrastructure,” he added. “The best trusts and boards have realised they have to update both, and suppliers which can support this should reap rich rewards.”
Read the interview with Neil Jordan in Industry View.
© 2013 EHealth Media.
If only someone with a bit of vision could set up an NHS agency to develop and support an NHS desk top operating system based upon a LINUX core, and then offer the service to the entire NHS, or better fund it from some of the billions spent on the stupid NPfIT, we culd have a virtually free standard OS across the NHS. We could get rid of Exchange, CAL licences and the Office annual rip off. OK we would have some problems with .Net apps, but I sure we could get round those in time. But no vision, no backbone, just bend over and take it from Microsoft. Its a shame.
I agree one of the main issues is not having the correct deals with suppliers, however, there is an additional issue around getting these updates out into the workplace.
I've seen many Trusts struggling with the standard MS offerings, SCCM and the like, to deploy software and resorting to the 'Man with Flash Stick' approach. There are simpler more cost effective ways to perform these deployments and subsequent maintenance. My preference for some time has been OS Installer (http://http://www.osinstaller.com). Historically this has only been offered as part of a managed service however Centrality, maker of the software, (http://http://www.centrality.com) is now offering it as a standalone product which would suit most NHS organisations.
I readily admit to not getting Office 2007 products (especially excel 2003), the hassle of chasing a ribbon around dents my productivity no end.
As Jlscott says, not having a clause to ensure suppliers maintain and update software in-line with industry standards is pretty unforgivable. These are mistakes we make time after time after time. Surely some work on model contract clauses to be included in any NHS contract is long overdue.
Well, you might think so, but as usual the broad brush is a dangerous tool. In fact most of our contract clauses concern themselves with maintaining backwards compatibility rather than forwards. For example we were very concerned for a while that vendors would force us to move off IE7. Generally our desktop infrastructure etc is quite well behind the latest versions, and the reasons for not upgrading come down more to money (and of course whether it would be well spent that way even if we had it) than anything else. If we all had the money [and wanted to spend it that way], then we would be putting it in the contracts, hence we'd pay more for that service but we'd get what we asked for. It's just a market thing really, as we don't invest enough overall and actually deliberately slow the market. The software is off course a factor and I wouldn't disagree that this can be addressed. However, if vendors were coming to me saying our product now requires IE9 or whatever, I'd have a bigger problem. I don't actually need all the power of 64 bit and all the rest of it on the desktop. In fact, in a discussion recently, we concluded that most of our users could not really care less about the OS and they'd be perfectly happy if their machine booted up, green screen style, in to the application they use all day. Isn't this forced escalator of software something we should be trying to get off, rather than perpetuate? Cue open source debate :)
It's so easy for people outside of the NHS (and often armchair 'IT techies') to criticise the slow transition to Windows 7 and later versions of IE. True, there are things which could be done better. But the biggest obstacles are local and national apps which are not compatible with either Windows 7, 64bit or newer versions of IE. Quite often contracts neglect to include clauses to ensure the supplier will maintain and update their software in-line with industry standards. Local Trusts are then forced to implement workarounds or stump up lots of cash to make this problem go away.
I'm often appalled at how mickey-mouse a lot of expensive clinical systems from the big name companies actually are.
It's a mess which we have to deal with now, but should be able to avoid in the future, if the people responsible for contracting new systems ensure that they are relatively future-proof.
The real issue is that Microsoft forgot the first rule of software development - make each upgrade backward compatible. The result of 'redesign' or 'Revolution' is that there is an enormous training issue to implement beyond Windows XP to deal with any upgrade. For the NHS this may involve close to a million people. Many organisations in the NHS will justifiably want to avoid this. Is Microsoft foregoing its licence fees for the non-adopters?
Windows XP (32 bit) was the last version to offer fullscreen DOS emulation.
None of the 64 bit versions of Windows (XP, Vista, 7 or 8) run DOS apps or 16 bit apps (e.g. those written in Visual Basic 3) at all.
AFAIK you can't install/downgrade to Internet Explorer 6 in Vista, W7 or W8 nor is there a 'IE6 compatibility' mode in later Internet Explorers.
Access 2010 and later break many Access 2003 and earlier applications...
You can't run Office 2003 on Windows 8 - prepare to be cut to ribbons ;-)
The list goes on and on. To be fair it's not just the NHS caught with their pants down on this.
Bring on the virtual machines running 32 bit XP.
You will probably find a lot of PC's with a Windows 7 or 8 badge but have been blown away with a Windows XP image for reasons Caledonianmacbrains has stated. Unless a national solution is found, i.e. another EWA, I just cannot see how the NHS can afford the latest wave of Microsoft products. The sooner the NHS can get away from their Microsoft addiction the better.
I haven't read the EHI report, but there are two significant points which this article and the accompanying interview with Neil Jordan of Microsoft don't address:
1. Mr Jordan states that Windows 7 and 8 have been testing with "the NHS Spine", but my understanding is that a lot of national applications delivered by web struggle to work on the latest versions of Internet Explorer. So even if Trusts can upgrade Windows, they often have to downgrade the version of IE - either for national or locally-procured applications.
This may prevent them from taking advantage of the latest HTML5 compliant browsers, or require installation of another browser such as Chrome or Firefox.
2. And even if Trusts can upgrade Windows, a lot of health applications are only warranted on Windows 7 32-bit at present. Windows 7 32-bit has the same memory capacity limitation that XP does. This wipes out a key benefit of upgrading - the chance to utilise more than 4GB of RAM.
When I was last involved in spine matters, BT were going to deliver a version of the GemAuthenticate smartcard client which supported Windows 7, but only 32-bit. That was some time ago, so I'd be interested to hear the latest understanding from other posters.
I know of several innovative Trusts who are desperate to roll out newer operating systems but who are still stymied by these constraints.
The Identity Agent is no longer a blocker. There are some guys at HSCIC who have built a 64bit version of the BT agent, plus there's the in-house HSCIC agent developed in conjunction with Microsoft which is completely new and runs on Windows 7 and 8 both 32 and 64bit. All available here: http://nww.hscic.gov.uk/dir