2012 has been a milestone year for NHS IT culture. Various commentators from across the clinical, IT and informatics spectrum have campaigned successfully to establish open standards, open data and open source as the central pillars of any new NHS-wide initiative.
But there is a still a long haul ahead in terms of getting these new values and themes to be adopted in the systems being purchased and installed across the NHS and there is always the problem of how to deal with the anti-open cultures of installed legacy systems across the NHS.
With the Labour Government's Choose and Book, Spine and GPSOC contracts coming up for renewal and other initiatives like the Child Protection Database and Southern cluster GP system being revived, - whilst ministers will be keen to see new Cabinet Office values adhered to, they will be even keener get stuff delivered without embarassment and before the next election.
Delivering the new values is a slow moving cultural change, led by clinical colleagues on the ground in hospitals with the right kind of challenges, not easily met by the products of the siloed age.
It must be frustrating for NHS IT leaders, who feel unable to lead this change themselves. But holding back and giving clinical users the reins is precisely the right thing to do, if we are to avoid IT slipping back into the bureaucratic abyss of the last decade.
Given this back seat role, NHS IT leaders and professionals have a vital role in educating and empowering our GPs, nurses, surgeons, physiotherapists, anaesthetists to become involved in the procurement process. But this education cannot be delivered without a reward in sight.
That's why I believe embedding Hackdays in the procurement process is so important. Its the only way to make sure that Openness and Innovation gets traction in this highly potent market for the UK economy.
But the urgent and often desperate need for governments to 'deliver' and see rapid evidence of action is often a threat to openness and innovation. The values and themes so carefully architected in Cabinet Office are all too easily overrun and ditched in favour of 'quick wins'.
How can we be sure that we won't trade Openness and Innovation for top down control and short term popularity - and a repeat of the mistakes made in the NPfIT era?. I really do hope that this need for quick solutions is addressed with openness rather than the secret deals that continue to haunt NHS IT, and meanwhile I'll keep an eye out for the next tender.