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Sunday 27th May 2018

Crises and crossroads

6th February 2007

Lord Hunt is back in the driving seat of the NHS IT programme, signalling the likely return to performance management. But is devolving responsibility down to local level now really the answer?


While the national NHS IT programme might fade but the vision remains.

1998 heralded the launch of the Information for Health and with it the NHS Information Authority. Trusts were left to choose the system that suited them and met the infrastructure and the targets set by the authority.

Four years later, most of the targets fell by the wayside blamed on everything from lack of cash to issues of data cleansing and migration and a fragmented NHS IT market unable to keep up with the needs.

The answer was in creating the current programme with a national procurement system, one which has delivered some success, BT says it is on course to deliver all 18,000 connections to the new N3 broadband network by its March 2007 target.

Progress, if slow, has been made in creating the NHS ‘Spine’ care records service, electronic prescriptions and the choose and book scheme is expected to miss its latest availability target in March.

But PAS is a different story: the patient administration and clinical systems have caused real problems, failing to provide the local bookend to Spine. Trusts are also less willing to use the national suppliers iSoft and Cerner, allowing some local procurement.

All this has prompted expectations that the national programme will entirely step back to allow trusts to set up their IT in line with their guidance and infrastructure, rather than their suppliers.

‘One thing is absolutely certain: if that is the intention, nobody is going to admit it or provide the programme's critics with an end point to tally up its successes and failures,’ she writes.

A shift in power is noticeable in the NHS operating framework for 2007-08, which talks about vision, and calls for IT plans to be submitted by all provider trusts by March.

These plans, she writes, will really show how much the national programme is changing.

Experts have plenty to say on what change should happen, agreeing with a national standards and local procurement model. Some call for it to be more ‘rigorously aligned’ with NHS reforms, while others want a rethink over the care records service.

As the first pilot sites start work on the summary care records, the controversy is unlikely to go away any time soon, with campaigners arguing for an opt-in scheme rather than the opt-out favoured by the government.

The announcement of the pilot sites for the summary care record will bring the national IT programme back into the public eye. So will the resumption of high-level investigations into its effectiveness.

And with the Commons health select committee expected to announce the terms of an inquiry into 'aspects of NHS IT', the programme is unlikely to disappear of our radar anytime soon.

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