NHS strategic health authorities (SHAs) and trusts in
London are reporting concerns about slippage in plans to deploy the
core IDX systems to "early adopter" sites.
The North Central London SHA's board minutes said it was expecting
"revised BT Capital Care Alliance deployment dates by end of July".
Connecting for Health (CfH) said this had not happened and
consultation with trusts and SHAs was currently taking place.
Barts and The London NHS Trust is due to be an early implementer of
IDX. Its board meeting in March heard, "Capital Care Alliance, the
local service provider for the electronic Care Record Service in
inner North East London, had announced a delay in the development
of the new computer system, which was due to go live at Barts and
The London in autumn 2005."
A spokeswoman for the trust said, "Barts and The London NHS Trust
remains on course to be an early implementer of the Care Record
Service. In consultation with Connecting for Health and Capital
Care Alliance, we are working towards implementing the system in
June 2006."
She would not say how the delay had affected the trust's IT support
and financing during the interim period.
One London trust has dropped out of the early adopter programme. A
spokeswoman for the Royal Marsden NHS Foundation Trust said, "The
implementation of the Capital Care Alliance/IDX system has been
deferred until later in the trust's IT programme, due to the
specialist nature of the trust's needs."
Such is the uncertainty over the delivery and funding of the
National Programme for IT (NPfIT) in London that another trust has
been reluctant to release local funds to implement it.
In March, St George's Healthcare NHS Trust identified a 1.86m
funding shortfall in implementing the NPfIT systems. However, it
decided to wait before releasing the funding. Board minutes from
the time say, "The cost model [from CfH] for staffing and funding
used may be flawed and is unproven. The confidence that the figures
are accurate is low. At present no trust has completed the initial
implementation so no-one has been able to identify the true costs.
The figures and numbers generated are indicative. Moving forward
now is effectively signing a blank cheque at a time when the trust
is managing a significant financial deficit."
In a statement to Computer Weekly, a trust spokesman said, "We are
committed to implementing the national solution. However, we
currently face a significant financial problem and we need to carry
out a full and thorough analysis of the costs and business benefits
of the project before funding can be approved.
"The 1.8m cost of implementing the Carecast package was a
projection based on a financial model provided by the NPfIT and we
will be looking closely at the experiences of the trailblazer sites
to develop a more accurate budget for implementation. In the
meantime, we continue to make preparations for delivery of the
software."
With no early adopters yet accepting the software, it is not clear
when the necessary experiences might be available to the trust. Yet
local funding may be critical to the success of the NPfIT. Although
the programme has spent 6.2bn on contracts, local trusts and SHAs
are still expected to fund some hardware and software, process
change management and training.
The issues raised by St George's could be repeated across the
country. In May, Anna Walker, chief executive of the Healthcare
Commission, highlighted a 500m financial deficit in trusts across
the country. In July, research from the Health Service Journal
showed a 750m funding shortfall at SHA level in England.
In the context of the budget of the NHS overall and the NPfIT in
particular, these might not seem like large amounts, but at trust
level they could have a significant impact on the deployment and
uptake of national systems.