Connecting for Health, which runs much of the NHS's £12.4bn
National Programme for IT (NPfIT), is expected to come under strong
criticism in a report commissioned by the government into the
progress of online health records.
The study by researchers at University College, London, is also
expected to highlight criticisms of the government by executives at
Connecting for Health.
Connecting for Health (CfH) pushed primary care trusts to
implement the summary care record, despite the immaturity of the
technical solutions, the report is expected to reveal.
The study analyses the first go-lives of the national summary
care record system, a key part of the NPfIT was designed to give 50
million people in England an online summary health record including
allergies and medications.
Staff implementing the project said they had been asked to meet
unrealistic deadlines. Local NHS project leaders struggled to
reconcile political timescales with making the technology work
properly. And although some GPs embraced the scheme others believed
they had been coerced into it.
One primary care trust informant described the command and
control structure at CfH as bullying while other staff told
researchers they were highly stressed, working far beyond their
contracted hours.
The report, scheduled for release on Tuesday, is expected to
show the lengths to which health officials were prepared to go to
convey the right message to the public on the summary care record
programme.
A mass mailing letter to explain the benefits of the summary
care record to patients went through 93 versions before it was
sent. In the event there was little public interest in the
letter.
Patients who took part in early trials were given the chance to
opt out of having their medical details on allergies and
medications uploaded to a central database. But health officials
paid for GP surgeries to have large plasma screens in their waiting
rooms to show the benefits of the summary care record.
In what researchers considered an Orwellian scene, health
officials equipped one GP surgery's waiting room to show a
PowerPoint presentation on a continuous loop to describe the
benefits of the summary care records to patients. A GP at the
practice said it had no control over the content of the display
which was “apparently ours for life”.
The researchers found that CfH had an internal organisation set
up to document and disseminate the benefits from the summary care
record but had no equivalent department to do the same on
“dis-benefits” and risks of the project.
Whitehall officials collected information from NHS trusts about
their progress and problems rolling out the summary care records.
But knowledge failed to circulate efficiently and most staff at
primary care trusts said they had not learnt much from other
early-adopter sites.
CfH is itself a victim of pressure from the government to meet
tight timescales and accelerate progress under the NPfIT. The
report is likely to say that politicians will need to recognise
that it is impossible for CfH to go beyond the technology. It
cannot help the NHS make changes in working practices and habits
while also adhering strictly to predefined goals and
milestones.
NHS CfH, which employs 1,500 people, paid for the study of
go-lives of the summary care record programme at Bolton, Bury,
South Birmingham and Dorset.
The report into the progress and problems of the “early-adopter”
go-lives of the summary care record is expected to recommend
changes to the way CfH is run and to highlight cultural problems
that will be harder to fix.
The Department of Health is recruiting two executives - a CIO,
and a Director of Programme and System Delivery to run the NPfIT,
on salaries of at least £200,000 each. The new CIO will have an
annual budget of £1.6bn.
CfH made no comment.
For more details see
Tony Collins'
IT Projects blog.