Connecting for Health faces criticism over national IT programme

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.