Tony Collins's IT Projects Blog

A new national database of confidential patient records is being opened to access by NHS staff who need no professional qualifications – despite official assurances that access to the summary care record will be provided only to specialists who are providing care or treatment.

Documents obtained by Computer Weekly under the Freedom of Information Act also provide evidence that NHS Connecting for Health – which runs part of the £12.4bn National Programme for IT [NPfIT] – has quietly decided to weaken assurances given to patients about the confidentiality of records.

An article in Computer Weekly, which disclosed that NHS staff can, without the need for professional qualifications, access the national summary care records database, was discussed by GP Paul Cundy on BBC Radio 4's Today programme this morning [3 March 2008]

In a speech yesterday [6 March 2008] the Home Secretary Jacqui Smith announced a revised timetable for ID cards – as if ministerial predictions on IT-based projects have a profound meaning.

How did the 1689 Bill of Rights come to be at the centre of a High Court case last week about Gateway reviews and the ID Cards scheme?

The case was brought on behalf of the government by the Treasury's Office of Government Commerce, which runs the Gateway review process. It was appealing a decision of the Information Tribunal that two Gateway zero reviews on ID Cards should be published. The 1689 Bill of Rights was cited by the OGC as part of its case that the Information Tribunal was wrong in the way it reached its decision.

Even the office of the Speaker of the House of Commons was represented in the High Court. The arguments put forward by Martin Chamberlain, the Speaker's representative, had the effect of supporting the government's appeal. If the case put by the OGC and the office of the Speaker over the 1689 Bill of Rights is accepted by the judge, Mr Justice Stanley Burnton, the Information Tribunal may have to reconsider its finding.

These are the events leading up to the High Court case last week and some of the main points made during the hearing.

BBC Radio 4's Today programme broadcast an item this week [10 March 2008 - 6.50am] on our article about the Office of Government Commerce's appeal to the High Court over a ruling of the Information Tribunal that early Gateway reviews on ID Cards should be published.

Co-presenter John Humphrys began the item by saying:

"The government does not want us to know how its big IT projects are going. It’s using an ancient law to keep these massive projects, most recently ID Cards, from public view..."

Spending on the NHS’s national IT scheme up to April 2007 was £1.5bn less than the Department of Health had expected, according to figures released by the government yesterday [13 March 2008].

The reduced spend on the main IT contracts under the National Programme for IT - NPfIT - was largely because of delays in the delivery of new systems. BT, CSC and Fujitsu, the local service providers to the NPfIT, are paid mainly when they meet milestones and have systems accepted by trusts.

Comment:

At a press conference in Whitehall last week [13 March 2008] doctors who work on different parts of the NHS’s National Programme for IT – NPfIT – flanked the health minister Ben Bradshaw.

Their repeated use of the word “exciting” to refer to the NPfIT or their work on it reinforced the impression that the programme has become politicized.

Richard Jeavons, senior responsible owner for service implementation on the NHS National Programme for IT - NPfIT – has affirmed his team’s commitment to the “Lorenzo” product from suppliers CSC and IBA Health

He has indicated that his team will stand by the product whatever happens.

Papers released by Bolton Primary Care Trust under the Freedom of Information highlight some of the lessons learned from its trial of the NPfIT summary care records system.

Martyn Thomas, visiting professor of software engineering at Oxford University's Computing Laboratory, has expressed concerns about the leaflet that's being given to patients who want to opt out of having their medical details to a summary care record.

He said:

"Opting out leaves patients with the same level of risk that they have currently, and the new summary care record introduces new risks: for example, that the information will be wrong or assumed to be complete when it isn't (most databases have a high proportion of incorrect data), that details of your medical history will be seen by people who should not have seen it, and that vulnerable people will be forced to reveal details of their medical history (by being compelled to log in to their HealthSpace website).

- NPfIT clinical director says opting out of national database of summary care records could be more prejudicial to health than not having a smear test

- GP IT spokesman says leaflet being sent to patients who want to opt out of summary care record is “alarmist”

- More than 250,000 patients may opt-out of summary care records on basis of today's numbers

A study of the Prison Service’s database of prisoner records has found thousands of omissions and inaccuracies, including the use of “self-harm” or no entry at all in the surname field.

Prison Service and IT staff are trying to correct errors in the networked Local Inmate Database System [Lids] - which holds records on more than 80,000 prisoners - after the Service's IT supplier EDS discovered that thousands of records contained incorrect information or data was incomplete or missing.

About thirty thousand offenders - 37% of the total in the database - did not have a criminal records number, and more than 21,000 - 26% of the total - did not have a police national computer number. The system provides information on transfers of offenders to and from prison, and records their risk rating.

The omission of information in Lids was criticised in an official report into the murder of Zahid Mubarek at Feltham Young Offenders' Institution in the early hours of 21 March 2000.

Compass, which helps users of outsourcing check whether they are paying market prices, is warning the government that public sector outsourcing is costing up to 75% over the market rate.

The company has public sector clients among its customers and so has an “insider’s” view of outsourcing pricing.

Officials at NHS Connecting for Health answer most media inquiries – but they have not yet replied to questions about a little-noticed speech in the House of Commons by the health minister Ben Bradshaw on 21 February 2008.

In a debate on the Health Committee’s report on electronic health records, Bradshaw cleared suppliers to the National Programme for IT – NPfIT – of any responsibility for delays. He told the House of Commons that the delays have not been because of problems with supply, delivery or systems.