The Government has announced an £851m boost for health service IT funding, alongside a raft of new and revised project deadlines and national technical standards.
The strategy, Building the Information Core - Implementing the NHS Plan, is designed to integrate disparate information systems across the service and make it more efficient.
But the strategy sets targets based on projects that have not been evaluated and allows the further slippage of deadlines for troubled, long-running projects like NHSNet and the implementation of computerised clinical terms.
The document confirmed that the NHS will standardise on Internet technology and SMTP for e-mail, XML for clinical messaging, and that the Read Codes for clinical terminology will be replaced with the US Snomed system.
New deadlines were outlined for the implementation of electronic patient records. And plans to develop a public key infrastructure - to be available for use across the NHS by 2002 - addressed security concerns.
Justin Keen, research fellow at the Kingcew's Fund independent NHS think tank, said much uncertainty remains. "Everything depends on the decisions made as a result of the pilot projects now underway," he said. The results of crucial studies into electronic patient records will not be available until September.
In many areas the Government has failed to specify how IT professionals will move systems from old specifications to new standards. By April 2003 Read code systems will be scrapped, "subject to successful development and testing" of alternatives. Experts remain sceptical over this deadline.
Meanwhile, NHSNet will continue to implement the X.400 messaging standard, even though the Government has said that SMTP is the technology of the future. Similarly, EDI data messaging technology, rather than XML-based systems, is still being rolled out. Launching the new strategy, health secretary Alan Milburn was candid about the state of NHS IT. "For too long the NHS has thought of IT in isolation. Something that is not a priority for patient care and health services. Let us set this right,"
he said. His admission follows enormous spending on NHS IT and the promise of more to come. In the three years to March 2001 some £1.5bn will have been allocated to NHS IT, with an additional £851m over and above annual NHS spending earmarked to 2004.
Healthcare IT professionals have welcomed the extra funding and the move to new global standards, but have been left confused and demoralised by the flood of new deadlines.
According to one IT manager at a large teaching hospital, electronic patient records, a cornerstone of Government NHS IT strategy, are "a pig to implement", while senior strategists at the NHS told Computer Weekly that the timetable outlined in the document was impossible to meet.
The Government has not said how the NHS will recruit the skills to complete these projects. Health IT consultant Neil Spencer Jones said, "There is a horrendous lack of IT skills in health. Salaries are half what they are in the private sector and people inevitably move."
The target to have 95% of GP practices connected to NHSNet by the end of March was dismissed by John Locksley, a GP and committee member of the Torex User Group, who pointed out that having a connection was not the same as being able to use the system.
"The document pushes back targets for things that should have been done four years ago. NHSNet is not secure. I can't even e-mail consultants in the local hospitals," he said.
Health minister Gisela Stuart defended the £2.3bn NHS IT spend. "There is a lot to do in terms of infrastructure building and agreeing standards," she said.