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NHS IT schemes 'under-funded and over-ambitious', trust board is told

Tony Collins

A confidential paper issued to the board of the UK’s largest NHS trust says that new initiatives under the £12.4bn National Programme for IT (NPfIT) are “invariably under-funded and over-ambitious”.

It adds that the pressure on central Whitehall budgets has increased the transfer of costs to the NHS.

The paper to the board of Leeds Teaching Hospitals NHS Trust, obtained by Computer Weekly under the Freedom of Information Act, also includes praise for the NPfIT. It says that the electronic transfer of prescriptions to pharmacies and a broadband network are among key elements that are progressing well.

But the most important part of the NPfIT – a national care record which puts medical information on 50 million people in England onto central systems – has been scaled back, says the paper. The central system now “essentially covers only ¬allergies and recent GP prescribing”.

The NPfIT was launched in 2002. It was set up mainly to give 50 million people in England an electronic health record they could see and alter, and which would be accessible across the country by authorised clinicians. The other key parts of the scheme were e-prescriptions, a broadband network, and a system to allow GPs and patients to book hospital appointments online.

The lack of new patient administration systems means many trusts “will be unable to meet national e-booking targets and will struggle to meet other national policy requirements”. E-booking is a top ministerial priority for the NHS. The aim is to allow patients and doctors to book hospital appointments online during a visit to the GP.

The paper, by the trust’s director and deputy directors of informatics, also says that, since core software has been delayed, trusts are “increasingly looking to procure new patient administration systems outside the National Programme”.

With the creation of several large contractor conglomerates, “smaller often more innovative companies have struggled to survive”, it adds.

Local service providers “are not keeping up with the scale and complexity of the National Programme”. The paper describes some supplier offerings as “obsolescent”.

Connecting for Health, which runs the NPfIT, acknowledged that at this stage the care record will not contain any diagnoses or problems, but added that “ after evaluation of the early adopter activity, 2007/08 will see the gradual delivery of the NHS Summary Care Record system to GP practices across England”.

Connecting for Health also said, “While a handful of NHS trusts have, due to their own particular business needs, gone out to procure their own systems outside of the National Programme, they remain committed to the National Programme and we are in on-going dialogue with them to meet their clinical and business needs in the future and they are expected to join the programme in due course.”

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