The NHS Confederation, which represents more than 90% of statutory health service organisations, has expressed concerns to the House of Commons’ Health Committee about aspects of the National Programme for IT [NPfIT] in the NHS.
In a paper to the committee, which is investigating aspects of the NPfIT, the NHS Confederation said that organisations continue to be “fully committed to the overall vision” of a Care Records Service” which aims to give 50 million people in England an electronic health record.
But it said that “delays in the delivery of key operational systems which feed the NHS Care Records Service, such as patient administration systems, are “causing real problems and costs within the service”.
Says the paper:
“Delivery of the Care Records Service is wholly dependent on the availability of the key feeder systems such as hospital patient administration systems (PAS). The deliverability of these key systems has been, to say the least, disappointing. Many Trusts are having to extend contracts on existing and outdated PAS, deploying patches and fixes to maintain required functionality”.
The Confederation adds that feedback from its members indicates that there is a “persistent feeling of disconnect with the National Programme”.
Says the paper:
“At a local level members are concentrating on the local deployment of systems as they become available under the National programme. They are not at all clear on either the content or the progress of [the] NHS Care Records Service. They do not see it is a component that they own or have any particular responsibility for. As a result their commitment to NCRS is somewhat limited. This affects their ability to be advocates for the initiative both within their organisations and with the wider public.”
The NHS Confederation also says that many IM & T managers in the NHS “see that, based on their understanding of what is to be held on the NHS Care Records Service, the programme is too ambitious in its scope and that the architecture is over-complex”.
“Many are unconvinced that the balance between what is held centrally and what is held locally may not be appropriate. Concern has been voiced that the amount of clinical information really required for a patient who is treated physically away from their usual address is minimal and restricted to allergies and high risk factors.
“The view is that restricting the national database to only these items would both aid the implementation and reassure patients around the confidentiality issue. The concern is that the range of clinical indicators to be held at national level is likely to grow and that this itself will undermine public confidence in the security of their personal information.”