NHS Confederation: we need NPfIT cash but spent differently

“There’s a real hazard of doing [with the NPfIT] what we did with Concorde” – NHS Confederation

John Humphrys, a presenter of BBC R4’s “Today” programme, this morning interviewed Nigel Edwards, Director of Policy at the NHS Confederation, about a report of the Public Accounts Committee on the National Programme for IT.

Some of the points made by Edwards were a touch contradictory but that was probably because Humphrys was looking for simple answers to difficult questions. That’s his job.
Edwards made it clear that he and the Confederation support the idea of an e-record, but he also spoke of pessimism among members of the NHS Confederation over the future of the NPfIT Care Records Service. The NHS Confederation represents 90% of NHS organisations.

Humphrys: Did your organisation, the NHS Confederation, want this computer system?

Edwards: You can’t do modern healthcare without a computer system. It would be like trying to do healthcare without telephones. The benefits from having an integrated electronic record in terms of the quality of care you can give is really indisputable. You do need the system. The big question is: is it best done nationally as part of a very big programme or is it better done locally but making sure that the bits that are put in place locally all fit together and talk to each other.”

Humphrys: This is a national system?

Edwards; This is a very big national system. Bits of it –

Humphrys: So you didn’t want it?

Edwards: Bits of it are working well. The real controversy is over the Care Records system which is at the heart of the [NPfIT]. That’s the record of each individual patient and it’s the lifeblood of IT in hospitals and primary care. That’s the bit that you need to work. There are bits around it like email and e-prescribing which are working quite well. But the real concern – and I think among the people I represent growing pessimism – that this central bit, the Care Records system, will actually deliver on time.

Humphrys: And what that would mean, presumably, is that if I had a heart attack in Manchester and they rush me into hospital, they could key in my name and they would see that I was a patient of a GP in London and these were the problems – that sort of stuff?

Edwards: The government and the previous prime minister got very excited about that. In fact the real benefit is much more about your local care. It’s [so that] your GP, your hospital consultant, the x-ray department – and the x-ray bit of this is working well – can all talk to each other; so [that] we can make sure that drugs you get don’t interact with each other. We can get much better at managing your care in an integrated way because what goes with a lot of healthcare is that people fall through the gaps between different bits of the system. Getting that right is really important.

Humphrys: Given the problems that we now know – and have known for a while – that this huge centralized system has, do you, the NHS Confederation, say that that has to be abandoned?

Edwards: If you’d asked us a year ago we’d have said: ‘it looks like we’re turning a corner’. Now the level of pessimism is at a point where the government needs to call this in. You cannot abandon the programme.

Humphrys: No, but the central point of it?

Edwards: Is the central point of it really working? There are a lot of people who are waiting to replace their computer systems, who are having to wait for this stuff to be delivered. They need to get on with it.  They are having do temporary solutions now. We need local determination of what’s needed within national standards.

Humphrys: So the answer to that question is if they come to you and say: ‘should we abandon the central feature of this system?’ you would say ‘yes’? 

Edwards: If we could keep some of the big savings they have made from the procurement, then we would say ‘yes’. 

Humphrys: But don’t spend more money on it?

Edwards: There’s a real hazard of doing what we did with Concorde which was to say: ‘we’ve started so we’ll have to finish’. We need these systems. We can’t stop now. Some of them are close to success but we really need a very hard look at this.

Humphrys: Assuming we have spent – and we are not quite clear this- £3bn to £4bn already, what you are saying is: ‘don’t chuck another £8bn at it and wait another six, seven or eight years or whatever it happens to be?

Edwards: We need to spend the money. The big question is: what is the best way to spend the money.

Humphrys: This is not the best way?

Edwards: This is increasingly looking like it isn’t.



MPs question the future of £12bn NHS IT scheme – Computer Weekly

Government IT disasters: a clear case for change – Computer Weekly

NHS IT warnings the government ignored – Computer Weekly

MPs give NPfIT six months to deliver CRS – E-Health Insider

Warning over fresh NHS IT delays – BBC Online

New delay for medical records scheme – Press Association

Much frustration over NPfIT – BBC correspondent – IT Projects blog

NPfIT central contracts will never work – MP tells BBC – IT Projects blog

NHS Trust mulls abandoning IT scheme – FT

London trust apologies to 442 patients for IT-related delays – Computer Weekly

Report of the Public Accounts Committee on the NPfIT – House of Commons website