NHS staff record programme provides template for electronic patient records

Good project management will be the key to the success of NHS electronic records. James Rogers reports

Good project management will be the key to the success of NHS electronic records. James Rogers reports

Experts have welcomed the latest development in the NHS' £325m strategy for electronic staff records (ESR) but warned that strong project management will be needed if it is to deliver the expected rewards.

Live testing of the ESR, which is the health service's new national pay and personnel system, began at University Hospital, Birmingham earlier this month.

Officials predict that the ambitious project to replace 30 different systems supporting 1.2 million staff in England and Wales will save the NHS £400m over 10 years. However, the project is already a couple of months behind schedule.

Of the 275,000 staff who join the health service every year, more than 200,000 have transferred from other NHS employers, according to government officials.

Given that the NHS is one of the largest organisations in the western world, this underlines the importance of implementing an adequate centralised system for personnel records and payroll.

Murray Bywater, managing director of IT healthcare research firm Silicon Bridge, said he believes that the ESR project has a great deal to offer the NHS. But he warned that it will have to be carefully managed.

"It is a big task to convince everyone that a standard system will meet all their local requirements. The implementation team will have to do a lot of work with individual NHS organisations and it will need strong project management," he said.

NHS officials have confirmed that the ESR, which is subject to the Government's Gateway review process for managing major IT projects, is being carefully developed.

Philip Hewitson, chief executive of the NHS National Shared Services Initiative said, "It is very, very important to get it right."

Perhaps even more importantly, NHS officials believe the ESR could serve as a model for another mammoth IT project: developing and rolling out an electronic patient record (EPR) system across the whole of the NHS.

"There are some major data management and scalability issues that will be very applicable to EPRs," said Hewitson.

He also stressed the relevance of the ESR's data protection features - a highly sensitive issue in the health service - to the forthcoming EPR.

"The ESR has all the data protection implications that the EPR will have - we are putting processes in place that safeguard the individual and the organisation, which are both electronic and management-based," he said.

The ESR is one of a number of modernisation projects being developed by the NHS National Shared Services Initiative, which was launched in October 1999 to explore opportunities to improve the quality and value for money of non-clinical services in the health service.

Health minister Lord Hunt has already predicted that the project will save the NHS £400m over 10 years - money which will then be redirected to front-line patient care.

Launching the staff record trial in Birmingham, Hunt said, "This is a vital piece of work in helping to modernise the NHS.

"ESR will allow the transfer of staff details from one NHS employer to another, cutting red tape, reducing bureaucracy and saving time."

The ESR, however, is more than just an IT system. Projects such as this are critical in helping to modernise the NHS, which is undergoing a massive overhaul of its IT infrastructure.

Earlier this year, the Government announced the health service's future technology strategy, in what promises to be the UK's largest ever IT project.

The long-term objectives of the scheme include providing broadband access to all NHS clinicians and support staff by December 2005, as well as implementation of domain-to-domain encryption.

A national appointment bookings service is expected to be implemented by December 2007, as will EPR systems in all primary care trusts and hospitals.

Evidently, the stakes are high for NHS IT, which now finds itself on the front line of Tony Blair's battle to modernise the health service.

Implementing change across the whole of an organisation, particularly one of the complexity and size of the NHS, is never going to be easy.

Officials have admitted that the sheer scale of the ESR project has put it about eight weeks behind schedule. However, they are hopeful that the lost time can be made up.

In addition to the Birmingham pilot project, 15 more sites are scheduled to test the system early next year. Officials estimate that this stage of the roll-out will be complete by about mid-2003, before the project is extended to the rest of the NHS over the following two years.

Like so many other NHS IT projects, building the ESR is an extremely complex task, although it has the potential to bring great benefits, both for staff and patients.

"It is probably more difficult than anticipated but if the benefits can be achieved then they will be equally great," Bywater said.

ESR consortium
A consortium led by healthcare giant McKesson has been appointed to deliver the contract for the electronic staff record, implementing the Oracle Human Resource Management System (HRMS) across the NHS. Consortium members include:
  • McKesson - the prime contractor
  • IBM Business Consulting Services (formerly Pricerwaterhouse Coopers Consulting) - providing programme implementation, change management and business process re-engineering
  • Oracle - software provider
  • IBM - hardware provider.

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