Local NHS IT managers face uncertainty over contractual control of suppliers.
NHS IT managers at last month’s Healthcare Computing Conference in Harrogate said they were still confused about their role in the Department of Health’s national IT programme.
Department of Health policy states that all new IT contracts must include a clause that allows control of the contract to be passed to the appointed local service provider. These suppliers are also expected to take over existing contracts.
They will be responsible to strategic health authorities, and will be the health service’s prime IT providers in each of five distinct geographic regions. They will be private sector consortia led by companies such as IBM and Atos KPMG Consulting.
Some NHS IT directors believe the plan will enable the Department of Health to migrate legacy systems to new applications, which could lead to a degree of standardisation of NHS systems. But IT managers warned that the novation to new suppliers could add extra layers of complexity to current contracts and sideline existing systems and suppliers.
One IT director based in the South West, for example, explained that some of his hospital’s IT contracts still have five years to run. He is also worried about the impact on the specialist IT companies that play a crucial role in how the health service operates.
"For a lot of people, support for many of the primary healthcare systems comes from third parties," he said. "These work with the likes of the pathology and radiology systems that are core to a hospital’s work."
He went on to underline just how important these specialist suppliers are to the day-to-day running of the health service.
"An average-sized general hospital is doing about 100,000 radiology exams a year and 3,000 pathology exams a day. It is not the glamorous, high-tech end of things, but it is the bread and butter of delivering patient care," he said.
Another NHS IT director said, "The problem comes when you may have two or more hospitals already working with one supplier. What happens when the local service provider comes in and does not want to be responsible for using the existing systems that have been in place for a number of years?"
While IT managers welcome the £2.3bn cash boost to health service technology, they believe there is still much work to be done explaining the nuts and bolts of the national programme to the people on the ground.
Electronic records Medics check out open source option
NHS IT chief Richard Granger hinted during his keynote speech at the Healthcare Computing conference in Harrogate that open source software might have a role in the delivery of electronic patient records.
The development of an electronic patient record is one of the most fundamental and controversial parts of the NHS national IT programme.
Granger was speaking after Ed Hammond from Duke University Medical Centre in the US highlighted moves by the American Academy of Family Physicians to support the use of open source technology for electronic health records.
The AAFP is one of the largest US medical organisations, with a membership of more than 94,000, and it has convinced software supplier MedPlexus to provide its own XML and Java-based electronic health record as the core for an open source product