The commitment needed to successfully deliver the national programme for IT is a little like "jumping off a cliff" and "reading the manual about how to land on the way down," one of the NHS's top IT directors told the Autumn Forum healthcare IT conference in Birmingham last week.
The comments by Martin Judkins, chief information officer of Birmingham and the Black Country Strategic Health Authority, highlighted the risks associated with implementation.
They also indicated that the detailed plans for implementing the IT-led modernisation of the health service were being developed as the programme progresses.
Judkins, who was wholly positive about the national programme for IT (NPfIT), told the conference that delivering it successfully will require "talent, patience and commitment."
He continued "It is a big programme and things do go wrong. For a lot of people the programme is a bit like, for something on that scale, jumping off a cliff when you have never done it before.
"You would not do it if you were in your right mind. And you are reading the manual about how to land on the way down. That is the way it feels to me. Commitment is having the courage, if you like, to jump over that cliff."
He said there was much talk about trusts not having enough money to implement the national programme. "In our patch we do have the money," he said.
Judkins said his authority was committed to raising the level of spending on IT to 4% of turnover by 2008. In most trusts the IT spend is about 2% of turnover.
"If you are not committed to 4%, forget it," he told the audience. However, he accepted that efforts to achieve the funding were against a background of "much financial pressure" including deficits in some trusts.
The national programme is viewed as "one of the highest risks" by the risk management board of Birmingham and the Black Country Strategic Health Authority, said Judkins.
This was, he said, evidence that the board is taking the undertaking seriously. The risks associated with the programme related to its "do-ability, affordability and usability".
And he warned against taking seriously the critics who make a lot of noise in the media. "Just because cynical clinicians are being quoted does not mean they are all against you," he said.
Judkins warned that there will be frustrations with the plan, and that events will happen late. "But remember - most clinicians want this. There is not anything else coming."
What the national plan will offer
At the conference there were presentations and discussions on the role of care-provider organisations in implementing the NHS's national programme for IT.
The programme is expected to cost between £6.2bn and £30bn to implement and is one of the largest engineering projects in the world. It includes a national database of summary electronic records, electronic booking of hospital appointments, a technical infrastructure and e-prescriptions.