Your shout: NHS IT, NPfIT, patient services

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Computer Weekly readers' give their views

NHS IT and the British Computer Society

An open letter to the Health Select Committee calling for an independent review of the national programme for IT in the NHS and featured front page (Computer Weekly, 11 April), contained a seriously erroneous statement purporting to be the view of the British Computer Society. At no stage has BCS "expressed concern that NPfIT may show a shortfall of billions of pounds".

Although members of the BCS are perfectly entitled to express their views or concerns individually, they are not permitted to publish or pass them off as a BCS statement. The BCS issues statements of concern only when officially endorsed as a qualified, collective and verifiable viewpoint, usually on behalf of a relevant forum. In this case I have consulted with the chair of BCS's Health Informatics Forum, who confirmed that no statement on NPfIT financial shortfalls have been issued or published by this forum.

David Clarke, Chief executive, BCS

Computer Weekly replies:

We checked the factual statements made in the open letter. Last September the BCS circulated a document "Radical Strides - Interim Synthesis for Consultation" which said, "It is felt that there is a medium-term funding gap estimated at over £10bn pounds that needs to be covered locally; and there is concern about overall Connecting for Health longer-term finance too."

This was a draft consultation paper issued by the BCS's Health Informatics Forum on which comments were invited before the final paper was prepared. It was written in part to provide informed, constructive criticism on the NPfIT.

No information has emerged since which shows that concerns over a potential gap between the cost of implementing the NPfIT and the availability of funds have been allayed.

Future-proofing the national programme

In response to "Scrutiny is vital for NHS success" (Computer Weekly, 11 April), we should like to emphasise that the NPfIT is under constant review, scrutiny and audit by parliament and government bodies.

As with any large and complex IT programme, there will be issues and difficulties to deal with. We remain confident that the technical architecture of the national programme - which is modern, robust and designed to be future-proof - is appropriate and will work.

Central purchasing of core IT systems and services will save the NHS in England an estimated £3.8bn over 10 years. Furthermore, the NHS IT programme uses new, innovative contracts under which the taxpayer does not cover the cost of failure to deliver.

Crucially, at the heart of the NPfIT is the aim to deliver great benefits for patients, the public and staff working within the NHS. Already, benefits are evident such as more and more patients being able to choose and book a hospital appointment at a time and place convenient to them, and a greater number of prescriptions being transferred electronically - over 725,000 prescriptions at the latest count.

Further achievements include over 1,200 local service provider system deployments, more than 200,000 staff registered to use the new system and 14,000 connections made to the new high-speed broadband network.

NHS Connecting for Health has invited all 23 academics to a meeting to give them an opportunity to raise their concerns and provide them with an overview of the programme, its progress to date and its technical architecture.

We have every confidence that the NPfIT will be delivered and implemented successfully by NHS Connecting for Health, and ultimately, go towards improving patient care in the NHS.

Rosie Winterton, Minister of state for health services, Department of Health

It's about transforming patient services

The NHS Confederation did indeed say in a briefing for our members that "the IT changes being proposed are individually technically feasible but they have not been integrated in this way, so as to provide comprehensive solutions, anywhere else in the world" (Computer Weekly, 11 April). However, this comment was made in 2003 - I think we can all agree much has changed since then and I would suggest a more up to date quote might be appropriate in the future.

Furthermore, I would like to stress that the statement was not expressed as a concern, but rather an observation. The next sentence of the briefing actually went on to say, "[NPfIT] will enable the NHS to fundamentally change the way care is delivered, drive up quality and make more effective use of its resources."

I would also like to make it clear that the NHS Confederation remains committed to ensuring the NHS has the highest-quality IT systems that allow clinicians to share information about patients and integrate services through the use of cutting-edge technology such as digital x-rays.

A programme of this magnitude is bound to create concerns, because while people regard it as an IT project, it is actually about transforming services for patients. And the biggest outcome that the programme will be judged on is patient safety.

One of the biggest challenges now for Connecting for Health is convincing the service that the NPfIT can really transform care for patients. In order to make this work there needs to be active engagement from both clinicians and managers.

I can assure all readers that we feel improved services for patients and increased patient safety is a goal worth pursuing. We will continue to work closely with the Connecting for Health team to ensure that this goal is achieved.

Gill Morgan, Chief executive, NHS Confederation

Standardisation should be at the right level

The key issue for me about NHS IT is the paradox of Patricia Hewitt (on Today, Radio 4, 12 April) saying that the Department of Health is working to decentralise the management of the NHS to primary care trusts - and at the same time centralising control of the management information available to those same trusts.

It is time strategic planners realised that IT is just one aspect of the communications system of a business, and that you do not have local control of a business unit unless the unit has appropriate control of its IT.

The overall business needs to agree how those units are going to communicate - so there need to be agreed protocols for information exchange. But that does not require the level of obsessive standardisation and control underlying the NPfIT in the NHS.

We received a huge post bag in response to our articles on the NHS national programme for IT in Computer Weekly, 11 April, and we will be running a further selection of letters in the near future.

Jacky Smith, Information manager in adult social care

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