NHS IT devolution plan goes into action

New arrangement boosts regions' control of £12.4bn programme

Whitehall officials will start dismantling parts of Connecting for Health next month in a bid to "reinvigorate" the £12.4bn National Programme for IT (NPfIT).

Under the plan, which forms part of an audit by NHS chief executive David Nicholson, some staff, job roles, budgets and responsibilities will be transferred from the agency to local and regional organisations.

The rethink means that responsibility for meeting key local and national objectives of the NPfIT will be dispersed to more than 150 senior responsible owners at local and regional health service sites.

Among these, the regional senior responsible owners - in practice, the chief executives of strategic health authorities - will be expected to commit to ensuring that deployments meet the NHS's contractual commitments to local service providers.

Under the contract, the NHS has to place a minimum amount of business with these suppliers each year.

The NPfIT Local Ownership Programme is Whitehall's response to a report by the National Audit Office last year that said that a critical factor in the success of the NPfIT would be the local support of doctors and other NHS staff.

But so far it is unclear how much freedom local senior responsible owners will have to operate, and whether they would be held responsible for any failure of the NPfIT, which after four years continues to be beset by uncertainty - in particular over electronic health records.

By the end of this month, trusts are expected to submit to Whitehall local IT plans that reflect NPfIT commitments as well as "national expectations".

Connecting for Health will continue to be responsible for NPfIT commercial strategy, contract negotiations, specialist technical functions and overall finance.

This will leave strategic health authorities and NHS trusts to take more responsibility for defining the requirements and design of NPfIT products, and their subsequent delivery and implementation.

Cluster organisations - which represent NHS organisations in dealings with local service providers - are to be abolished.

At last week's annual Healthcare Computing conference in Harrogate, the new arrangements - known as the NPfIT Local Ownership Programme - were met with ambivalence.

In reply to an NHS delegate who was concerned that responsibility for the programme was being passed around, conference panellist Colin Tully, who is professor of software practice at Middlesex University, said, "Unless you devolve real responsibility to the smallest possible unit, then I think it is all hot air."

The transfer of responsibilities is due to happen on 1 April. However, if all arrangements are not finalised by that date, a memorandum of understanding may be put in place to give the NHS management control of Connecting for Health "until such time as resource is transferred", according to a paper published by Stephen Singleton of the North East Strategic Health Authority.

A spokesman for Connecting for Health said, "Funding is passed from NHS Connecting for Health to the NHS for things like the early adopter sites of the Summary Care Record to help support them with the additional costs of being one of the first sites to test systems and go live.

"We will also be passing money to the NHS as a consequence of the NPfIT Local Ownership Programme, but this has not yet been finalised."

Read more on the National Programme www.computerweekly.com/npfit

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