The introduction of the national programme for IT may stifle NHS innovation if small suppliers do not make their voices heard, says Roger Wallhouse.
Since the mid 1990s the health IT supplier community has undergone significant change, culminating in the introduction of the national programme for IT in 2002.
The main impact of the NPfIT to date has been the slowing down of procurements to a trickle, as NHStrusts were either prevented from proceeding with their electronic patient records (EPR) projects or, as many did, decided to put them on hold until the NPfIT plans were solidified and the implications for trusts, particularly financial, were made clear.
With the NPfIT's emphasis on scale and standardised solutions, the merger of suppliers iSoft and Torex is just another step, albeit a giant one, in the industry rationalisation to the point where, once the NPfIT contracts are all let, NHS trust users may well have no choice as to their suppliers.
Whether a merged iSoft/Torex business will be allowed to continue with its plans is a matter for the Office of Fair Trading, as is the decision as to whether the matter is referred to the Competition Commission.
Although the NPfIT is laudable in its aim of achieving a wired-up service, doubts remain over whether this is possible in what many believe to be an aggressive timescale. It also creates tensions between trusts, which are ultimately responsible for purchasing and using the systems, and the NPfIT, which wants to guide the overall strategy centrally.
Given that the aim is for trusts to actually use the new IT systems once in place, it is important for trusts to let local service providers (LSPs) know which companies' products are most appropriate to their needs.
This way LSPs can work with trusts in delivering the IT structure we all need. LSPs in general know little about EPR and healthcare software and so need to realise that a wealth of talent and innovation exists within companies which currently have no formal NPfIT status.
These firms and trusts need to help LSPs recognise the skills, expertise and products they offer. The problem, particularly for small companies, is getting their voice heard; and for the LSPs how do they sift through all the approaches made to them to determine which have merit.
NHS IT directors need to be aware that the need of the NPfIT to implement common systems will stifle innovation.
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Roger Wallhouse is managing director of Health Systems Solutions