Comprehensive information in the form requested is not available. This is because the overall cost of the national programme for information technology (NPfTT) includes both central costs, and the costs managed by local national health service bodies incurred in implementing the systems, for example in training staff and upgrading computer hardware. Local information is not routinely collected in a way that differentiates expenditure on the IT programme from other local TT-related expenditure.
Within the Department, NHS Connecting for Health, which came into being in April 2005, is responsible both for central expenditure necessary for ensuring delivery of the IT systems under the national programme, and for maintaining the critical business systems previously provided to the national health service by the former NHS Information Authority. NHS Connecting for Health does not prepare annual whole-programme budgets for NPfTT activity separate from those for its wider responsibilities as this would involve the unnecessary apportionment of common management, administrative and support costs. For the same reason, separate outturn figures are not routinely reported for management information purposes.
Information covering all NHS Connecting for Health's responsibilities is shown in the following tables.
£ million 2005-06 2006-07 2007-08 2008-09 2009-10 Capital 1,198 1,055 915 917.0 800.0 Revenue 799 638 607 631.3 580.00
Actual expenditure Forecast Outturn 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 Capital 360.0 429.0 589.0 686.0 535.1 562.6 Revenue 260.0 539.0 528.0 507.0 528.4 573.8 Notes: 1. All sums exclude capital charges. 2. The amounts include the original costs of NPfTT contracts, which have not changed, but also include new and additional requirements that have been added, supported by separate business cases and funding, as reported by the National Audit Office. 3. Expenditure plans for years beyond 2009-10 are currently being reviewed in the light of announcements made in the pre-Budget report, and of the evolving IT needs of the NHS.
Lorenzo release 1.0 is currently being used for radiology requests and results by the University Hospitals of Morecambe Bay NHS Trust in its general surgery and urology wards, and for the same purpose by Bradford Teaching Hospitals NHS Foundation Trust, where, since December 2009, the clinical documentation functionality has also been implemented. South Birmingham Primary Care Trust (PCT) has a number of podiatrists using the system, working in eight different physical locations across the PCT.
In October 2009, Hereford Hospitals NHS Trust went live with clinical documentation in rheumatology, and Five Boroughs Partnership NHS Trust went live across their Halton, Wigan, St. Helens, Warrington and Knowsley sites. In December 2009, Stockport PCT was the sixth trust to begin using the Lorenzo system.
The next software release (release 1.9) extends functionality for all patient administration and clinical care management activities. Bury PCT went live with release 1.9 at the beginning of November 2009 and staff are now regularly using the system to manage case notes, view detailed patient records, and administer care activities.
In London there have been five Cerner Millennium deployments, at Barnet and Chase Farm, Queen Mary's Sidcup, Barts and the London, the Royal Free Hampstead NHS Trusts, and since November 2009, at Kingston Hospital NHS Trust. In addition, the London Programme is managing two other sites at Homerton and Newham which were installed systems outside the National Programme, bringing the total Cerner Millennium sites in the capital to seven.
In the south, eight health communities have to date gone live with the system. Each health community typically comprises an acute Trust and the associated PCT sites in its area. The relevant acute trusts are Winchester and Eastleigh Healthcare NHS Trust; Surrey and Sussex Healthcare NHS Trust; Weston Area Health NHS Trust; Taunton and Somerset NHS Foundation Trust; Nuffield Orthopaedic Centre NHS Trust; Milton Keynes General Hospital NHS Trust; Buckinghamshire Hospitals NHS Trust; and Worthing and Southlands Hospitals NHS Trust.