The National Programme for IT is being reconfigured to reflect the changes described in the White Paper “Equity and Excellence: Liberating the NHS” and the outcome of the cross-Government review of ICT projects initiated in May.
A departmental review of the National Programme for IT has concluded that we deliver best value for taxpayers by retaining a national infrastructure and applications whilst devolving leadership of IT development to NHS organisations on the principle of connected systems and interoperability with a plural system of suppliers.
The programme has delivered a national infrastructure for the NHS, and a number of successful national applications such as choose and book, the picture archiving and communications (digital imaging) system, and the electronic prescription service should now be integrated with the running of current health services.
The remaining work of the programme largely involves local systems and services, and the Government believe these should now be driven by local NHS organisations. Localised decision making and responsibility will create fresh ways of ensuring that clinicians and patients are involved in planning and delivering front line care and driving change. This reflects the coalition Government’s commitment to ending top-down government.
The new approach to implementation will be modular, allowing NHS organisations to introduce smaller, more manageable change, in line with their business requirements and capacity. NHS services will be the customers of a more plural IT supplier base, embodying the core assumption of connecting all systems together rather than replacing all systems.
This approach will also address the delays, particularly in the acute sector, that resulted from the national programme’s previous focus on complete system replacement. It will allow NHS trusts to retain existing systems that meet modern standards, and move forward in a way that best fits their own circumstances.
An appropriate structure for health informatics is a key element of the organisational design work currently underway following the publication of “Equity and Excellence: Liberating the NHS”. The direction of travel being announced today for IT services very much reflects the key theme of the White Paper, of bringing decisions closer to the front line. It follows that the national programme will no longer be run as a centralised programme. Some elements will need to continue to be nationally managed and it is expected that new structures will be fully in place by April 2012.
Existing contracts will be honoured and it is vital that their value be maximised. However, by moving IT systems closer to the frontline, it is expected to make additional savings of £700 million, on top of the £600 million announced by the previous Administration in December 2009. These savings will mean that the total cost of the programme will be reduced significantly from the original forecast of £12.7 billion for combined central and local spending to £11.4 billion.
A separate review of the summary care record is currently underway, incorporating two elements: what content the summary electronic record should hold and make available for sharing across the health system; and whether the processes by which patients are able to withhold their consent are as clear and simple as possible. This review is expected to report by the end of September.