NHS IT revamp: Coalition wields £700m scalpel

Swingeing cuts to National Programme for IT

The coalition government has announced £700m of cuts to the National Programme for IT (NPfIT) - the multibillion pound revamp of NHS IT started by the Labour government back in 2002.

£200m of the cuts will come from scaling back a contract to deliver new patient administration systems (PASes) under the NPfIT.

The NHS had originally chosen two suppliers, BT and CSC, to install the new patient administration systems (PAS) at hospitals across England. However, the rollout of the systems fell behind schedule, missing its original deadline by four years.

CSC, which is installing the Lorenzo PAS in the north, Midlands and east of England, has seen the £200m cut to its contract confirmed today.

Health minister Simon Burns yesterday told the House of Commons that the Department of Health will now give hospital trusts the power to choose their own systems. Health trusts will now no longer be forced to rely on BT or CSC to install new PASes, but will instead be able to choose from a range of different suppliers to either upgrade existing systems or install new systems of their own choosing, providing the systems meet certain standards around interoperability and security.

Hospitals will be given more control over which systems they use under coalition plans
(Photo credit: Shutterstock)

Speaking in the House today Burns said that giving local health trusts more choice over the systems they use will help end the delays and uncertainty for hospitals waiting for a new PAS under the NPfIT.

"This approach will... address the delays, particularly in the acute [hospital] sector, that resulted from the national programme's previous focus on complete system replacement," he said.

"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," Burns added.

According to Burns, different hospitals and health trusts will still be able to...

...share information, saying that the local trusts will be able to choose from systems built "on the principle of connected systems and interoperability".

The Department of Health's existing contracts with BT and CSC to install new PAS at hospitals and support local systems will continue until 2015/16, albeit in a scaled-back fashion.

A DoH spokeswoman was unable to confirm how many hospitals will still receive a new PAS from BT and CSC under the slimmed-down contracts.

The plans to cut £200m from CSC's contract forms part of £700m of fresh cuts to the NPfIT to the programme announced by Burns today.

Taken together with £600m of cuts announced last year by the previous government , the cost of the programme when its final contract finishes in 2016 will be £11.4bn, compared to the £12.7bn original projected cost of the programme.

National IT infrastructure and systems that have already been built under the programme - such as the N3 national broadband network, the PACs image sharing system, the Choose and Book online hospital appointment booking system, the Electronic Prescription Service - will be retained but maintained locally rather than by the NHS' central IT organisation, Connecting for Health (CfH).

The NHS X-ray sharing system PACs will be managed locally
(Photo credit: Shutterstock)

"The remaining work of the programme largely involves local systems and services, and the government believes these should now be driven by local NHS organisations," Burns said, adding: "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."

With many of the responsibilities of the CfH moving to local health trusts, a spokeswoman for CfH said that the agency was likely to undergo "changes", but could not confirm if the agency would be scrapped.

A separate review of the NPfIT's Summary Care Records (SCRs) project - centralised electronic records of a person's allergies and drug prescriptions - is underway and is expected to report its findings by the end of the month.

The review will look at what content the SCRs should hold and whether the process by which patients consent to having their details stored in an SCR is simple enough for patients to understand.