NHS IT revamp destined for major surgery?

Health reform could be "nail in the coffin" for £12.7bn National Programme for IT

The government has signalled that the £12.7bn programme to revamp NHS IT may be in line for a shake-up.

The National Programme for IT (NPfIT), which comprises 10 tech projects designed to modernise healthcare in England, has faced criticism for its four-year delay to the rollout of new patient administration systems to hospitals, and over concerns that electronic medical records are being created without full patient consent.

Yesterday the Department of Health (DoH) published a whitepaper entitled Equity and Excellence: Liberating the NHS, which sets out the government's ambitions to reform the health service and indicates the NPfIT could experience changes as a result.

The whitepaper gives one of the clearest hints that the centrally managed NPfIT will not survive the reform intact by saying the DoH will "apply cuts to its budgets for centrally managed programmes", as part of a drive to save up to £20bn to be reinvested in front-line services.

The NPfIT has already had its budget cut by £600m under a savings programme announced by the Labour government last year.

The whitepaper also said GP practices, hospitals and other NHS outlets will be able to choose from a "more plural system of IT and other suppliers".

Allowing hospitals to choose from multiple IT suppliers would mark a significant departure from the NPfIT, under which just two suppliers, BT and CSC, are responsible for supporting and upgrading local computer systems at hospitals across most of England.

The National Programme for IT is unlikely to survive the government's reform of the health service intact
(Photo credit: Shutterstock)

Tola Sargeant, analyst with TechMarketView, predicted the whitepaper will have a negative effect on the NPfIT.

"That sounds like another nail in the coffin for the National Programme for IT in the NHS and the agency that runs it, NHS Connecting for Health," she said in a research note.

The whitepaper also points to changes in the way patients' electronic medical records are handled...

Electronic health records called Summary Care Records (SCRs) have been created for more than one million patients across England, with the DoH aiming to create an SCR for every NHS patient who chooses to have one by 2012.

The SCRs initially include a patient's allergies and prescriptions and, as the patient receives care, are updated with details of the health problems and treatments.

At present any GP or hospital doctor who is treating a patient is able to access that patient's SCR, which is stored on a national database called The Spine.

However the whitepaper suggests that access arrangements could change, saying: "The patient will determine who else can access their records and will easily be able to see changes when they are made to their records."

Currently patients who have had a SCR created can access it through the NHS website HealthSpace.

Patients are to be given more control over their electronic medical records
(Photo credit: Shutterstock)

In future, however, patients will also be able to download their medical records and share them with "any organisation", according to the whitepaper.

Another area of the NPfIT that could be given a boost is Choose and Book, the online and telephone booking service that allows patients to be treated at a hospital of their choice.

"We will look at ways of ensuring that Choose and Book usage is maximised," the whitepaper said.

The coalition government is set to spell out the full extent of any planned changes to the NPfIT in the coming weeks.

According to reports, NHS CEO Sir David Nicholson told a press conference yesterday that a paper on the future of NPfIT will be published within the next four weeks.