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NHS IT project told to improve or risk break-up

Unless the multibillion-pound Care Records Service 'improves appreciably' within six months, the DoH should consider pulling the plug, according to MPs
Written by Nick Heath, Contributor

The Department of Health must turn around the multibillion-pound Care Records Service within six months or risk seeing the scheme broken up, according to MPs.

The rollout of the Care Records Service (CRS), a project to link up medical records at English hospitals, is now years behind schedule. Currently, the patient administration systems (PAS) needed to lay the groundwork for electronic medical record transfers are only deployed in 133 of England's 380 acute hospital trusts.

A report released today by the parliamentary spending watchdog, the Public Accounts Committee (PAC), labelled the DoH's progress on the CRS rollout as "very disappointing" and said its 2014-15 completion date — already four years later than originally planned — is now in doubt.

Unless the deployment of the CRS "improves appreciably" over the next six months, the DoH should consider pulling the plug on the planned national rollout, according to the PAC.

Instead, the PAC recommends the DoH should consider allowing trusts to apply for money to buy their own electronic medical-records systems.

PAC member Conservative MP Richard Bacon told ZDNet UK's sister site silicon.com it is time to dump the centralised rollout of CRS.

"The national rollout of care records is a naïve and oversimplistic distraction from getting a detailed local care-record services going.

"The local service providers are never going to deliver what is required — power and the vast majority of money left in the pot needs to be returned to the local hospital trusts," he said.

Technical problems and delays have affected the two software systems that will be used to run the CRS — Cerner and Lorenzo. By the end of 2008, iSoft's Lorenzo care-records software had not gone live throughout a single acute hospital trust and several London hospitals reported difficulties in running the Cerner Millennium system.

Interim PASs are being provided to trusts in the North, Midlands and East while they wait for the Lorenzo CRS to be rolled out — which will need replacing again when Lorenzo is ready for deployment.

The majority of the 133 PASs rolled out so far will need further upgrades before they are able to handle full electronic medical records.

The rollout of the CRS to acute hospital trusts is among the biggest of the 10 IT projects that make up the £12.7bn National Programme for IT (NPfIT).

Difficulties with PAS rollouts have been compounded by the decision by Accenture and Fujitsu to walk away from the NPfIT, leaving only CSC and BT as the two main suppliers for the programme. Accenture and Fujitsu had previously been rolling out PAS systems to hospital trusts.

Doctors' union the British Medical Association (BMA) urged caution on NPfIT spending in the wake of the review.

Dr Vivienne Nathanson, head of science and ethics at the BMA, said in a statement: "With the UK deep in recession the government must ensure that Connecting for Health confronts the lessons of the past — the NHS IT project can't be paid for with a blank cheque. Trusts must have more freedom to implement IT systems that take into account their local needs."

In a statement, the DoH played down the PAC's criticisms. "We welcome the report. New IT systems in the NHS are delivering better, safer and faster care," it said.

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