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Reaction: The end of the National Programme for IT



GP leaders and other key healthcare opinion formers give their reaction to the Government’s decision to pull the plug on the National Programme for IT.

To read Pulse’s story covering the Government’s announcement, please click here.

Dr Chaand Nagpaul, GPC negotiator

‘Giving NHS organisations more choice of IT systems makes sense, but we also need to be aware of the problems that could arise from a more localised approach.’

‘The provision and experience of IT for clinicians on the ground is likely to vary according to the level of support and resources available locally. It is important that successful national IT initiatives are not lost, and that innovation is not stifled.’

‘There still needs to be some central accountability to ensure consistent and equitable delivery, manage local implementation, avoid wasteful duplication of effort, and support local decision-making. For example, a nationally accredited list of systems would be helpful.’

‘We look forward to discussing the plans when more details are available.’

Professor Iain Carpenter, co-director of the Royal College of Physicians’ Health Informatics Unit

‘Taking the decision to align IT systems more closely with the needs of the front line is a good idea in theory.’

‘The real challenge though will rest in making sure that we get the right health informatics structures in place. One of the dirty secrets of the NHS is the regrettable state of medical record keeping. Earlier reports have been shown that this compromises patient safety and clinical care.’

‘If IT in the health service is going to regain the confidence of the medical profession then more emphasis has to be placed by the DH on making sure that the new systems accurately capture the dialogue between doctor and patient. Everything else flows from getting that right.’

Frances Blunden, senior policy manager at the NHS Confederation

‘The announcement that more freedom will be given to NHS organisations to find their own solutions to information technology challenges is welcome but it is important to remember that removing some elements from the national programme is likely to shift cost to local providers.

‘The national programme has had some notable successes with technology like PACs, which has transformed the use of images such as x-rays, in the NHS, making them far easier to share, manipulate and examine. Any changes must preserve the advances that have been made.’

‘Good information systems are essential to running a modern health service, they improve patient safety and reduce cost, it is vital that every effort continues to be made to get this issue right.’

Health think-tank 2020health

‘We are pleased to see that the way forward appears consistent with the recommendations from our report “Fixing NHS IT – a plan of action for a new government” published in March.’

‘In particular, we welcome the approach towards more locally driven procurement, more modular implementation, retention of key national infrastructure, and the prospect of significant cost savings.’

‘However, the brevity of the announcement leaves several key issues unclear and on which our report gave a clear steer for action:

• Without properly joined-up IT, the government will not be able to achieve the White Paper’s vision (para 1.10) for “a better NHS that… is less insular and fragmented, and works much better across boundaries…”. Is the government fully committed and supportive of the need for ‘joined-up IT’ and how will this now be enabled, and under what governance model?

• The risk of a purely local approach to procurement is a return to the highly fragmented position in the 1990s. Standards for inter-operability have yet to reach the maturity level to ‘plug and play’. Where feasible, NHS organisations will want to cooperate together to get best value from procurement through robust frameworks and sharing of best practice.

• What is the future of the Care Records Service, and in particular the Summary Care Record and the detailed care record, especially in view of the on-going difficulties in rolling out local hospital implementations?

• Major decisions are faced around key national infrastructure and systems – eg adapting Choose and Book for the greater patient choice advocated by the White Paper; the renewal of the N3 national network ; accelerating the benefits from widespread electronic prescriptions.

• What elements of a centralised NHS IT organisation will remain to set strategic direction, set standards and ensure the IT implications of new NHS policy are reflected in implementation plans?’