Shift in IT policy as trusts told they can develop their own system

Today's long-awaited informatics review recognises that progress on the NHS care records services has been so slow NHS trusts should now be helped to procure their own interim systems.

Connecting for Health director of informatics Gordon Hextall denied the change meant the end of the national programme.

The strategic vision remains, but there is now "a greater emphasis on the standards and interoperability so that patient information can be made available wherever it's needed", Mr Hextall said.

He added: "We need to make that information flow in the meantime, rather than something that's done at the end [implemention of the national programme]."

Impatient acute trusts have been hesitant about investing in interim systems because of fears they would have to scrap them when the national programme became available.

CfH will now support trusts looking to implement separate systems by helping them ensure they can "talk to" future national systems. But Mr Hextall said there would be no new centrally allocated money to help trusts.

"Trusts have a trade-off decision to make: can they afford to buy an interim system that will realise benefits more quickly and will therefore be best for them?" Mr Hextall said.

CfH will consider whether economies of scale could be gained through NHS-wide procurements of interim systems, but the money will have to come from the local NHS.

The review says CfH should now see itself as "the source of technical, commercial, service and programme management support expertise to the NHS", not simply as the implementer of the national programme.

Earlier this year CfH established a framework of approved interim IT suppliers that have reported a surge in interest from trusts.

Colin Maclean, chair of the Royal Berkshire foundation trust, which has gone public with its intention to explore alternatives to the national programme for its care record service, told HSJ that he would applaud more flexibility.

"We all need the core offering that the DH is trying to deliver, by which I mean the spine and the ability to exchange patient records," he said. "But once we have that there are big benefits in recognising local and regional differences."

The review outlines the five essential elements of a future national IT system which clinicians say they want. They include the ability to schedule beds, tests and theatres and e-prescribing. Local implementers will now need to work those into their programmes.

DH interim director general for informatics and NHS medical director Sir Bruce Keogh said he was optimistic about future clinical engagement in NHS informatics. Clinicians were incentivised by the move to make performance data more transparent and a generation of young health professionals were ripe for working with chief information officers to bring clinical credibility to local IT plans.

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