A shake-up of NHS IT announced by the government has left key elements of the national programme for IT unchanged.

Last week the Department of Health said the government’s review of the high profile Labour initiative had concluded it was necessary to devolve “leadership of IT development to NHS organisations”.

The upgrading of local IT systems has seen the greatest delay. The DH said trusts would be now given more choice about systems they take.

However, the two main provider contracts agreed under the previous government - with BT and CSC - remain in place.

DH director general for informatics Christine Connolly, speaking after the announcement last week, said a number of trusts would still have to take products as agreed under the contracts, although they would have more choice about which elements to implement.

Ms Connolly said the shake-up meant trusts could buy products outside the national programme, but they would have to pay for it themselves. It is unclear if this decision expands on flexibilities introduced by the previous government. The DH said it would save £700m from the national programme, on top of the £600m announced under the previous government.

Ms Connolly said £200m of this would come from the CSC contract - although the details of the cut have yet to be agreed. The remaining £500m is an estimate of savings by local trusts on what they now plan to spend on implementing IT changes, compared with earlier plans.

But the DH’s commitment to deliver and pay for the most significant part of the national programme - the electronic care record - remains in place. In the North, Midlands and East of England regions its implementation has been significantly delayed and the DH has yet to agree with CSC a new plan for delivering its main product, the Lorenzo 1.9 detailed care record.

In April the DH told CSC to produce a convincing plan for successfully installing the product at several trusts. If nothing is agreed it could lead to CSC and Lorenzo being abandoned as the single solution for the regions’ hospitals. The CSC contract is worth about £3bn.