IT strategy lies in ruins as only five trusts hit April EPR targets

Next month's targets for the introduction of electronic patient records will not be met, officials at the Department of Health and its information policy unit have admitted.

Just 3 per cent of trusts look set to meet targets to introduce EPRs next month, compared to a goal of 35 per cent set by the NHS Information Authority, according to DoH figures. The DoH is already holding a review of the EPR programme, the results of which are also due next month, HSJ understands.

Just five trusts have complete systems in place, raising serious questions over the target for 100 per cent of trusts to have level-3 EPR in place by 2005 - a central plank of the 1998 NHS IT strategy, Information for Health.

Delegates at Healthcare 2002, the annual NHS IT conference held this week in Harrogate, were pessimistic that the service would meet the timetable for roll-out.

But junior health minister Lord Hunt was not there to hear their concerns - at the last minute he pulled out from his keynote speech opening the conference.

An EPR project manager criticised the lack of central guidance on EPR, contrasting it with the support provided on Y2K and NHSnet. 'The whole EPR process has been characterised by a total lack of central management direction and support.'

Insufficient money, limited management resources, sheer complexity and lack of national guidance were all repeatedly cited as ongoing problems dogging progress on EPR.

Hammersmith Hospitals trust IT director Howell Huws said: 'The main issue is around money, but it is also about staff capacity to implement EPRs.' He predicted that smaller hospitals would have particular difficulties without national support.

Just as many health authorities last year raided supposedly ringfenced IT budgets to meet service pressures and political imperatives, suggestions are emerging that the pattern may be repeated this year. 'I've heard rumours all across London of that happening, ' said Mr Huws.

Bedfordshire Heartlands primary care trust director of finance Phil Bradley said: 'It is likely that they may be raided again to meet key financial and 21-week waiting times'. At best he predicted that three-quarters of earmarked information and technology funds would be saved.

On the first morning of the conference, the appointment of Dr Gwyn Thomas, acting chief executive of the NHSIA to the substantive post, was announced. Dr Thomas has been acting in the post since last October following Nigel Bell's sudden departure.

Dr Thomas told HSJ it was too early in the strategic and financial frameworks round to tell whether the funding problems of last year would be repeated. 'I do not know as the SAFF rounds are still being argued through, 'Dr Thomas said.

And he insisted that one of his top priorities was 'to speed up the electronic records programme'.

But Dr Thomas drew a distinction between EPR and the wider development of electronic records, suggesting that new approaches to EPR and electronic health records are under consideration.

Dr Thomas was at pains, though, to scotch any suggestion of a national procurement for EPR.

'People are concerned that we may jump into a national procurement of EPR.That will not happen at all.'

What will change, he stressed, is a far greater emphasis from the NHSIA on services rather than systems, potentially providing a new managed service delivery model for electronic records: 'This is the shift I am trying to make, 'Dr Thomas said.