IT strategy loosens Whitehall red tape

The NHS's information strategy, launched today - six months later than originally planned - says that 'with immediate effect' IM&T projects with a lifetime cost of less than 20m can be approved at regional, rather than Treasury, level.

The move is part of a bid to make the whole procurement process 'less bureaucratic' and allow 'all parts of the NHS' to engage in 'the acquisition of major information systems over the next seven years'.

The strategy, written by NHS head of IT Frank Burns, envisages a huge expansion in the use of computerised patient records, electronic transfer of information between GPs and hospitals, telemedicine, and electronic libraries.

In less than five years, Mr Burns wants to see:

35 per cent of acute hospitals and 25 per cent of health authorities with level 3 electronic patient records, which allow clinicians to order tests and prescriptions electronically and get results.

NHSnet used for appointment booking, referrals, lab tests and results.

Telemedicine and telecare 'considered routinely' in health improvement programmes.

A national electronic library for health.

By March 2005, the stragegy calls for:

'Full implementation' at primary care level of electronic health records.

All acute hospitals to have level 3 EPRs.

Electronic transfer of patient records between GPs.

24-hour emergency access to patient records.

'Modernising Britain has been a central theme of the government's programme since it came to office in May 1997,' the strategy says.

'Crucial to that objective has been the drive to modernise the NHS. Better care for patients and improved health for everyone depend on the availability of good information, accessible when and where it is needed.'

The NHS Executive's information management group is being disbanded and replaced with a special health authority to be called the NHS Information Authority.

This will 'provide a lead' in implementing the strategy.

The document says 'preserving the confidentiality of patient information' will be of 'paramount importance'.

A clinical information management programme will be set to develop clinical data standards.

A clinical data standards board will be created to 'mandate professionally agreed clinical standards throughout the NHS'.

A number of 'beacon sites' will be set up. Their function will be to 'explore the issues associated with the creation of EHRs' as a short- term objective.

But the document is gives little information about where the money for these developments will come from.

It simply says: 'The government recognises that without a significant increase in the current levels of investment the NHS cannot deliver this strategy.'

Health secretary Frank Dobson is expected to put numbers on the strategy when he formally launches it today.

But the document does address one burning issue - who pays for NHS organisations to connect to NHSnet. It says that in future all messaging charges will be paid by the NHS Executive, rather than users - although money will be recovered by top-slicing from regional budgets.

Further easing of the rules on procurement is expected next month, although the Treasury has not yet agreed exactly how much purchasing freedom will be given to trusts.

As expected, the strategy relies on the Read codes.

The document says that 'dependent on the outcome of the evaluation recommended by the public accounts committee' - which was highly critical of the procurement process for the codes earlier this year - they will be 'introduced as the standard for operational clinical systems'.