The very latest view of progress with the national IT strategy is contained in the recently published document Supporting Transformation - the first of what promises to be an annual statement of programme benefits.
Naturally enough this report accentuates the positive and a quick superficial read will give the intended impression of real progress across a wide swathe of the programme.
Progress, will of course, look different to different stakeholders. Ultimately however, the only serious test of the benefits so far of the£3.5 billion invested to March 2007 is the degree to which an ‘informed patient’ will judge that their care has improved.
Much of the expenditure to date has of course been committed to essential infrastructure and the ‘informed patient’ will recognise that the benefits of this spend will not be visible at the point of care. Nonetheless the programme has invested considerable time effort and expenditure in programmes where real and observable service benefits are claimed and it is on these programmes that the ‘fair’ judgement of the ‘informed patient’ should be focussed.
In making their own judgement patients will be influenced by the importance to them of the projects to which priority has been given and the degree to which actual progress is faithfully and accurately reported.
Against these criteria there can be no doubt that patients will readily appreciate the priority and service benefits associated with the PACs investment but in relation to Choose and Book, electronic transfer of prescriptions and electronic transfer of GP records they may be less enthusiastic. Not because these things don’t provide benefit in their own right for some patients but because they may provide less urgent and less important benefits to patients as a whole than, say, the Summary Care Record where there is the potential for wholesale improvement in the clinical care and safety of all patients.
This particular priority as perceived by patients is well reflected in a number of quotes from patients in Supporting Transformation about the benefit of shared electronic records which may give the impression that these benefits are already in place or very close. Regrettably this is not the case and the ‘informed patient’ may well be disappointed that a key priority for them is not a key priority of the programme if judged by the rate of progress. The missing link for shared electronic records across the NHS is sophisticated clinical systems in hospitals and by even the most optimistic analysis these are still many years away from being a reality.
As usual the statements of senior executives and ministers in the press release accompanying Supporting Transformation are full of unjustified hyperbole which in no way reflects the substance of the report. Claims are made that ‘lives are saved’ which are not evidenced in the actual report and whilst it is fair to claim credit for considerable progress in some areas the implication in these statements that the national IT programme has already had a dramatic impact on the quality of clinical care would not find much of an echo across the NHS.
In a recent speech to the World Health Congress the chief executive of the NHS is reported as claiming that 400 lives have been saved by the investment in the national IT programme. Assuming this claim can be backed up with evidence it is put in perspective by the fact that, according to the National Patient Safety Agency, in excess of 1000 NHS patients a year are currently killed through errors and mistakes inEnglandandWalesand many of these will be attributable to clinical documentation in some way.
In the appendix of Supporting Transformation credit is again claimed for the fact that NPfIT only pays for systems delivered and that “suppliers have borne the cost” of the acknowledged delays in delivering clinical systems to hospitals. Given the potential of shared electronic records to ‘save lives’ as so readily acknowledged and trumpeted by the NHS leadership, it is reasonable to adduce that it is patients rather than suppliers that are paying the real price for the lack of priority and progress in this area of the national programme.
Frank Burns is a former NHS chief executive and was the author of the 1998 strategyInformation for Health. He is currently working as an independent healthcare consultant. Email fgburns@yahoo.co.uk
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