Conflicting reforms are set to cause a major IT upheaval in Scotland's NHS, according to Unison.

Several imminent changes risk a plunge into confusion and duplication, according to union spokesman Dave Watson. The most wide-ranging is the big reduction in the number of trusts, proposed in the white paper, Designed to Care. Added to this is the recent strategic framework for Scottish IM&T development. On top of these come the millennium problem and the uncertainty over how the Computer Sciences Corporation outsourcing contract will be superseded next April.

Together, these factors may force trusts to scrap millions of pounds of new software, Mr Watson claims.

The new Scottish IT strategy requires health boards, trusts and GPs to pass patient data around electronically, foreshadowing NHS head of IT Frank Burns' strategy for England and Wales.

In a speech last month, Scottish health minister Sam Galbraith summed up the objective as 'developing communications to bring airline-style booking'. All hospitals and GPs will have to meet this target by 2002 so that patients leaving a GP surgery will already know the date of their hospital appointment.

But so far no definite procurement guidelines or budgets have emerged, and strategies are simply being 'dumped on health boards who have little or no IT expertise', says Unison. Mr Watson warns that trusts have already invested large sums in proprietary software, while merging many existing trusts - also set out in the white paper - will involve substantial work in integrating existing systems and switching to whoever wins the outsourcing contracts currently held by CSC.

'Health boards are having difficulty turning these fine words into practice. The management executive is just ploughing on with retendering [of outsourcing] at the moment, but we need them to come up with a coherent IT strategy to meet the white paper objectives. At the moment all we have is a mission statement.'

A Scottish Office spokesperson said 'internal discussions are going on at the moment to work out a full IT strategy', but was unable to predict a publication date.