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The state of NHS IT

The state of NHS IT

The new report from the man who demanded the cash for NHS IT

Derek Wanless’s follow-up to his landmark 2002 report on future NHS spending contains an analysis of progress on the NHS’s National Programme for IT (NPfIT).

The new report says NPfIT “has not been without its difficulties, with most progress tending to relate to systems that were not originally part of the modernisation plan”.


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It outlines progress to April this year on the original four key deliverables of the scheme.

Integrated care records service

Wanless cites The NHS Plan, published in 2000, which said this “could become a reality by 2004, when 75 per cent of hospitals and 50 per cent of primary and community trusts would have implemented electronic patient record systems”.

He adds: “However, controversy has seriously undermined this aspect of the NPfIT, partly due to the absence of any published plans for the design and implementation” of the National Care Records Service, while wrangling over patient confidentiality means “real progress is only just beginning”.

“National roll-out is expected to begin early in 2008, but it will be several years before coverage is complete. A date has not yet been specified for the
system to be fully operational.”

Electronic prescribing

“As of April 2007, nearly 16.5 million prescription messages have been issued electronically, with the service being used for around 8 per cent of daily prescription messages. The system is being actively used by 1,700 GP practices in England (around 20 per cent).

“Every GP surgery, along with community pharmacies and other dispensers, was expected to have access to the service by 2007, although this target will almost certainly be missed due to slower-than-expected uptake.”

Electronic appointment booking (Choose and Book)

“The NHS Plan promised to achieve electronic booking of appointments by 2005. Choose and book began (albeit on a limited scale) within this time frame, with the first booking made in July 2004 (NHS Connecting for Health 2005b). Subsequent take-up appears to have been slow.

“The system currently relies on relatively outdated technology, which has led to dissatisfaction among GPs (Medix 2006). The Department of Health has not achieved its target for 90 per cent of all patient referrals to use choose and book by March 2007.”

New National Network (N3) project

“The NHS Plan aimed to have all GP practices connected to NHSnet by March 2002,
achieving 95 per cent connection prior to the deadline. Since then, NHSnet has been superseded by a new national network for the NHS known as N3.

“This aims to link all NHS organisations, providing secure networking services and the broadband capacity to meet all the current and future IT needs of the NHS. Connections to the N3 network started in April 2004, with full implementation expected to take three years. Progress as of April 2007 appears on schedule.”

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