The government has accepted a series of recommendations from the House of Commons health committee on the future of the NHS’s £12.4bn National Programme for IT (NPfIT).
MPs probed the electronic patient record systems – with a summary care record (SCR) and, eventually, a detailed care record (DCR) for each patient – that are at the heart of the huge computer project in September.
There was “perplexing lack of clarity” about exactly what NPfIT would deliver, the MPs said. “It is not clear what information will be recorded and shared on DCR (Detailed Care Record) systems, nor the range of organisations that will be able to share information.”
The MPs called on the government to publish clear information about its plans for DCR systems, making clear how the scope of the project has changed since 2003, and to set out clear milestones for achieving the increasing levels of interoperability and automation offered by DCR systems.
In its response, the government said it accepted the recommendations. A review of the arrangements for NHS organisations to share the information on the detailed care records was “already under way with strategic health authorities (SHAs) and suppliers”, the response document says.
It adds: “A maturity model of secondary care settings already exists which describes the opportunities for moving from systems being linked simply by interfaces to interoperable systems that can move patient data between national, local and existing departmental systems, and ultimately to fully integrated systems. Suppliers are being asked to map their proposals against the maturity model with key milestone dates.”
The government also accepted the committee’s recommendation that key NPfIT contractors should publish detailed timetables for delivering new patient administration, electronic prescribing and shared local record systems, and set a deadline for the successful deployment of iSoft’s long-delayed Lorenzo care record system – the software set to be implemented across two thirds of the NHS where CSC is the lead NPfIT contractor.
The government must make clear that if the Lorenzo deadline is not achieved “then other systems with similar capability will be offered to local hospitals”, the MPs said.
In its response, the government also gratefully welcomes the committee’s view that a comprehensive review of NPfIT was not necessary. Unlike the health committee, the powerful Commons public accounts committee has called forcefully for a review – a call backed by computing academics and others.
Health minister Lord Darzi is set to examine how NPfIT can ensure it delivers clinical benefits as part of his wider review of the future of the NHS, however.
NHS chief executive David Nicholson is also reviewing “how the NHS uses informatics to improve patient care”. The Department of Health has said Nicholson’s inquiry is not a review of NPfIT or the Connecting for Health, although it will examine the IT agency’s “management arrangements” – a subject of much uncertainty because the DoH has not advertised for a successor to departing NHS IT chief Richard Granger.