Whitehall: 'Don't bin whole NHS IT programme... yet'
Cabinet Office wonks eye up two NPfIT features
A team from the Cabinet Office has recommended that the Department of Health (DH) gives more time to two elements of England's NHS National Programme for IT (NPfIT) dealing with the provision of key information systems.
The Major Projects Authority (MPA), set up last year to scrutinise expensive projects throughout central government, has said the Additional Supply Capability and Capacity (ASCC) should be retained for the south of England, and that CSC should be given more time to deliver the Lorenzo system from iSoft in the North, Midlands and East area for which it is local service provider.
The recommendations are within the MPA's assessment review of NPfIT, which has been made available on the Cabinet Office website.
One of three recommendations, that the programme should be dismembered and reconstituted under different management because of so many negative perceptions, was effectively accepted by the DH last week. But the other two recommend that elements of NPfIT's plans to provide electronic patient record systems – the most problematic part of its work – should be continued, although with reservations in regard to CSC and iSoft's work introducing Lorenzo software.
The second recommendation is that ASCC, which was set up to give healthcare trusts a more flexible procurement model, should be approved for use in the southern cluster. despite the Cabinet Office having recently refused to do so. The review says the solutions available through the framework are tried and tested, and that preventing its use will slow down progress in the region.
The third recommendation deals with the deployment of the Lorenzo clinical information system, which has been subject to major delays and is identified as the major problem affecting the North, Midlands and East area of England. Although the precise text has been redacted from the review's summary, the commercial assessment says any further deployments should be subject to strict plans on a trust-by-trust basis. No trust should begin to deploy Lorenzo without ensuring the resources are in place, and a firm "walk away" position should be determined before any renegotiation commences.
A spokesperson for the DH said that the department will provide further details on its plans based on the review during the autumn.
Other elements of the review provide a more mixed picture than was conveyed in Health Secretary Andrew Lansley's comments last week. It says there have been substantial achievements in the delivery of infrastructure, such as the Spine and N3 network, and national applications such as Choose & Book, the Electronic Prescription Service and GP2GP record transfers. But their benefits have not been systematically quantified, making it difficult to present the achievements clearly.
The MPA says the programme has not been delivered in line with the original intent and that there is no confidence it can be delivered as originally conceived. There is a lack of commercial skills in the NHS to manage and procure ICT services and the market for systems provided by NPfIT does not include enough options to be truly competitive.
The programme board is now considering a reorganisation, but will not announce any decisions until after a "listening" pause. The review says a line should be drawn under the original case for NPfIT and new, more localised arrangements should be established within the structural reforms of the NHS. ®
This article was originally published at Guardian Government Computing.
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Cart before horse
The problem with the NHS procurement model isn't that it needs tech thrown at it.
What the NHS needs is
1) Get a service delivery model that knows what it is meant to be delivering
2) Get a management structure that stays the same for longer than the tenure of a health secretary
3) Identify responsibilities within 2) for doing 1)
4) Enforce 3)
5) Sack any idiot who thinks that GPs can run the NHS
Until the strategy is fixed operational structures and methods will always be temporary. Without some degree of strategic and operational stability and an agreed change methodology you will never know enough to define your data management requirements.
And only a complete moron would build their data management around tech considerations.
At this stage there really is no IT angle.
A slightly more IT-centric version of Colin's list
1. Establish a standard protocol for transmitting patient details from system to system
2. Only purchase systems that support it
(HL7 covers the first as I recall)
They're saying "keep the same sh*t but call it a different name and throw more money at it in the hope that by lining the major directors pockets with more taxpayers money they'll come over all moral and feel obligated to get it working"
Lets face it, if you cant write a custom package with £XXBn and 10 years, why not try the "off the shelf" package every other Major company uses?
My GP is best placed to decide what would make their record keeping easier, not some consultant from FujSERCEDSHPIsoft who's paid to get as much money for as little effort they can
UK Gov IT, spending taxpayers money on endless failure to ensure a Lords seat and a Knighthood for their whitehall mates