NHS IT juggernaut rumbles on

Analysis The major casualty of an overhaul of NHS IT has been revealed. The National Programme for IT (NPfIT) is no more - up to a point.

The death of an unwieldy acronym is hard to mourn, but otherwise the coalition's changes to the scheme are marginal. Indeed, if anyone is to suffer as a result of the decision to trim £700m from the scheme, it's unlikely to be BT or CSC, the last contractors standing.

Christine Connelly, the Department of Health's director general of informatics since 2007, insisted yesterday their multibillion pound contracts will be honoured by taxpayers.

"The best way to deliver value is to honour the contracts," she said.

That means despite the localist rhetoric that accompanied minister Simon Burns' announcement yesterday that NHS trusts would proceed "in a way that best fits their own circumstances", a guaranteed, undisclosed number will be compelled to buy services the two firms. In CSC regions that means more deployments of iSoft's troubled Lorenzo patient records software.

Elsewhere "a more locally-led plural system of procurement should operate", Connelly said.

The detailed sources of the new £700m saving are currently unclear. Some £200m will be taken from CSC's £3bn total deal, Connelly said, but negotiations to determine how are ongoing. One likely cut is a national procurement of software for running GP surgeries, she suggested.

The remaining £500m will come from unspecified cuts to the budget for local services. Given the BT and CSC local contracts will remain largely unchanged, that means those trusts which are not forced to buy from them will have to find cheaper solutions by that "plural system of procurement".

The announcement yesterday contrasts with Tory calls for a radical overhaul, or even scrapping, of the NPfIT before the election. Instead, the coalition plans tweaks that will save less than six per cent of budget, weeks before the Comprehensive Spending Review is expected to herald cuts of 30 per cent across the rest of the public sector.

So far the Department of Health has spent more than £5bn on the NPfIT and is still intends to spend at least that again. "The money that has been spent so far I believe has been value for money," Connelly said.

In fact the changes announced yesterday are mostly bureaucratic, and conservative with a small "c". Connelly explained that two complete areas of work - infrastructure such as the Spine, and successful network applications such as the digital imaging system - will no longer be considered "projects" but be moved out of the NPfIT and run by the NHS as IT services.

No doubt it's a significant change for those working on them, but to taxpayers it means nothing.

Indeed, Connecting for Health, the 1,200-strong central quango created to deliver the world's largest civilian IT project, will remain unchanged, for now at least. "Our intention is to dismantle the central bureaucracy," Connelly said, unable to provide specifics.

This week's announcement also has no impact on Summary Care Records, the most controversial aspect of the entire scheme. A separate review of the related questions of what they should contain and how public consent for them to be shared should be obtained is ongoing. ®