No Funding for IT Development Projects

The Department of Health has failed to secure extra funding for a series of development projects that had been thought vital to demonstrate how the latest generation of information technology could be applied to the NHS.

The decision suggests that the Treasury and DH do not believe that a further series of demonstrator projects are required to achieve the rapid national implementation of electronic records, e-prescribing and electronic booking scheduled to begin from April 2003, and that insufficient time exists to carry out and evaluate projects and meet national implementation targets

Sir John Pattison, the DH’s head research, information and analysis wrote last week to those leading prospective projects to inform them that he been unable to secure funding for any of the projects his team had been considering.

Projects that had previously been considered likely candidates to receive funding included: Lightbulb, a Microsoft-led consortia focused on Birmingham; and Lockheed Martin in the North West.

The failure to secure funding represents an apparent reverse for Sir John and his team who have invested considerable time in evaluating proposed projects and a blow for the suppliers who have invested time and resource in developing proposals. It also creates further uncertainty about how the NHS is to deliver its ambitious IT development programme.

E-Health Insider understands that, with funding for demonstrator projects unavailable in the current financial year, the DH has decided there will no longer be sufficient time to commission, implement and evaluate projects ahead of a national roll-out programme. Sources close to the DH suggest that thinking has moved on rapidly over the past month.

Fresh emphasis is apparently being placed on existing pilots, including the work of the ERDIP programme on electronic records; three enterprise pilots for electronic booking; and three e-prescribing pilots.

But rather than carry out further proof-of-concept projects for web services based systems, the preferred route would now appear to be to take a leap of faith with a national roll-out programme, probably phased and with some built in evaluation.

National contracts are expected to be awarded from April 2003 to a small number of consortia of accredited suppliers, each possibly lead by a heavyweight IT firm.

Significantly, the DH points to NHS Direct, where a £68m national contract was awarded to dark horse Axa Assistance in 2000, as a model of how a national implementation can be successfully delivered to a tight schedule.

In March Sir John Pattison appeared to rule out the award of single national contracts for systems, but made clear contracts would be awarded to a small number — between one and five — accredited suppliers, possibly based around consortia.

The objective for 2002-2003, he explained, was to establish standards and national specifications for these core systems, shortlist suppliers nationally, and streamline procurement procedures to allow very rapid implementation from April 2003.

An initial set of baseline standards and system specifications is expected to be announced within the next month The NHSIA, meanwhile, is also understood to be set to announce details of its four main programmes in the next couple of weeks, covering infrastructure, electronic booking, electronic records and electronic transfer of prescriptions.

An indication of the NHSIA’s direction of travel is provided its new Health Records Infrastructure (HRI) programme, designed to create web services based electronic records services from three of its existing national operational systems: the NHS Strategic Tracing Service, NHAIS – the National Health Authorities Information System, and NWCS – the system detailing hospital activity.

The goal is to integrate these three systems with new access controls, authentication and permissions mechanisms to form a ‘Core Health Record Service’, which will be accessed through a web-based Health Record Portal. Over time, the aim is to develop the Core Health Record Service to provide the route to other more detailed health records services.

What is unclear is how the ambitious new NHSIA programme, which appears to be based on creating an information infrastructure to support web services, will fit with the emerging national plans to deliver infrastructure, electronic booking, electronic records and e-prescribing.

DH sources suggest, however, that the detailed national IT strategy is now nearing completion and that, subject to Treasury approval, the full programme should be unveiled in June.

At ground level within the NHS, meanwhile, many IT managers are struggling to protect vulnerable IT budgets from raids, while coping with massive organisational change and uncertainty. PCTs were recently advised not to begin new major new IT procurements until further national guidance is issued.

Two months on from the new tightly-focused strategy on NHS IT announced by Sir John at Harrogate and a month after promises of massive increases in NHS investment in the Budget, it remains unclear as to how the transforming national programme will be delivered. In addition, the all important funding has yet to be committed.

The announcements due over the next month or so will need to offer a clear blueprint, spell out investment plans and give strong national leadership in order to provide the ambitious programme with real momentum.