Care records now running 2.5 years late

Health minister Lord Warner has said that plans to introduce an integrated electronic medical record for every NHS patient in England are now running at least two-and-a-half years behind schedule.

The health minister said that the plans for the national summary electronic record, the foundation for later national integrated electronic medical records, first due in 2005, were now running between two and two-and-a-half years late.

The first deployments of the national summary clinical record were originally due last year. But now that would not happen until “late 2007 or early 2008”, Lord Warner told the Financial Times.

In the interview Lord Warner, the minister responsible for England’s NHS National Programme for IT (NPfIT), said some parts of the programme "are going pretty well and pretty much to time", but added others "are going more slowly than we would otherwise like".

He said the Government had had to "regroup" over the integrated national electronic medical record for all 50m NHS patients in England, which is meant to make patients’ data available wherever and whenever it is needed.

As previously reported by E-Health Insider, the introduction of integrated clinical record has been subject to repeated delays and re-think on its content. The current plan is that the summary record uploaded to the spine will initially include only allergy and the most recent prescription information, without details of major diagnosis and procedures. Trials are meant to begin in 2007.

The delays mean the electronic record may not be in place until early 2008 and are due partly to delays in providing the software.

“I don’t feel apologetic about some of the missed targets,” Lord Warner told the FT. “If you don’t set some ambitious timetables you will not drive a big project of this kind… we owed it to people and the NHS to try to move as quickly as we could.”

Delays are also being exacerbated by NHS Connecting for Health having so far been unable to reach agreement with the BMA on what the patient consent arrangements should be for data. Lord Warner acknowledged that – three years in – the programme was at a “pivotal point”.

With next month’s National Audit Office report expected to criticise the national programme for failing to consult effectively  with staff and engage clinicians, Lord Warner told the FT: “That is probably a fair criticism in part. We possibly could have got into the game earlier, and we could probably have done it better earlier on.”

But he added that given the history of efforts for computerise the NHS many doctors quite understandably wanted “to see the reality” before they fully engaged. Lord Warner said this was now happening.

The health minister also sought to clarify “confusion in the public arena” about what the original £6.2bn of contracts awarded “does and does not cover”. He explained the £6.2bn covered the national infrastructure and applications such as electronic booking and electronic prescriptions and records software, but not the additional local spending needed to train staff, buy hardware, integrate existing systems, convert data and other local costs.

To meet the cost of implementing the programme, hospitals and other parts of the system would have to use their existing spending on IT – around £1.2bn a year and rising. As a result “spending over the next decade is going to be up nearer £20bn,” said Lord Warner.

He added that this was not all new money as the “NHS would have been spending about £1bn anyway on old systems”, but which would not have provided the same level of clinical capability that the NPfIT procured systems will eventually deliver.

Lord Warner also told the FT that, thanks to NPfIT, the NHS could take advantage of a whole set of agreements covering software and hardware that allowed it to replace local systems far more cheaply than in the past.