Granger says NHS chief exec fully backs NPfIT

NHS IT director-general Richard Granger claimed this week that the service’s acting chief executive Sir Ian Carruthers is fully behind the programme and the investments needed to make it work.

He also asserted said that the £6.2 billion investment programme will remain a top priority, irrespective of the financial crisis facing some parts of the health service. The upbeat message comes ahead of June’s excepted publication of a National Audit Office report on NPfIT and hearings by the Commons public Accounts Committee.

‘Ian Carruthers has a very strong commitment to make sure we do not waiver in the things we have said we want to do,’ Granger said in an interview with Computing.

Granger told the magazine that Sir Ian was “encouraging completion of the business case approval process for PACS, issuance of smartcards and completion of the order process for the last 5,000 circuits of the N3 network”.

Although progress has unquestionably been made on infrastructure projects, and areas like PACS, the Electronic Prescription Service and Choose and Book, key central clinical objectives of the project – summary national and detailed local electronic patient records – are already up to two years late.

According to the original 2002 strategy ‘21st Century IT Support for the NHS, A Strategic Programme’, against which contracts were awarded, summary electronic patient record pilots were due to be available from the end of the 2004.

But limited pilots are now not expected to begin until the beginning of 2007, involving text format summaries of allergies and medications, but without details of previous treatment or medical history. Only last week the BMA’s General Practitioner Committee again rejected NHS Connecting for Health’s preferred model of implied consent for including patient’s information on these summary shared records.

In its report Computing reported that after early technical difficulties, the NHS spine being developed by BT is back on track with the “current expectation” that pilots will start early next year. Granger told the magazine this timetable would depend on decisions from the clinical community on governance and what is to be held on the national summary record.

“Summary patient record activity will happen six to 12 months after we get a consolidated set of requirements following extended consultation with stakeholders,” Granger told Computing.

Elsewhere in the interview the NHS CfH boss said the perception of NPfIT as a Stalinist autocracy crushing all in its way was a misunderstanding. “I don’t think we have properly communicated what we’ve built: the spine is not a standardisation bulldozer with which to clear away lots of cherished systems, but rather the means by which those systems can be enabled to send information around the NHS.”

He added: “There is a balance to strike between the homogeneity we are accused of and an excessive heterogeneity that leads to an engineering impossibility around integration. History will tell if we have the balance right, but we are aware that we need to strike it.’

The interview also reports Granger as saying that trusts are more critical of products bought nationally, contrasting the 8,000 problems with iSoft software trusts have reported under NPfIT, while iSoft customers appeared willing to put up with them pre-NPfIT.

“The core software is a challenge for suppliers and we would like a lot more functionality than is currently available, but most of what is installed across trusts now is not sustainable.”