Granger says NPfIT programme substantially delivered

Richard Granger, the chief executive of Connecting for Health, today said that the NHS IT project has been substantially delivered with key component programmes now nearing completion, though 90% of acute trusts have yet to get new systems.

In a key development he said that live trials of the patient summary care record would begin ‘within days’, the first step on the roll-out to a national system of NHS Summary Care Record (SCR).

The NHS IT boss robustly defended the multi-billion programme he leads saying that much of the debate surrounding was mis-informed. He characterised debate surrounding NPfIT as ‘complete tosh’ acknowledging that some things are late, but stressing that the core message-based architecture was working.

Speaking at the Smart Healthcare 2007 conference in London today, Granger admitted that the NHS SCR had been ‘slightly more controversial’ than CfH had initially anticipated.

However, he says that the SCR early adopter sites were going well and CfH are now ready to go-live with the core software for the project in the next few days. “The Summary Care Record core software is now built and we will be going live with it in a few days time, first in Bolton and then in Bury.”

He said that debates around consent and confidentiality were valid, but felt that people opting out were not aware of the need for a record in an emergency. “I’m fairly confident that the people who are actively engaging in trying to prevent summary information being available to out-of-hours staff, accident and emergency staff and eventually ambulance staff, have not needed to have that information available.

“With the SCR we can guarantee that the person making serious decisions about your healthcare in an emergency will have all the necessary details about you. We are taking this on a step-by-step approach, and of course there are compromises to be made.”

The head of the Connecting for Health spoke of the programme as a work nearing completion and set out some impressive statistics on how far systems have been developed to date for use in the NHS: he said the figure for Choose and Book was 97%; the Electronic Prescription Service 48%; Picture Archiving and Communications Systems 80%; and the National Care Records Summary 82.5%.

He said GP2GP record transfers, however, remained at an early stage, currently just 9% ready. This he said was as a result of the ‘high degrees of interoperabilty’ required. Granger said this was largely down to systems suppliers ‘competing vendors seem to be really bad at doing this’.

The other big challenge remaining he said was delivering systems to the acute sector. He said that in the acute sector, 10% of sites now had new patient administration systems, but spoke of the significant difficulties stemming from implementations in brownfield sites, where moving to a new system was "like changing the wheels of a vehicle without the vehicle actually stopping."

He added: “There is a lot more work to do, but we would not have got to this point without our dedicated ring-fenced funding. I think that with a bit less whingeing and a bit more support, we might have even got the programme done quicker.”

Referring digital x-ray systems Picture Archiving Communication and Storage, one of the big successes of the programme so far, he said that it would have been desirable to start the programme with such a crowd pleaser for clinicians: “I’d have liked to have started the programme with PACS myself,” he joked.

On Choose and Book, Granger reminded the audience that the government has made it the patient’s right to have choice. Quizzing the audience on how many had done so in the past year, less than half put their hands up.

Granger said: “GPs have said publicly they didn’t become GPs to be a glorified travel agent, but the patient must remember that they should exercise their right to have an appointment at a time that works for them.”

The CfH chief exec dismissed calls from opposition MPs for an independent review of the National Programme for IT, describing the idea "as controversial as the national programme" itself.

Granger said that opposition MPs had read too many reports saying that nothing within the National Programme works or is likely to be delivered. Instead he argued that on key programmes the programme had successfully delivered or almost delivered systems, suggesting that on key areas the multi-billion pound programme is nearing completion.

Referring to calls by Liberal Democat MP Norman Lamb, for a halt to the programme while it is reviewed, Granger said: “In my opinion, it is as controversial as the national programme itself to suggest to 18m patients that they aren’t going to be able to get bookings immediately, amongst other successes of this programme.

“It’s an interesting idea, but not the kind you could execute without massive disruption.”

Concluding his presentation, he told delegates that despite the achievements there remained a long way to go to achieve the goals of NPfIT, but added that there was now a lot more in the specification than was originally intended in 2002.