NHS Informatics Review says trusts need ‘interim’ systems

NHS trusts are to get support, and in some cases may get national funding, to select and install “interim” systems as a result of the NHS Informatics Review.

The change in emphasis comes in response to delays of four years or more in the strategic, detailed electronic record systems at the heart of the National Programme for IT in the NHS.

The review, which was led by the Department of Health’s interim chief information officer, Matthew Swindells, before his departure to the private sector, says that good information and good information systems are essential for the delivery of Lord Darzi’s Next Stage Review of the NHS.

It reaffirms the goal of the national programme to deliver integrated care records systems, but acknowledges the impact on trusts of lengthy delays in the delivery of strategic systems from local service providers.

It also spells out the need to use proven systems until better ones becoming available. Interim systems are expected to range from very specialised departmental systems through to hospital-wide patient adminsitration systems.

NHS Connecting for Health, the agency in charge of the national programme, is already working with trusts and strategic health authorities on specific requests for help on interim systems.

Speaking at a DH press conference today, NHS medical director and interim director general for informatics Sir Bruce Keogh said that NHS informatics has been through some “turbulent times.”

However, he stressed that the move on interim systems was not a licence for open season. “If people start going it alone it could be at a huge opportunity cost.”

The review says trusts urgently need systems that can benefit patients and clinicians. It says many proven systems are available that offer real benefits and that these should be used until better alternatives are ready.

Trusts will be able to get interim systems through their LSP or buy directly from suppliers using the Additional Supply Capability and Capacity framework contract.

Speaking at the press conference, Gordon Hextall, acting head of CfH, denied that the move represented the abandonment of the strategic goals of the NHS IT programme.

“As the recent National Audit Office report pointed out, it will take four years longer to put systems in everywhere,” said Hextall. He said in many cases trusts needed systems ahead of 2012 that can help them deliver care.

He said interims could be particularly helpful in terms of departmental systems but indicated that they could also apply to larger PAS systems. “If a hospital has a PAS that is not spine connected, it could get huge benefit from getting a system linked to the spine.”

“There is no departure from the strategic vision, but a greater emphasis on standards and being able to have information flow across different care settings and care providers.” He said that there would be no hard and fast rules, with trusts dealt with on a case by case basis.

“There would need to be a business case and it would need to be funded locally, unless it was something the LSP were contracted to deliver locally,” said Hextall. “LSPs will be the starting point. If trusts want to buy independently they could buy through ASCC.”

Asked whether national funding would be made available in some cases, Hextall told E-Health Insider: “It could be.”

He added: “We have tough contracts in some places and in others we will have to be imaginative.”

Questioned on how soon NHS trusts could get clarity on how they can purchase or get hold of interim systems Hextall declined to be drawn, but said that to be of use interim systems would have to be delivered rapidly.

Asked whether trusts that deploy interim systems now will have to move again when strategic systems become available, Hextall said the consultation with the service had provided the clear message that they still want the strategic national programme vision delivered. “Everyone was content that strategic solutions need to be deployed when they are ready.”

Hextall told EHI that CfH was there to assist NHS trusts and was already responding to specific requests for help. “We have started already on areas like document management and e-prescribing. If there is any way of us funding nationally then we will. We are here to help.”

Although no hard and fast details were announced today, Hextall indicated that one existing option would be for NHS organisations to use would be the 61 clinical vendor contracts awarded by CfH in May’s ASCC framework contract.