‘Rescue plan’ to fix NPfIT published

A rescue plan that promises to save the NHS £1 billion and realign the NHS IT programme to support health service reform, has been published by health think tank 2020health.org.

The report argues that getting NHS IT right is “critical” for a new government, but that it should resist clarion calls to scrap the late-running NHS IT programme. 

It argues that new IT-enabled ways of working are essential to enable the NHS to meet ever-growing health demands, while also being able to achieve tough productivity targets.

Indeed, author John Cruickshank warns of a risk of “hiatus” for NHS IT after the election expected in May.

His report, ‘Fixing NHS IT – an Action Plan for a New Government’ sets out what it describes as a “rescue plan” for NPfIT.

It urges that core parts of the national infrastructure should be retained – including the N3 network, PACS and the Electronic Prescription Service – but the Summary Care Record should be reviewed.

It also argues that shared care records in primary and community care and secure data centres are successes that should continue.

The report says future national IT approaches should only be done in limited circumstances. Provided they meet nationally agreed standards, trusts should be free to set their own direction to meet local clinical priorities.

The report calls for “a radical reorientation and downsizing of the central IT organisation” to ensure it becomes more transparent and accountable to the NHS. It then calls for an accompanying strengthening of IT provision at the local level.

It says the top priority to be addressed by trusts, with the support of a scaled back central IT organisation, should be “addressing the care records service in acute hospitals where the failings are greatest."

“The Programme’s most significant failure lies in acute hospitals, where centrally provided solutions have been very late because the NHS does not conform to a ‘one size fits all’ model, and for a mixture of contractual, software delivery and deployment reasons,” the report argues.

It adds that the delivery of the overall vision for the Care Records Service “remains at least five years away." 

The study, which is based on confidential interviews with NHS officials and the private IT contractors involved in NPfIT, assesses successes and failures.

“It argues that the perception that the problem can be fixed simply by axing the Programme and localising everything will only makes things worse,” said Cruickshank.

Instead, the approach it recommends is to accelerate the benefits from exploiting the new NHS infrastructure, while halting or redirecting failing parts of the programme.

In total 30 recommendations are made, all to be carried out within 12 months of a new government taking office.

To help meet the challenges of caring for people with chronic conditions, the report says far greater use of telemedicine is required, following the example of Scandinavian countries. Greater use of collaboration technologies and document scanning is also called for.

“We believe the recommendations in totality will save more than £1 billion and lead to significantly improved patient outcomes,” said Julia Manning, Chief Exec of 2020health.org.