Connelly: NHS must look beyond NPfIT

The Department of Health’s director general for informatics says that it is time to think beyond the National Programme for IT in the NHS, or risk being held prisoner by it.

She argues that for too long the NHS, media and suppliers have been too focused on systems rather than information and its use, and that the national programme is only one part of the information challenge.

Society and technology have both dramatically changed and the NHS has failed to keep pace, she argues.  “Technology has moved on and society has moved on, it is time we in the NHS do too."

NHS needs to get over NPfIT

In an exclusive interview with E-Health Insider following her keynote address at eHealth Insider Live 2010 last week, Connelly said that NPfIT remained unfinished business, particularly in the hospital sector.

However, she said it was only one part of a much wider agenda that aims to use information to place patients in control of their health.

The aims were set out in the government’s recent consultation on a new information strategy for the NHS, ‘Liberating the NHS: an information revolution.’

However, this made little mention of either the national programme or the other technology projects that will be needed to bring it about.

Connelly rejected the suggestion that this made it a soft option. The focus on a separate information strategy was a very deliberate move by the Secretary of State for Health, she said, designed to reflect the central role information must play.

Look beyond 2010

Connelly told EHI: “We can’t be stuck with a strategy that was determined in 2000. The question is how do we determine our strategy for the next five years?

“There comes a point where we have to look up and say are we going to allow where we are now on the national programme to determine our future, or to define our future for the next ten years?”

“How do we better support some of the things going on in the market, a market that has changed hugely since the national programme was first drawn up? We’ve had such a focus on systems that we’ve lost sight of the real goal."

But she acknowledged this focus on systems is because NPfIT has not delivered as promised to all parts of the NHS, the biggest and most obvious failure being hospitals.

NHS IT remains a mixed picture

“Different parts of the NHS are in a different state,” she said. “Primary care, where doctors do have electronic systems, remains one of the most advanced health sectors in the world.

"They are a great source of information. Mental health and community, they have also now got good systems.

“The place where we have definitely had difficulty is the acute sector, but let’s not confuse that difficulty in hospitals with the whole of the health service.”

Yet despite the government’s September pronouncements on trusts having greater choice of systems, Connelly makes clear that choice should be provided through some revised versions of the existing local service provider contracts.

Choice of modules through LSPs

“Taking modules through LPS contracts might be a better way of getting more flexibility from the contracts we have,” she told EHI.

Addressing the situation in London she said: “In London the SHA has a plan, that all trusts have signed up to and we will be implementing it with the London LSP.”

Turning to the North, Midlands and East she said: “In terms of NME we continue to be focused on ensuring that release version 1.9 of Lorenzo has been stabilised, and once that has been achieved we can move to wider roll out.”

Birmingham Women’s Hospital NHS Foundation Trust became the third to go live in October and is due to be followed by Pennine Care NHS Foundation Trust , now due in 2011-more than a year later than previously planned.

She confirmed that the latest version of iSoft’s electronic patient record system, Lorenzo, which is known as Release 1.9, must to be installed in four different sites for a release key milestone payments to local service provider CSC.

The same milestones will open the way for further deployments, which she suggested could occur simultaneously.

Many parallel Lorenzo implementations

“Once we get to that point we’ll be able to do many implementations in parallel,” says Connelly. “Until the product is stable you can’t do that.”

Asked to clarify whether the iSoft product is yet stable she says not. “No the product is not yet stable. We are cautiously optimistic about Birmingham Women’s, but we’ve still not yet stabilised Morecambe Bay.”

Turning to the Additional Supply Capability and Capacity procurements in the South, she confirms that, subject to business case approval, the DH plans to restart the procurement for child and community health systems, followed by ambulance and acute systems.

“Our intention is to move forward with a whole set of things under ASCC. But we’re much further ahead on child and community health than we are on acute and ambulance.”

ASCC now moving to business case

She explained that delays on ASCC have resulted from the government’s major projects review, which has required ASCC receive clearance from the DH, Treasury and the Cabinet Office. Having cleared these hurdles a business case is now being prepared.

Connelly urged anyone interested in the future of NHS information and technology to engage with the current consultation that runs until mid-January, saying that it was genuine and open.

“Our intention is to deliver the white paper and the consultation is looking for best thinking on how we can use information to deliver it. That is a massive challenge.”

NHS Information agenda now mainstream

However, she repeatedly stressed that there is a need to move on from contracts and focus on the bigger picture of helping the public and patients to make greter use of information to drive openness and quality.

She said that many other industries have achieved the types of transformation of services the NHS was now aiming at; but to make the changes needed required a mainstream engagement of the whole health service. “This can’t just happen at the fringes."