Experts warn £260m not enough

A new government fund to boost adoption of e-prescribing will not be enough to help “laggard” trusts start the journey towards electronic patient records, health IT experts warn.

On Friday, health secretary Jeremy Hunt announced a £260 million fund, primarily for hospitals to increase their use of e-prescribing.

The ‘Digital Challenge’ fund would be a “critical stepping-stone in helping the NHS go digital by 2018”, the Department of Health said.

EHI Intelligence senior analyst SA Mathieson said the fund was substantial, but may not help “laggard” trusts that were not already on the road to EPR.

Research for EHI Intelligence’s forthcoming report, ‘Routes to EPR’, found that the budgets for individual EPR projects usually ran into tens of millions of pounds.

"Given the large cost of complete projects, the focus on e-prescribing has its merits," Matheson said.

"However, the drawback is that e-prescribing is one of the more advanced pieces of an EPR system.

"One of England’s largest trusts told us it will not be able to introduce it until it has improved its hardware and communications infrastructure, and another is implementing it as what it sees as the final stage of its EPR project,” he added.

“So this fund risks helping already good trusts become better, while not doing much for laggards."

Colin Sweeney, ICT director at King’s College Hospital NHS Foundation Trust, said the fund was encouraging, but questioned whether it would be enough to achieve the government’s ambitious targets for a digital NHS.

He said e-prescribing was hugely beneficial, but something many organisations struggled to implement. The costs involved were high and benefits were mainly related to patient safety rather than finances.

Sweeney explained: “£260m sounds like a lot of money, but you have to think about how many organisations there are in the country and to make it work you have to have the infrastructure to make it mobile”.

This involved investment in a wireless network and mobile devices to be used at the bedside.

“There’s a fair amount of investment in e-prescribing, not just the software, a lot is the infrastructure. You also need training and acceptance of a different way of working,” he said.

“That money will struggle to cover e-prescribing, as far as full EPR goes it will involve more money than that.”

Royal Cornwall Hospitals Trust IT director Simon Goodwin said the found would help overcome one of the biggest barriers to introducing e-prescribing, which was affordability.

“That said, the biggest issue is managing the major change involved in moving from paper to digital,” he added.

Goodwin was not aware of the process for getting the money, but said on a fair shares basis, Cornwall could expect 1% of the fund.

“Given that we are introducing this (e-prescribing) now, we would expect to be eligible to apply and make use of the fund to accelerate introduction and ensure we have sufficient portable technology in clinical areas to maximise convenient use by busy clinical staff,” he said.

IT trade body Intellect welcomed the fund, but said that e-prescribing should be part of a wider medicines management strategy.

“Simply bolting on ePrescribing with barcode patient identification is the tip of the iceberg and will not fulfil the highlighted patient safety and financial benefits unless considered as part of the wider medicines management and EPR strategies,” head of healthcare Jon Lindberg said.

Intellect recommended that the DH and NHS England not be too prescriptive in awarding the funds to trusts.

“Trusts need to demonstrate a good understanding of how their proposed solution will address their problem and deliver outcomes that improve patient care and safety, and efficiency,” Lindberg said.

“The role of the centre is to promote common standards and provide support for trusts to meet their goals.”