Warner rejects call for CfH architecture review

Health minister Lord Warner has rejected calls from leading computer academics for an independent review of the technical architecture of the NHS national programme for IT.

Speaking at a conference in London yesterday he said: "…I do not support at the call by 23 academics to the House of Commons Health Select Committee to commission a review of NPfITs technical architecture. I want the programme’s management and suppliers to concentrate on implementation, and not be diverted by attending to another review."

The 23 academics earlier this month wrote an open letter to the Commons Health Select Committee calling for an independent review of the £12bn NHS IT programme.

In their letter the group urgently called for an independent technical review, describing it as an essential step to help ensure the project succeeds. The group urged the Health Select Committee to carry out “an immediate inquiry to establish the scale of the risks facing the NPfIT".

The 23 leading computer sciences related academics first wrote to the Health Select Committee in April this year expressing their concerns about the technical feasibility and risks associated with the £12bn NHS IT programme, currently running two years behind schedule.

They were subsequently invited to meet with NHS IT director Richard Granger who subsequently invited briefing. CfH and the academics issued a joint statement saying “a constructive and pragmatic independent review of the programme could be valuable”. No such review has since occurred.

Warner said the CfH programme was central to the government’s NHS modernization agenda and had already been vindicated by July’s National Audit Office report. “A positive report was received from the National Audit Office this summer despite subsequent attempts to undermine the objectivity of that report.”

The minister’s speech equated criticism any aspect of the late-running programme as opposition to health service reform and digitization. “Critics of the programme often conveniently overlook the unsatisfactory nature of the current paper-based system.”

In his speech Warner outlined the achievements of the NHS IT programme in delivering infrastructure. Offering a choice selection of key facts about the programme he highlighted the N3 network, claiming it as the “largest virtual private network in Europe”.

He said the planned storage capacity for Picture Archiving and Communications (PACS) – for which 72m images are now held digitally – was 10 petabytes. “Enough to store 1.3m DVD films,” Lord Warner helpfully explained.

He offered Tesco supermarket store openings as a helpful comparator to progress on PACS. “I’m told that Tesco opens one new store week, so we’re actually digitizing hospitals faster than Tesco is opening new stores.”

Warner also said the over 5.6m electronic prescription transfers have now occurred, with 1,023 – about one in ten practices – now using the system. Other achievements highlighted were NHSmail, where over 200,000 users have been registered and the introduction of the GP Quality Management and Analysis System.

Notable by its absence though was any mention of the delays to the systems at the heart of the programme: the national summary and local detailed Care Record Service applications that are meant to deliver detailed integrated electronic medical records for everyone in England.

To date in the secondary care sector the programme, through its prime contractors, has delivered just over a dozen replacement patient administration systems, and a handful of very few clinical systems. Key suppliers have either been sacked or replaced, creating further delays.

Warner acknowledged that not all had gone smoothly: “Given its size and ambition it is not surprising that there are glitches. But overall we are well advanced with delivering the infrastructure of Connecting for Health.”

He, however, restated the government’s commitment for the programme: “"Let me be clear and unequivocal: the Government is committed to ensuring that NPfIT is fully implemented and delivered. We are not going to be deflected by naysayers from any quarter. We recognise that more needs to be done on articulating the benefits that the programme will bring to patients and also to NHS staff."