Granger: Rip and Replace Fears Unfounded

Fears of a wholesale rip and replace strategy to update NHS IT are unfounded and existing ‘legacy’ systems will continue to be vital, NHS IT boss Richard Granger told the British Computer Society’s Primary Health Care Special Interest Group (PHCSIG) conference this week.

In a well received speech the Director General of NHS IT told an expert audience steeped in the development of primary care IT: “We are going to hold on to what’s there already, we’re not going to bulldoze.” He continued: “If you use a system at the moment and it serves you well I can see no rational basis for replacing that system.”

Mr Granger continued: “There is a lot of asset out there already and in most cases systems are less than four years old.” He stressed that the immediate priority was to get the maximum level of interoperability from existing systems. Illustrating the current problem he highlighted how practices with fully electronic record systems have to physically print out patient records and post them to transfer them to other practices

However, he added that he was pleased at the movement among the supplier community to meet the interoperability challenge. “I’m very pleased the supplier community is responding to treatment on that,” said Mr Granger. He revealed that membership of the supplier interoperability forum had passed 40 and that he had asked the Confederation of British Industry to become involved and act as a catalyst.

Moving on to update the audience on progress on specifying Integrated Care Records Services (ICRS), Mr Granger asked for a show of hands from for who had seen the restricted circulation Output Based Specification (OBS) for ICRS. He appeared somewhat taken aback when a third to half of the audience raised their hands, and observed: “Our document control system is clearly not working.”

Mr Granger explained that although he had no problem with publication of the OBS document, it was a draft document that would develop and be fleshed out over the next couple of months. “It’s not a done deal, it’s just a stake in the ground.” He promised to review the position on making more information available and said a 30-page summary of the OBS document would be published within weeks.

With supplier responses to the OBS document due by the end of June, Mr Granger said he was shortly expecting to receive 10,000s of pages in response and revealed that “Suppliers are really hacked off at the size of the document and their response.”

And the requirements set out in the OBS are already proving too much for some suppliers, added Mr Granger. “I know a number of bidders are in the process of dropping out.” He predicted that there many suppliers will recombine with other bidders. “I think that’s good as its being realistic about where they will fit.”

E-Health Insider understands the casualty rate is particularly high among prospective National Application Service Providers (NASPs). Up to three of the seven on the long list are said to be in the process of bowing out.

Mr Granger went on to stress that the aim of the current National Programme procurements was to put in place solid foundations that could then be built on rapidly. Once the procurement phase is completed (read EHI passim) he said the intention was to start getting useful tools into the hands of clinicians as soon as possible.

“We want to get things out into the field as soon after contracts are signed as possible. One of the things we want to do is picture archiving; it’s one of the technologies that can deliver real benefits early.”

Seeking to manage expectations he warned though that providing rich functionality would take time, and some people will initially be disappointed at the functionality of ICRS. “Some people will be disappointed as it will not deliver the functionality they want immediately.”

Mr Granger revealed that he is not the only person in his family frustrated at the current state of NHS IT, as his wife – an NHS speech therapist – shares a PC that has a broken on-off button with 16 other people. Asked by the audience whether he’d enquired whether it was stuck on or off, Mr Granger said he had. “I had to cook my own tea that night”.