Granger Tells NHS Boards to Take on IT

A sign of the times was provided last week when it was standing room only at the NHS Confederation’s annual conference in Glasgow to hear NHS IT Director Richard Granger give details of the National Programme for IT (NPfIT) in the NHS.

Speaking at his third major conference in as many weeks Mr Granger said “We are now trying to communicate the programme out to the NHS England.”

And Mr Granger’s strongest message to the audience of NHS leaders and senior executives was that they had to make sure IT is a board-level issue for their organisation, rather than regard, or ignore, it as a backroom activity.

This was backed by Charles Goody, the NHS Confederation’s lead on IT, who stressed that the success utterly depended on local ownership. “IT should be on your board agenda every month, not just once a year. If you don’t it won’t be delivered.”

The clear sub-text was that once contracts are signed later this year and the national programme begins to move into delivery mode, the first NHS organisations to benefit will be those that have prepared, planned and are ready to move.

To help ensure success Mr Granger exhorted the audience of NHS leaders to let IT specialists into the boardroom and stop regarding them as train spotters: “Most of us have burnt our anoraks, give us the chance to be in boardroom. We’re not strange.”

Mr Granger also challenged head on the notion that he was responsible for preventing local projects going ahead, or somehow had control of all NHS IT funds. “I’ve not put any barriers up for you to deploy and use systems,” stressed Mr Granger. “I’ve never said people should stop buying things on the ground they need now and can afford.”

The idea that he suddenly controlled all IT funds was simply not true, he added. “I don’t know where this ‘I’ve got all the money’ is coming from.” The extra £2.3 billion being invested was “additive”, above and beyond the baseline spend already built into local budgets. “This year we have £450 million of new money and £850 million of baseline spend.”

He told the audience that one of the questions he was being asked was whether existing data would be included in the new integrated electronic care records to be delivered by the programme. The decision he said “would be down to individual clinicians and managers.”

Earlier the main clinical lead on the programme, Professor Peter Hutton, chair of the Academy of Medical Royal Colleges, had earlier set out the challenge faced: “IT in the NHS has had a bad history, it has been run by enthusiasts, hasn’t delivered and the benefits to patients have been negligible.”

Drawing on his own clinical experience to illustrate the current problems of fragmentation and duplication of records, Professor Hutton told the audience: “I anaesthetised a patient on Monday who had four sets of notes and six ID numbers!”

Describing the national procurement currently underway Mr Granger said: “We’re in a vibrant procurement. I know it’s vibrant because the suppliers are squealing.” The audience, packed with trust chief executives, chairs, finance directors and other senor NHS executives, was also told that the programme was about the NHS exerting its power and scale.

Emphasising the sheer scale of the challenge he said that it was estimated that 500,000 people currently use IT to do their job in the NHS, a figure now set to rise to 850,000 users. “There’s only one comparable user and that’s the US Department of Defence.”

One of his main achievements in his first eight months in post had been to establish a team to deliver the programme. He described how the team of 206 he had gathered around him, was drawn from the NHS, industry and civil service. “It has elements of many successful projects I’ve worked on in the past,” said Mr Granger.

He also praised the “strong” team of chief information officers at strategic health authorities and announced that CIOs will be supported by “a number of people who will manage the interface with contractors”.

The NHS IT boss also revealed that plans were being developed to ensure local staff are increasingly involved in the national programme: “Behind the scenes we are working to set up some formal machinery for patients, managers and clinicians on how they can feed into requirements.”

But perhaps the most striking part of the session was not the actual content of Professor Hutton and Mr Granger’s presentations, but the sheer number of senior NHS executives who virtually mobbed the NHS IT boss at the end, with a host of questions often about quite basic aspects of the national programme.

The two abiding impressions were that the NPfIT still has a big communications challenge ahead; and that for a lot of NHS organisations the NPfIT has only just begun to register on their radar. Many are just not ready for it.