Review of Connecting for Health imminent

Gordon Hextall, chief operating officer of NHS Connecting for Health has revealed that a review of the NHS National Programme for IT is to be carried out to bring it up to date with NHS policy developments and the impact of new technologies.

Hextall said that it was five years since the original policy Information for Health was published in 2000 and the strategy now needed updating. “The challenge is to constantly take stock of a changing situation and adjust accordingly.”

Speaking to EHI Primary Care, Hextall indicated that the key delivery dates for the national programme would be subject revision: “The original targets were published two years ago”. He said it was not reasonable to hold the programme against targets published this long ago, and had subsequently been subject to change.

He said that the review was aimed to update the programme. "We’re looking to refresh business and technical architecture to take into account changes in policy and developments in technology and architecture."

"Things change," said Hextall. "We’ve had additional projects added that we’ve had to deliver including QMAS, Contact and Payment by Results."

CfH is tasked with delivering the IT strategy based on the Delivering 21st Century IT Support for the NHS, published in 2000 – itself an update on the 1998 strategy Information for Health. Since the publication of these documents NHS reforms have been introduced to greatly increase the role of the private sector in NHS provision, foundation NHS trusts have been created, the Patient Choice agenda given primacy, and a complete re-organisation of PCTs and SHAs announced.

Hextall declined to be drawn on whether the review would include the scope of systems to be delivered and the initial implementation dates for the core clinical solutions to be delivered by LSPs, which have already slipped from 2004, to 2005 and now look likely to be delayed until at least 2006.

Addressing the British Computer Society Primary Health Care Special Interest Group conference in Cambridge last Friday Hextall stressed that in key areas the programme was being delivered at pace and scale, with five new PACS systems going live in September alone.

He said that following the signing the contract with Accenture to deploy PACS in the North east and Eastern regions there would not be a long delay, as NHS organisations had made preparations. “The NE and Eastern have been doing business cases in advance so there will not be a delay.”

In addition to the 1,000-odd implementations so far counted by CfH he said a further “576 are predicted to the end of the year”.

The CfH COO said that in fact the readiness of NHS organisations to take new systems is now proving the bottle neck to deployment. “NHS performance is now an issue,” said Hextall. “Local IT issues need to be overcome, and clinicians and NHS managers need to be ready to go.”

He claimed that in September for the first time deployment capacity would exceed demand from the NHS. “In September deployments are outstripping business call orders for the first time.”

Hextall added that the performance of some suppliers in delivering the programme continued to be an issue: “Supplier performance has been an issue for us not just with our contractors but with existing suppliers as well.”

Outlining progress on the development of the data spine delivered he said that in July 2004 four elements had been delivered to support phase one of Choose and Book: messaging, the personal demographics service, access control and the spine directory.

In February 2005 two further elements were added: Electronic Transfer of Prescriptions and GP-to-GP record transfers. Then in June an update to Choose and Book was added “to allow indirectly bookable services”, together with Payment by Results.

The next full spine release will come in December and introduce legitimate relationships, and a new identity agent that should “cut the log-on time to the spine to two to three seconds”, said the CfH COO. December will also see an update to the Personal Demographics Service.

Once these updates are in place there will in future be only two updates to the spine each year, one of which LSPs will be expected to take. “This will simplify version control of the Spine,” explained Hextall. “It will allow the LSPs to get on without continually doing regression testing.”