Granger answers Choose and Book critics

NHS IT chief, Richard Granger, says that low usage of the Choose and Book system is not something he can do anything about.

Granger said in a wide-ranging interview in Computing magazine: “The core application is there, does what it was asked to do and was delivered on time.

“There have been some configuration problems, some service availability issues and a series of user requirements which emerged subsequent to the launch that we have had to deliver, but low usage is not something I can do anything about.”

The Connecting for Health chief executive is reported to have been angered by a recent statement by his boss, NHS chief executive, Sir Nigel Crisp, to the Commons Public Accounts Committee in which Choose and Bookwas described as being a year late.

Granger maintains in the interview that the delays are NHS-wide issues outside the National Programme for IT’s (NPfIT) remit and beyond his control. The central application was delivered in July 2004, and all upgrade and service availability targets have been met.

He said there were two sources of delay: some logistical problems such as the upgrading of hospital systems by NHS trusts and some more political, such as take-up, because many GPs were not sold on the patient choice policy that Choose and Book allows.

In the interview, Granger reflects on “a tough year in which we have put some of the cornerstones in place.”

Widely reported problems with London’s local service supplier, BT, appear to be under control. "BT is on report and being closely monitored, and it is staying behind to make sure its homework is done," the CfH chief says.

He repeats oft-rehearsed messages about the NPfIT successfully tackling of a lot of work that was not originally scheduled for it and about the radical changes in the NHS which have increased the organisational complexity facing the NPfIT team.

On the main planks of the national programme Granger says:

N3 – the national network. There have been some installation quality problems with supplier BT, but the implementation is about to deliver its 12,000th connection and is about 2,500 ahead of a schedule due to be completed in March 2007.

Electronic Transfer of Prescriptions. So far, 72 GP practices and six pharmacies are live on the system and about 70,000 electronic scripts had been processed by the end of October. "We are on the verge of being able to connect some of the large pharmacy networks, so we expect exponential growth," says Granger.

Electronic patient records. The core software is in place and will be completed by the end of the year, says Granger. But as well as the central application, local systems need to be upgraded to access the spine. He says the hospital end of the programme has hit problems and continues to run about six months behind schedule. He predicts that the next couple of months will be critical, as the first two patient administration systems are due to go live in hospitals in London and the South.