Uncertain future for IT programme

Whoever wins the election this May, the National Programme for IT may be overhauled. Susie Sell reports.

Eight years after the National Programme for IT was announced, it remains unclear when it will be complete (Photograph: istock)
Eight years after the National Programme for IT was announced, it remains unclear when it will be complete (Photograph: istock)

In a parliamentary response last month health minister Mike O'Brien exposed the latest hiccup for the National Programme for IT when he revealed that expenditure plans for the programme beyond 2009/10 are still undecided.

Mr O'Brien referred to 'ongoing discussions with the Treasury' about how £600 million of savings will be clawed back from the IT programme, a target identified last year by ministers.

The news is the latest drama for the programme, but with a general election due in a matter of months, it's unlikely that it will be the last this year.

After all, already beset by problems, delays and spiralling costs, will either of the main political parties take the programme forward in its current form post June?

Significant changes
'No,' says independent health IT consultant Ewan Davies. 'Whoever wins the next election, there are likely to be significant changes to the programme.'

If Labour wins, it will have to decide how to achieve the £600 million savings. This is 'yet to be determined' according to a DoH spokeswoman.

However, when the announcement was initially made it was clear that the cuts would not be from elements of the programme already in place. Rather, it would be the ones yet to come to fruition that were most at risk.

Mr Davies believes the 'obvious' thing to cut would be the plan to create regional detailed care records. 'This is the area where there has been the least progress, and the area most likely to go,' he says.

'Meeting the requirements of all the different care providers over such diverse patches was always a stupid idea ... and an obvious thing to cut.'

Meanwhile, Dr Paul Cundy, former chairman of the joint RCGP/GPC IT committee, believes that if Labour stays there will be 'very little change'.

'There will probably be more focus on co-ordinating and cobbling together the existing systems we have,' he says.

However, Dr Cundy believes that under the Conservatives things might be very different.

While the Conservatives seem to have moved away from suggestions the programme would be scrapped if they came to power, it is unlikely to remain unchanged. A spokesman said: 'Clearly we need IT in the NHS, but we just need it to work better.'

Dr Cundy believes that under a Tory government the summary care record (SCR) would be under threat, owing to its controversial nature.

'Its whole existence is on blind faith that it will be beneficial. But we have very little emerging proof of its tangible value where it has been working,' he says.

Mr Davies agrees. He suggests that the SCR is most vulnerable, followed by the electronic prescription service and then Choose and Book, owing to the fact that all three have had 'interesting histories'.

Tories the safe option?
Despite the feeling that the Conservatives are likely to make changes to NPfIT, some believe that the programme's future is safest in their hands.

'One thing politicians aren't good at is admitting they were wrong. An administration that doesn't have to defend the past will have a better chance of moving the programme forward,' Mr Davies says.

But, whoever wins the election, what do GPs want to see happen?

Dr Grant Ingrams, chairman of the joint RCGP/GPC IT committee, says the major focus for GPs is for the services on their desk to be working properly.

'We want to make sure money isn't starved from the development of the systems we have already, and that there are ongoing improvements to their functionality and safety,' he says.

Dr Cundy agrees. He says that the last thing that GPs want in the future is an overhaul of the system. 'GPs want certainty that the system we have currently will continue to be developed and won't be left in limbo,' he says.

Mr Davies suggests that it is important to recognise that the NHS has reached a certain point with the programme, which should now be capitalised on.

After all, it's been eight years since the programme was announced and despite its problems, it would be a blow to morale to start from scratch.

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