A Department of Health review of the NHS’s National Programme for IT (NPfIT) concluded that a local, plural approach should replace the current centralized, national strategy. The program was originally designed to replace local NHS computer systems and to procure information technology (IT) centrally. But it has been criticized for implementation delays, concerns about patient privacy and security risks, a low degree of clinical functionality, and its expense.
Under the new policy, NHS trusts and general practitioners will choose their own IT systems and providers, rather than adopt an appointed "local service provider." These localized IT systems will be connected, rather than replaced, to create a national IT infrastructure. IT systems that are already integrated into health services will remain in place. The Department of Health expects the transfer of responsibility for IT from national to local bodies to save £700 million (US$1 billion), though the department has not detailed where the savings will come from.
NHS Connecting for Health was established in 2003 as the agency responsible for implementing the NPfIT. The agency’s primary objective was to implement a single, national Spine, containing Summary Care Records for each NHS patient; the Summary Care Record was to be a secure electronic record containing demographic and clinical information, accessible from any point of service within the NHS. In addition, Connecting for Health has been responsible for development and implementation of a national electronic prescription service (including electronic transfers from physician to pharmacy) and Choose and Book, an electronic appointment booking system accessible across NHS sites.
Two separate reviews of the Summary Care Record commissioned by Health Minister Simon Burns, health minister responsible for IT (and led by Professor Sir Bruce Keogh, medical director of the NHS in England, and Joan Saddler, director of patient and public affairs), concluded that a core record containing electronic summaries of core patient information "will prove valuable for patients needing emergency care." However, the reviews recommended that the record be scaled back to contain only patients' demographic details, medications/treatments received, allergies, and adverse reactions. To address privacy concerns, it recommended that this information be copied from a patient’s GP’s records, with any additional information added only with explicit consent of patients. The reviews also recommended increasing awareness about patients’ right to opt out of the record.
Sources:
http://www.dh.gov.uk/en/MediaCentre/Pressreleases/DH_119293
http://www.bmj.com/content/341/bmj.c4988.full (subscription required)
http://www.dh.gov.uk/en/MediaCentre/Pressreleases/DH_120379
http://www.bmj.com/content/341/bmj.c5714.full (subscription required)