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Tuesday, May 30, 2006

NHS electronic records will be two years late

Plans to give all 50m NHS patients in England a full electronic medical record are running at least two to two-and-a-half years late, Lord Warner, the health minister who oversees the project, has confirmed. He also admitted that the full cost of the programme was likely to be nearer £20bn than the widely quoted figure of £6.2bn. The latter figure covered only the national contracts for the systems’ basic infrastructure and software applications, he said.

Hospitals and other parts of the NHS would, however, spend billions more on training staff, buying PCs and upgrading and assimilating existing systems over the decade-long programme, Lord Warner said in an interview with the Financial Times.

The extra money did not mean the programme would cost more than expected, he said, but instead reflected the full expense of switching existing IT spending from outdated systems to the new ones.

The delays to the electronic care record, which mean it may not be in place until early 2008, come in part because of delays in providing the software, which is being developed by iSoft and other companies.

But the record’s introduction is also being stalled by a fierce and unresolved dispute within the medical profession over what should be included on the national medical record, and how patients’ data should be added. Some see it as threatening to “derail” the programme.

Lord Warner said some parts of the programme “are going pretty well and pretty much to time”.

But others, he admitted, “are going more slowly than we would otherwise like”. The government has had to “re-group” over the national summary record, meant to make patients’ data available “wherever and whenever” it is needed.

The programme originally proposed that the summary record would include major diagnoses, operations and recent tests, as well as current medications and allergies. It was also proposed that patient data would be added on an “opt out” model, implying that consent to have the basic
data added would be assumed, but with patients retaining the right to opt out.

Ministers recently agreed, however, that the initial upload of data, in pilot schemes to be run next year, would cover only current prescriptions, allergies and contra-indications, and that patients would then be asked if they were happy to have other information added.

But the British Medical Association family doctors’ committee has recently rejected that proposal, saying patients’ consent should be sought even before their medications are added to the summary record.

The programme had reached “a pivotal point”, Lord Warner said, and with many hospital doctors favouring a much richer summary record, “the medical profession have to come together” to agree on what data will be included and how it is added.


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