Taxpayers are now facing an estimated £2 billion bill, despite the company already failing to deliver a fully functional version of its software, The Times reported.

The £11.4 billion National Programme for IT, set up in 2002 by bliar, was at the time spun as the world’s biggest civilian computerisation project.

It aimed to give doctors instant access to patient records wherever they were being treated and CSC had signed a deal to computerise records in most of England.

Digitising the medical records of the country’s 62 million people was the core objective of the National Programme for IT in the NHS, accounting for £7 billion of the total estimated cost.

Andrew Lansley, the Health Secretary, announced in September that he was abandoning the scheme to create a national patient database because it had “let down” the health service.

He made the decision to “urgently dismantle” the failed project after criticism it was not value for taxpayers’ money.

Yet the company stated in official US papers that it was in talks with the British Government for its contract to be extended until 2017, at a cost of up to £2 billion.

Computer applications installed as part of the scheme have also failed or been scrapped.

However, £250,000 in bonuses has been paid by the DoH to 80 people involved in the scheme as a reward for “an exceptional contribution to delivery”.

CSC, one of the world’s biggest IT providers, had been contracted to provide patient record software, known as the Lorenzo system, to 166 NHS hospitals. But it has delivered on 10 projects. None of those systems is fully functional.

CSC has signed deals worth hundreds of millions of pounds with Royal Mail, Identity and Passport Service and UK Atomic Energy Authority.

The Coalition’s Major Projects Authority, established to review Labour’s financial commitments, found the scheme was not fit to provide services to the NHS.

A cross-party committee of MPs concluded the programme had proved “beyond the capacity of the DoH to deliver”.

Katherine Murphy, of the Patients Association, said it was “shameful” to pour more money into a failed initiative.

Patients should be given greater access and control over their medical information, the consultation said.

However, there are worries over the security of the system and that the information will be passed on or sold in so called ‘technology and data markets’.

Patients could be pressured into giving third parties, such as insurers access, to their record or to disclose details contained in it, it was warned.

In documents released with the Autumn Statement, it said: “All patients in the NHS will have online access – where they wish it – to their personal GP records by the end of this Parliament.

“GP practices that can already provide online access are encouraged to do so as soon as possible.

“These measures will help to position UK companies in the development of a personal information market, which is likely to be the next stage of development on from the growth of social networks.

“Online access to one’s own personal data enhances personal control and participation in public services. It also fuels innovation and growth in the supporting technology and data markets.”

Concerns were raised last year that the Summary Care Record was being rolled out too fast with patient records being uploaded to the national system unless people directly opted out.

The roll-out was halted but it now appears that it is to be restarted again and all patients who have already been contacted will have an online record by 2013.

The summary care record is part of a wider online medical records database to allow NHS staff to access brief medical records of patients they may treat outside their home area. However, in pilots, it was found that staff were passing access ‘key cards’ to each other breaching security rules.

Guy Herbet, general secretary of the campaign group No2ID, said: “The problem is this is a Trojan horse for the continuation of the Department of Health’s continuing centralisation of all medical records, and its seeming desire to share them with its friends in the pharmaceutical and medical technology industries.

“That’s a real threat to privacy and medical confidentiality. And the government has continued the previous administration’s work of taking records out of the hands of clinicians who have a direct duty to you.”

Gus Hosein, Executive Director of Privacy International, said: “In theory, this system is a positive development; everyone should have access to their own information.

“The problem is that the NHS is insisting on building a multi billion pound computer system to store records containing our most intimate and potentially compromising information.

“At best, it will fail, as large government IT systems have historically tended to do. At worst, it will create a data protection nightmare. The benefit of giving patients access to their medical records is vastly outweighed by the huge expense of the system and the significant threat to privacy.”

Chaand Nagpaul, the British Medical Association’s GP IT lead, said: “The BMA does believe that patients should be given the option of accessing more information online so that they can make informed decisions about their care.

“However, take-up has been very slow in those areas where patients have been offered access to their records online.

“It is essential that further work is undertaken to assess the level of demand amongst the public before further investment is made. With the NHS being asked to make efficiency savings of £20 billion, we must not waste money on expensive systems that patients will not use. It is also important any electronic system has built in confidentiality and data security safeguards.

“The UK’s research base and wider NHS could benefit from plans to publish datasets more widely and open up new channels of communication between different parts of the health service. It is important though that confidential data is not inadvertently disclosed. Proper safeguards must be put in place to stop this from happening. “

From:  http://www.telegraph.co.uk/All-patients-to-be-given-online-access-to-medical-records

The governance board of the programme will now be scrapped, and local trusts will be given the freedom to develop their own versions of the electronic care record rather than having the rules dictated by Whitehall. A new Cabinet Office oversight committee will monitor future IT investment to ensure money is not wasted.

But many trusts across England have large contracts with private suppliers to supply their care record systems, and their cancellation could leave taxpayers even more out of pocket.

The Department of Health’s own chief information officer, Christine Connelly, told MPs on the Public Accounts Committee in May that a £3bn deal with CSC to deliver systems in the north, midlands and east of England would cost more to get out of than to keep going.

She said: “Potentially, if you ask me about the absolute maximum, we could be exposed to a higher cost than the cost to complete the contract as it stands today.”

A decision will be made on the future of the contract later in the autumn.

However the Cabinet Office’s Major Projects Authority said that some parts of the £12.7bn programme had worked and would be retained, including the NHSmail email system and the Choose and Book process of arranging hospital referrals.

Andrew Lansley, the Health Secretary, said: “Labour’s NHS IT Programme let down the NHS and wasted taxpayers’ money by imposing a top-down IT system on the local NHS, which didn’t fit their needs.

“We will be moving to an innovative new system driven by local decision-making. This is the only way to make sure we get value for money from IT systems that better meet the needs of a modernised NHS.”

Roger Goss, co-director of the pressure group Patient Concern said: “Thank goodness politicians have decided to stop money being poured into a huge bottomless pit. Now we must pray that they don’t sanction pouring it into endless incompatible regional pits.”

From: http://www.telegraph.co.uk/Dismantling-NHS-computer-scheme-could-cost-more-money

The Public Accounts Committee says that although £2.7bn of taxpayers’ money has already gone on the scheme, it is unclear what the benefits have been and so ministers should think about whether the rest of the cash could be better spent elsewhere.

Although the intention was to create a single network that would allow NHS staff across England to access any patients’ details, the report says this will not happen now and the country has been left with a “patchwork” of costly and fragmented IT systems whose future is uncertain because of reforms to the health service.

The chief executive of the NHS, Sir David Nicholson, also comes in for criticism for failing to oversee the project properly while civil servants provided “late, inconsistent and contradictory” information to the MPs’ inquiry.

Margaret Hodge, the committee’s chairman, said: “The Department of Health is not going to achieve its original aim of a fully integrated care records system across the NHS. Trying to create a one-size-fits-all system in the NHS was a massive risk and has proven to be unworkable.

“The Department has been unable to demonstrate what benefits have been delivered from the £2.7 billion spent on the project so far.

“It should now urgently review whether it is worth continuing with the remaining elements of the care records system. The £4.3 billion which the Department expects to spend might be better used to buy systems that are proven to work, that are good value for money and which deliver demonstrable benefits to the NHS.”

The integrated electronic care records system was a central part of Labour’s £11bn National Programme for IT in the NHS, which was set up in 2002 and faced repeated criticism since then over its cost and technical problems, most recently from the National Audit Office.

In the report the MPs say the intention to allow rapid sharing of patients’ records was “worthwhile” but the Department of Health has been unable to make it work.

They claim that creating a single system was always a “massive risk” especially as clinicians were not asked for suggestions on its operation.

In the north, midlands and east of England just 10 of 166 trusts have received only a basic system, while no mental health body has received one. Dozens of different interim and local schemes have been devised, at greater cost.

Whitehall officials are said to lack “basic management information” on the number of systems built and their cost, even though there is a body overseeing the whole project with 1,300 staff that has spent £820million.

Sir David Nicholson was accused by the committee of having “lacked the capacity to meet his responsibilities fully” as Senior Responsible Owner for the scheme, leading to “increasing costs and delays”.

The Department of Health is now trying to renegotiate some contracts and is working on a slimmed-down “menu of modules” that hospitals can choose for their patient records systems, but there is no guarantee the systems will work with each other.

In addition, the Strategic Health Authorities responsible for delivery of the programme are being scrapped and there is “considerable uncertainty” over how the new NHS bodies will adopt the IT systems and how much it will cost them.

Andrew Lansley, the Health Secretary, said: “This is yet more evidence that Labour’s botched approach to IT in the NHS failed taxpayers and failed patients. Their one-size-fits-all IT programme has once again been found unworkable.

“This Government is taking action where Labour failed. Already, we have reduced expenditure on Labour’s costly IT schemes by £1.3 billion. We are making sure that systems are not imposed on the NHS from the centre which organisations do not want. And we will shortly announce our plans for even stronger action to deliver value for money for taxpayers and the NHS.”

From: http://www.telegraph.co.uk/NHS-should-consider-abandoning-7bn-IT-project.html

It published an email showing that it had informed the NHS of the security breach and saying “we mean you no harm and only want to help you fix your tech issues”.

It had taken master “admin” passwords from the system “months ago” while searching the internet for other materials, but had not exploited them.

On its Twitter account, which it uses to boast about its attacks, LulzSec claimed it had reported the security vulnerability after the dying wishes of Alice Pyne, a 15-year-old British terminal cancer sufferer whose online “bucket list” has become an internet phenomenon.

It said: “Greetings … we’re a somewhat known band of pirate-ninjas that go by LulzSec. Some time ago, we were traversing the internet for signs of enemy fleets. While you aren’t considered an enemy – your work is of course brilliant – we did stumble upon several of your admin passwords.”

The Department of Health admitted that the system had been breached, but said it was only on a local level. It has reported the incident to police.

“This is a local issue affecting a small number of website administrators,” a spokesman said. “No patient information has been compromised. No national NHS information systems have been affected.”

The incident is the latest in a string of computer security breaches, and has raised concerns about the security of patient data, which is being digitised en masse and uploaded to a national system as part of the much-delayed NHS national programme for IT.

LulzSec emerged in May when it published a database of more than 70,000 American X Factor contestants’ personal details, including their dates of birth and phone numbers. In a hacking spree, it has attacked Nintendo and Sony, and an FBI-linked security association. It says its attacks are for entertainment purposes.

From: http://www.telegraph.co.uk/Fears-for-patients-data-after-hackers-hit-NHS

The programme has been described as not being “value for money” in a report from public spending watchdog the National Audit Office (NAO) and critics have called for the project to be abandoned.

But yesterday, Department of Health (DoH) CIO Christine Connelly told the parliamentary public accounts committee that cancelling the contract with supplier CSC could potentially leave the DoH “exposed to a higher cost than the cost to complete the contract as it stands today”.

She said if the contract were terminated, the resulting contractual costs could run up to “several hundred million pounds”, with the possibility that the supplier could seek damages.

Still further costs could be incurred during the process of moving health trusts over to new care records systems, she said.

But Connelly went on to say that the DoH is still considering all options for the contract with CSC, which the DoH has previously stated includes termination.

Sir David Nicholson, chief executive of the NHS, told the committee that the DoH is not currently minded to cancel its contract with CSC: “That’s not what we’re planning to do at the moment.”

Bizarrely he said the DoH could still get something “really good” out of its contract with CSC.

Care records systems are being installed across the whole of England, although progress has been slowest in the north, east and Midlands, the NAO report found.

CSC has repeatedly missed it’s required targets- known as milestones, for the rollout of the care records systems.

By March this year, CSC had missed 67 milestones set under its Local Service Provider (LSP) contract, and recently suffered a further setback when one of four trusts chosen to be early adopters of the care records system pulled out of the project.

The NAO report found that £2.7bn has been spent installing care records systems across the whole of England, and that there is a further £4.3bn still to be spent.

The care records system is being installed in the north, east and Midlands by CSC under the terms of its LSP contract, which is worth just over £3bn, but the DoH has said it expects negotiations will reduce the contract’s value by about £500m.

From: http://www.silicon.com/doh-cio-warns-on-cost-of-scrapping-e-records-project

The National Audit Office also said some patients would not even get one as large chunks of the NHS had pulled out.

In conclusion, the NAO said the system was not providing value for money – something the government rejected.

The Electronic care records are the key part of the overall £12.4bn NHS IT project.

The scheme was launched in 2002 by Tony Bliar with the aim of revolutionising the way the health service uses technology and also includes developments such as digital x-rays and fast internet connections.

It is the third time the NAO has looked at electronic records – and each time the findings have been more damning.

The report from the NAO presents a depressing account of delays, contractual wrangling and technical glitches.

The original vision for the scheme was compelling – a national network connecting hospitals, GP practices, ambulance services and mental health trusts, and an end to the tortuous paper trails that have caused frustration and misery for doctors and patients alike.

But the complexity and cost of the scheme meant it was always seen by many as a high risk strategy. And when it ran into trouble the plans were scaled back, and the original vision set aside.

Many GPs and hospitals are now working with different systems, prompting the NAO to question whether further investment in the national programme would be pouring good money after bad.

The latest report details a range of problems that the programme is struggling with.

In London, all GP practices and more than half of hospital trusts have pulled out, while in the south three-quarters have. However, this has not been accompanied by a proportionate drop in cost.

Meanwhile, the contract covering the rest of country is currently being renegotiated. Even after such a scaling back, roll out in places that remain part of the system is still proving difficult.

The NAO said it doubted the final deadline of 2016 – which is already six years later than originally envisaged – would be met.

And even in those trusts that have electronic records, there are problems. For example, some hospitals have struggled to introduce electronic prescriptions.

The NAO said the difficulties were caused by a range of factors, including the government being too ambitious, difficulties with technology and the complexity of the NHS.

The problems have prompted some critics to call for the entire scheme to be scrapped – although this is something the NAO stopped short of suggesting.

The government has already announced there will be a review of the project. This is due to start next week.

Tory MP Richard Bacon, a member of the House of Commons’ Public Accounts Committee and long-standing critic of the plans, said: “It is perfectly clear that throwing more money at the problem will not work.

“This turkey will never fly and it is time the Department of Health faced reality and channelled the remaining funds into something useful that will actually benefit patients. The largest civilian IT project in the world has failed.”

But the Department of Health said while the original vision “was flawed”, the project still had the potential to deliver value for money.

Dr Chaand Nagpaul, of the British Medical Association, said: “We cannot turn the clock back, but this report provides useful lessons on how best to use resources in the future.”

From: http://www.bbc.co.uk/news/health-13430375

In many cases, patients will not be asked for consent for their data to be shared, because it is claimed it will be “anonymised”, a process which deletes certain information with the aim of making individuals unidentifiable.

However, in a letter to the British Medical Journal, Dr Ian Brown of the Oxford Internet Institute said that NHS rules mean such unwitting participants in research can be “trivially” re-identified. They are also not to be told or given a choice about how their medical records will be used, he said, and misled about the risks to their privacy.

“This is something that is just getting going,” Dr Brown told The Telegraph.

The SUS replaces previous record sharing arrangements that were typically on much smaller scale and involved patient consent.

It will supply data where patients’ names and addresses have been replaced by their date of birth and postcode.

“As a postcode typically contains about 20 houses, almost all patients are easily identifiable by reference to these facts,” Dr Brown said in the letter, which is co-signed by Lindsey Brown, a researcher in public health ethics at Bristol University, and Professor Douwe Korff, a data protection law specialist at London Metropolitan University.

Some of the “anonymised” data also includes the unique NHS Number for each patient, making them even more easily identifiable. According to Dr Brown and his colleagues, such weak privacy policies could be illegal under European data protection laws.

“Patients are not currently being adequately informed about possible secondary uses of their medical data for medical research,” said Dr Brown and his colleagues.

“[Patients] are not asked to give clear, specific, free and informed consent; are not offered unambiguous and effective opt-outs; and are misled about the level of anonymisation of their data and the likelihood of re-identification,” they added.

The Department of Health had not responded to a request for comment.

The letter is a response to suggestions by scientists that the rules on accessing to patient data should be further relaxed. They have welcomed SUS and argued that easier access to sensitive data records will spur medical advances.

“It is irresponsible to insist that no regulation and governance should interfere with researchers’ access to health records or record linkage capabilities,” said Dr Brown and colleagues.

The National Programme for IT was conceived under the Labour government at a cost of around £12.7bn, making it the most expensive pulic technology programme in the world.

Since coming to power, the coalition has announced it will abandon the name and shave an £700m from the price tag, in addition to the £600m cut made by Alistair Darling in 2009.

Several suppliers have dropped out and doctors’ groups have questioned the clinical value of the scheme, which will digitise patient records and make them available throughout the NHS.

From: http://www.telegraph.co.uk/NHS-misleads-patients-over-sharing-medical-records-with-drug-firms

A service set up to enable millions of patients to email their GPs and access their Summary Care Records online has proved to be unwanted by the vast majority of potential users, according to a major new study.

It was also predicted that patients would access use the HealthSpace service to access their Summary Care Records and notify their GP of errors, thereby driving up data quality in NHS medical records.

In fact, only 2,913 of 2.24 million patients invited to open an advanced HealthSpace account actually did so, and the research team did not find a single person who had accessed their Summary Care Record.

Research into trials of the service, published on BMJ.com, comes as the Government promises an ‘information revolution’ which will offer patients much more control over their records.

Professor Trisha Greenhalgh, from Barts and the London School of Medicine and Dentistry, who led the research covering uptake of HealthSpace from its release in 2007 until mid-2010, concludes in the report: ‘Unless personal electronic health records align closely with people’s attitudes, self-management practices, identified information needs and the wider care package, the risk that they will be abandoned or not adopted at all is substantial.’

She adds: ‘The findings raise questions about how eHealth programmes in England are developed and approved at policy level.’

Problems with HealthSpace uncovered by the researched included a complex registration process, a ‘clunky’ user interface and low levels of knowledge about, or interest in, the product from GPs and other healthcare staff.

HealthSpace’s future is already under review by the Treasury, with the Government increasingly looking for patients’ IT services to be developed by private providers.

Researchers said the recent emergence of rival products from commercial IT giants including Microsoft and Google raised serious questions about the place of a standard-issue personal health organiser from the NHS.

A Department of Health spokesman said: ‘Healthspace gives patients access to their Summary Care Record online and enables secure communication between clinicians and patients.

‘The UCL research has produced a historical snapshot, rather than insight into patients’ needs and expectations. Healthspace continues to be developed in response to those aspirations and the commitment to give patients, as well as clinicians, access to their Summary Care Record.’

From: http://www.pulsetoday.co.uk/story.asp?sectioncode=23&storycode=4127785

The quantitative study by Raft, which interviewed 50 older people, people on low incomes and those with a learning disability from Bolton, Salford, Bury and Manchester, found that although few people had heard of NHS Choices and Easyhealth, participants were positive about the services when they were demonstrated to them.

However, some felt NHS Choices in particular was aimed at people that were newly diagnosed and could not help those who had had a condition for many years.

Others said that fear of health information, puts them off searching for health information “as a computer can’t reassure you if you’re frightened.”

In relation to HealthSpace, again, few participants had heard of the service including those in Bolton and Bury which are early adopters for the summary care record.

The reaction was mixed and found that it was “clear that most people would only wish to used certain functions of the website” such as the calendar function to help them remember hospitals appointments and the communicator.

Several added that they saw no advantage of seeing a record of medications or allergies when they already knew that they had them.

The report concludes that there is a high degree of trust in the information from the NHS websites which could usefully be used to promote the websites for effectively.

“Most people felt that leaflets and posters in GP surgeries and hospitals clinics would be suitable. Several people suggested the idea of TV advertising.”

The study also aimed to address those who had never accessed the internet, which amounts to 9.2 million people across England. It found that those who would consider learning wanted to do it as possible to home as possible in such as at home, community group they attended, GP surgery or hospital clinic.

Another finding was that although many people did not have access to computers or did not know how to use them, family members were able access the websites and provide the information.

The report recommends that “By promoting NHS websites to all computer uses, we can indirectly improve access to electronic health information for those people who do not use a computer.”

Marlene Winfield OBE, director for patient and public at CfH said: “This report is already helping CfH in the design and delivery of its products and services.

“It will we hope, contribute to the wider digital inclusion discussions taking place as a result of the current health whitepaper and the information strategy consultation that followed it.”

From: http://www.e-health-insider.com/major_nhs_public_websites_unheard_of

Those requiring treatment for cancer will be able to study survival rates – and waiting times – for different medical teams and then opt to have treatment where they wish, under the plans to be announced today. Proposals are being drawn up to give patients online access to their medical records.

Miss Lane Fox says that the most useful online services for consumers should be made available to NHS patients over the next few years.

It is hoped this will help drive up hospital standards as patients choose not to use the services of poor doctors, who will then lose funding. Patients will also be asked to rate the service and treatment they receive from different hospitals and medics.

They will be able to choose which GP they register with and whether to be treated at an NHS hospital or private or charity-run institution, within certain cost limits.

Miss Lane Fox, the founder of Lastminute.com, says the data could prove invaluable.

The Department of Health is the only major Whitehall department which will not see its spending cut this week. However, Andrew Lansley, the Health Secretary, still has to push ahead with major reforms as the ageing population is causing a sharp rise in health-care costs.

Miss Lane Fox, the Government’s digital champion said: “A recent YouGov poll found that 40 per cent of people believe the NHS can learn from the service offered by supermarkets, banks and utility companies. I’ve always believed in the power of information and technology as an incredibly useful tool.

“There’s clearly an appetite for a new approach. The Department of Health is launching a consultation this week into how information and technology can help people take more control of their health and make the best choices for themselves and their families.”

The consultation will study how internal data could be offered to websites like TripAdvisor or Mumsnet, which could “empower patients and families”.

Mr Lansley said: “The first principle of the White Paper is that the NHS should ensure that for patients, ‘no decision about me, without me’ is the invariable practice. To realise this means patients must have more say and more choice.”

From: http://www.telegraph.co.uk/NHS-patients-to-see-medical-records-online

The Department of Health has published the results of two simultaneous reviews of the SCR, covering the content of the record and the information patients receive before their record is uploaded.

The reviews were set up by the coalition government this summer, following concerns about patients’ awareness of the SCR and the kind of information added to it. This had led to the suspension of further patient information programmes.

The review of the content of the record, led by NHS medical director Sir Bruce Keogh, concluded that the core record should only contain a patient’s demographic details, medications, allergies and adverse reactions, and that these should continue to be copied from the GP’s medical record.

The review group said the DH should only consider expanding the content of the record “when we have built trust in the system and when patients request that we should do so.”

Sir Bruce said: “In an advanced national health system, it is reasonable for citizens to expect that when they arrive in accident and emergency or require treatment out of hours, the clinicians treating them have access to enough basic medical information to prevent anyone making wrong or even dangerous decisions.”

The separate Patient Information and Preference Review group, led by national director of patient and public affairs Joan Saddler, concluded that an opt-out form should be included in the patient information packs, and that these should also be simplified.

It said services such as HealthSpace should also continue to provide access to SCRs.

Almost 30m patients have already received information about the SCR but the review concluded that there should be no requirement to send another letter to those patients.

However, it said but there should be awareness raising campaigns at local, regional and national levels to ensure patients realise that an SCR is being created for them unless they choose to opt out.

Health minister Simon Burns said he was pleased that a consensus had emerged about the importance of the SCR in supporting safe patient care, so long as the content of the record was limited to core information.

He added: “Coupled with improvements to communication with patients which reinforce their right to opt out, we believe this draws a line under the controversies that the SCR has generated up to now.

“We see this review as having taking a significant step towards the goal of patients owning their records and using them to share decision-making with healthcare professionals.”

A BMA spokesperson said: “We welcome the progress that has been made towards an emergency electronic record that supports urgent care, yet recognises many of the understandable concerns of patients and clinicians.

“Much will depend on the way the amended scheme is put into practice, and the BMA looks forward to continuing our work with government on its implementation. It is essential that patients have genuine control over who has access to their records, and when changes are made to them.”

The review groups concluded that patients should play a key role in deciding the evolution of the record and that new arrangements should be introduced to define responsibility for decisions about the introduction of any new content to the record.

They said the principle should be that any change to the scope of the record should be driven by citizens and patients with appropriate advice from professional bodies and in line with the IT capability.

Saddler said the availability of core information when patients need care was essential if patients were to be at the heart of care but it should also be easy for patients to opt-out.

She added:”Patients must be the ones who decide if any additional information should be included in their SCR, supported by appropriate professionals. This is the only way we will build trust in the SCR and its use.”

The SCR Content Review group said standards should be defined to support a patient’s wish to add information to their SCR such as end of life preferences, a care plan for patients with long term conditions or the inclusion of a patient’s significant medical history.

The review groups, which between them took evidence from almost 50 bodies, said it had heard strong opinions that the use of smartcards was not universal within GP practices which had implications for accurate updating of the SCR.

The reviews said use of smartcards was outside their remit but recommended that further options were investigated to mitigate the risk of practices not using smartcards.

The review group on Patient information and Preferences also recommended that the outer envelope that patients receive should have clear emphasis that the information contained in the envelope is about “Your health records, you need to make a choice.”

John Heyworth, president of the College of Emergency Medicine, said the college welcomed the decision to proceed with the SCR.

He added: “Clinicians working in emergency departments are currently often deprived of key background and patient information, particularly during the initial phase of time critical treatment and this may significantly compromise the quality and safety of care provided.

“Immediate access to such records will lead to better and safer care for our emergency patients.”

The review’s conclusions were backed by a range of bodies including the Patients’ Assocation, The Royal College of Nursing, Asthma UK and Sue Ryder Care.

From: http://www.e-health-insider.com/summary_care_record_given_go-ahead

The moves will save another £700m on top of the £600m that the Labour government said it would cut from the cost of the programme, Mr Burns said in a written ministerial statement.

According to Christine Connelly, the health department’s director-general for informatics, the £1.3bn savings to reduce the programme’s overall estimated cost to £11.4bn will come from a variety of sources.

They include an anticipated – though still to be negotiated – £500m cut in the cost of CSC’s £3bn deal to supply systems to most of the north, east and west of the country; a £112m saving already booked from reducing the scope of BT’s deal in London; and £200m being taken out of the national programme’s own costs.

In addition, there will be an anticipated £500m reduction on an estimate that it would cost the NHS locally £3.5bn to install the systems.

The “core assumption” of the programme will now be one of “connecting all systems together rather than replacing all systems,” Mr Burns said, allowing NHS trusts to keep those that match modern standards while moving forward “in a way that best fits their own circumstances”.

The promise of a more devolved approach was welcomed by critics of the programme and the NHS Confederation. But both struggled to be clear about the implications.

Richard Bacon, a Conservative member of the Commons’ public accounts committee, said: “The big unanswered question is when it is all finished, what will we have got for all the money? There is still some £5bn in the programme to be spent, but it was meant to deliver something very special.”

Mr Burns said that in spite of “more plural” suppliers, the existing contracts with BT and CSC that have huge penalty break clauses “will be honoured”. Frances Blunden, the NHS Confederation’s IT specialist, said it was “a fair question” to ask “where will money come from for a wider choice of suppliers if the existing deals are to be honoured?”.

The statement does, however, represent something of a U-turn for the Conservatives, who had threatened ahead of the election to scrap all the programme’s central databases. The existing national infrastructure is to be kept, although a review of the national summary record is still underway, focusing on its contents and patient consent.

“The early indications [from the review] are that we are past the point of should we or shouldn’t we have one,” Ms Connelly said, “although that question will be asked”.

From: http://www.ft.com/cms/s/0/785e2f70-bc41-11df-8c02-00144feab49a.html

This despite a misleading announcement from the Department of Health that uploads to the Summary Care Record (SCR) aka Snoopers Charter are ‘on hold’.

In just the last few days, the medical press has reported that:

• NHS East Riding of Yorkshire began sending out notification letters to patients the day before election day;

• GP practices in Hastings, East Sussex have uploaded records over the past 2-3 weeks, despite patients complaining they hadn’t received a notification letter;

• At least 9 other Primary Care Trusts are working towards upload, and practice managers – not GPs – may already have given the go-ahead for upload at some practices in South West Essex.

Clearly, whatever deal was agreed between the British Medical Association and the NHS, there is no effective barrier to upload. And CfH is desperate to create a ‘critical mass’ of records, which it thinks will make the system impossible to scrap.

Health Direct warns that you need to act quickly.

30 million ‘Patient Information Packs’ were sent out in the run-up to the general election. No-one knows how many failed to reach their intended target. Both parties that now form the new government pledged to scrap the Care Records system but, every day that uploads continue, people’s medical confidentiality is being put at risk.

Please take a few minutes now or today to write to your new MP, urging him or her to call for an immediate halt to Summary Care Record uploads. POWER2010 has very kindly built an online letter-writing tool to help
you do this: http://www.power2010.org.uk/Halt

On the subject of the Nanny State’s Snoopers Charters- Home Information Packs (HIPs) were announced in the Queen’s Speech in November 2003, so were plans for a national ID scheme. The introduction of HIPs was subject to delays and plans were scaled back – just like the ID scheme.

In 2009 HIPS were finally issued and so were ID cards. The scrapping of HIPs was a manifesto pledge by the Conservatives and the Liberal Democrats, so was scrapping ID cards.

Yesterday Eric Pickles MP, the new Communities Secretary announced that “HIPs are history” and “laid an Order suspending HIPs with immediate effect” (pending primary legislation for a permanent abolition).

Meanwhile ID cards are still being issued and the UK Identity and Passport website states: “Until Parliament agrees otherwise, identity cards remain valid and as such can still be used as an identity document and for travel within Europe.” Alas we still await a Pickles style announcement from the Home Office.  See http://www.communities.gov.uk/news/corporate/1591777

The agency charged with rolling out the new system is warning of “adverse consequences” if people choose to opt out of the computerised network, which has been criticised as chaotic by doctors.

It is also claiming that the NHS currently has “significant problems” with lost records.

A document posted on the website of NHS Connecting for Health lists several dangers to patients if they continue to have their medical information stored on paper files.

It states: “Health-care staff treating you may not be aware of your current medications in order to treat you safely and effectively.

“Health-care staff treating you may not be made aware of current conditions and/or diagnoses leading to a delay or missed opportunity for correct treatment.

“Health-care staff may not be aware of any allergies/adverse reactions to medications and may prescribe or administer a drug/treatment with adverse consequences.”

While acknowledging confidentiality risks over the digital database, the document continues: “It is … misleading to suggest that not having such a record is risk free.”

The computerised record system, also known as the care summary record, is intended to make it easier for doctors and nurses to get access patients’ medical histories.

But the programme has been beset by technical problems and criticisms. Last month the labour Government halted the national roll-out after it emerged that data could have been logged on the system without patients’ knowledge.

Information about more than 1.25 million patients have already gone on to the database, which eventually could hold up to 50 million records.

The Big Brother Watch lobby group accused Connecting for Health of overstating the risk to patients if they opt out of the system, after a Department of Health spokesman said the problem of lost paper records was not “significant” as the agency claimed.

Dylan Sharpe, the Big Brother Watch campaign director, told the Daily Mail: “If you value your privacy ignore these false and misleading warnings and opt out.”

From: http://www.telegraph.co.uk/NHS-scaring-patients-into-accepting-electronic-records-database

Health Direct urges you to opt out of labour’s snoopers charter NOW- WHILST YOU STILL CAN!

NHS managers, under pressure to cut costs, are implementing the changes despite warnings about poor security in some offshore centres.

The Sunday Times has identified seven primary care trusts in northeast London, serving more than 1.5m people, that have begun to send patient details overseas. The databases are administered by about 200 workers in Pune, western India.

Although companies handling the records in India said security was “paramount”, there is a risk of patients being identified if the NHS numbers are matched with anonymised clinical notes carrying NHS numbers, already being sent to India by more than 30 trusts.

Typically, a set of clinical notes will be based on a consultant’s findings during a session with a patient, which he will read into a voice recorder during or after the appointment.

The recording is then transferred to a computer and sent to India, where it is transcribed. One source involved in processing the information said patient names can crop up during the appointment and may then inadvertently be included with the clinical data.

Workers in India are also producing letters for patients with appointments for cervical smear tests and breast screenings.

Pilot schemes for NHS offshore transcription services began more than four years ago and have rapidly expanded. The Royal Free hospital in London, the Derby hospitals trust and the Newham University hospital trust are among those sending clinical notes overseas.

Labour ministers have been anxious to allay concerns about the confidentiality of patient information since the launch of a £12 billion scheme to computerise health records.

In January 2007 Caroline Flint, then health minister, told parliament the project would “expressly preclude the transfer of patient information outside the United Kingdom”.

Trusts, however, believe they may send patient information outside the UK if it does not come under the electronic records project.

John Hemming, the Liberal Democrat MP for Birmingham Yardley and an expert on IT projects, said: “Given the government’s track record of losing data in this country, it is worrying that data are being sent overseas. Every transfer of information adds to the risk of it being lost.”

The possible risks of transferring patient data overseas were exposed last year when undercover reporters from ITV1’s Tonight programme were able to buy health records from a private hospital in London, processed in India. The sellers claimed to have access to thousands of UK medical records.

The transfer of primary care trust records is being handled by NHS Shared Business Services, a joint venture between the Department of Health and the IT company Steria.

From: http://www.timesonline.co.uk/tol/life_and_style/health/article7086816.ece

Health Direct urges you to opt out of labour’s snoopers charter- whilst you still can!

Until now, health ministers and officials have acknowledged that the world’s biggest civilian information technology project is running four to five years late, and have said they want to make £600m savings on the £4bn-plus worth of contracts held by CSC and BT to deliver it.

Up to now, however, no one has conceded that the programme will fail to deliver everything that was promised back in 2003 when the contracts were signed.

Following a revamped deal with BT – the London supplier, which has cut £112m or about 12 per cent off its contract – Ruth Carnall, the chief executive of the London strategic health authority, has said the spending reduction means “it will no longer be possible to provide the comprehensive solution that was anticipated in 2003″.

Not all NHS organisations in London will now receive the software needed to deliver the records, Ms Carnall makes clear in a letter to London chief executives.

Meanwhile, Christine Connelly, the health department’s chief information officer, has said that only about half of London’s 32 big acute trusts will now get the full solution. Others will be able to add clinical systems to existing patient administration systems.

In place of a dedicated means of sharing records across hospitals, and between hospitals and primary care – a key goal of the programme – London will have to rely on the national summary care record, Ms Carnall says. However, this contains little other than allergies and current medication, and does not yet carry referral or discharge information.

On top of this, the Tories have said they will scrap the national record if they win the election.

BT will no longer have to deliver new systems to London’s ambulance service or GP practices. And London can afford to pay for Map of Medicine, a decision support tool for treating patients, for only one more year, says Ms Carnall.

In much of the country, installations in acute hospitals are stalled after CSC missed a deadline to get its solution running at Morecambe Bay NHS Trust. The supplier risks being fired, but is likely to sign a similar, more restricted, deal if it does hit a new deadline for a successful installation.

Glyn Hayes, president of the UK Council for Health Informatics Professions, said it had been clear for some time that the programme was to be reduced. “But this is the first official admission that there are things it will not do that it was intended to do.”

It was unclear, he said, whether the Conservatives would in fact scrap the national record if they won. “But if they do, it knocks a hole in London’s plans,” because without it the capital had no easy means of transferring patient information between settings.

From: http://www.ft.com/cms/s/0/fba8e660-436d-11df-833f-00144feab49a.html

CSC, which holds the contract for two-thirds of England, missed the deadline to get the Lorenzo electronic medical record product up and running at the Morecambe Bay NHS Trust’s hospitals.

CSC originally said the system would go live almost two years ago, in June 2008.

The failure is the latest crisis for the much-troubled programme which is running at least four or five years late.

CSC and BT, which covers London, had each been given a deadline to get new systems running smoothly in a big, acute, hospital, with the Department of Health warning last year that it would “look at alternative approaches” if that failed to happen.

BT has since installed a system at Kingston Hospital to the health department’s satisfaction. Christine Connelly, the department’s chief information officer, said it now needs to go through a due process under its contract with CSC which could yet see a new deadline set and met.

But if progress is not made, she told the Financial Times, the department has the option of cancelling CSC’s contract to install the systems in acute hospitals and letting hospitals choose from other suppliers.

Morecambe Bay, she said, remained keen to continue and under the contract CSC has to be given time to propose a fresh deadline for deployment, with the programme then assessing the credibility of that and whether to agree it.

“We have to walk through this step by step,” Ms Connelly said. “In a contract as large and complex as this we cannot just set a deadline and say that’s it. We have to act responsibly and not expose the department and the taxpayer to risk.”

But, she warned bluntly, “we cannot wait for ever”.

CSC has contracts worth about £3.3bn to install hospital, community, mental health and GP systems, with the latter elements progressing much better.

But Ms Connelly said if CSC’s plan was not credible the NHS had the option of cancelling the acute hospital part of the deal, thought to be worth around £1bn. CSC did not respond to attempts to contact it last night.

BT, having hit its deadline, has agreed a contract variation, signed yesterday, which the department said would save the NHS £112m, or about 12 per cent of the contract value, as part of the £600m savings the health service is seeking on the programme as a whole.

As part of the deal, BT is now signed up to install much fewer full systems in London, with about half the hospitals likely to add clinical systems to their existing IT arrangements, rather than replacing everything, Ms Connelly said.

Allowing hospitals to choose other suppliers is already starting to happen in the south of England, although the first contracts for that have yet to be signed. That should start to take place from May this year, she said.

From: http://www.ft.com/cms/s/0/6a9f7ee2-3d26-11df-b81b-00144feabdc0.html