Health records scheme NPfIT at pivotal point

The NHS’s multi-billion programme NPfiT to create a universal electronic health record system has reached a “pivotal position” where it will require a big rethink if more progress is not made soon, David Nicholson, the NHS chief executive said.

The programme is running at least four years late. New installations in London are on hold, no roll-out of the programme has yet been agreed for the north of England and the Department of Health is still deciding how to replace Fujitsu, the contractor for the south, whom the NHS fired in May.

Mr Nicholson told the Commons health committee he remained “confident” that the NHS would have a workable system by 2015.

But in a first public admission that a rethink might be required, he told MPs: “We do have to think about how we take it forward. We can’t go on and on for this.”

While parts of the programme had gone well, he said, there were “some really difficult issues to tackle” around installation of the clinical record.

The software to be used for the whole of the north, Midlands and east England was finally being tested on a small scale. “Good results are coming out of that”, but “we need to be careful” before rolling it out.

In London, the latest installation at the Royal Free hospital has hit big problems which BT, the installer, and Cerner, the software provider, are working to resolve. “We have said to Cerner and BT that they have to solve that problem at the Royal Free before we will think about rolling it out across the rest of the NHS,” he said.

He hoped that around February there would be a decision about who would take over in the south. The options included BT, which is responsible for the London systems, and CSC, which runs the north; a combination of the two; or bringing in another contractor.

But he conceded: “We really are at quite a pivotal position. If we don’t make progress relatively soon, we are really going to have to think it through again.”

BT said it was “making good progress” at the Royal Free. A health department official said Mr Nicholson’s comments showed the seriousness with which the NHS was taking the successful introduction of the Cerner software system at the Royal Free. “The benefits to patients and clinicians when the system is fully working are clear. We remain confident that the situation at the Royal Free will be resolved and so are not prepared to speculate about possible scenarios if it is not.”


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