Reform of NHS records plan NPfIT saves £700m

The £12.7bn scheme to give every patient in England an electronic medical record will cease to be a centralised national programme, Simon Burns, the health minister, has announced.
Reform of NHS records plan NPfIT saves £700mInstead, the job will be devolved to the NHS, with hospitals allowed to introduce “smaller, more manageable change” using “a more plural, supplier base” than the two main contractors BT and CSC.

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”.


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