Healthcare IT on the hustings

As Parliament returns, IT journalist Jon Hoeksma reflects on what the party conferences had to say about NHS IT – and what Lord Darzi’s review of the NHS may mean for its national IT programme. 

With the firing gun for a general election keenly anticipated, healthcare is once again on the political centre stage. Politicians are already talking about how their policies will ensure that the NHS can deliver slightly more efficient or better quality healthcare.

And this time around, NHS IT may feature in a supporting role. In his speech to the Conservative Party conference in Blackpool, David Cameron attacked the government’s record on the NHS. One of the areas he singled out for criticism was the £12.4 billion health service IT strategy.

Up in Blackpool

Mr Cameron referred to “an NHS computer costing billions of pounds that many professionals in the NHS can't really tell you what it is for - although they are worried it is going to take away patient confidentiality.”

Another big public sector IT project that he singled out for attack was the national ID card scheme, which the Conservatives said they would abolish. "Lord Darzi said a review of England’s NHS IT programme is required to ensure it 'delivers real clinical benefits'.”

Meanwhile, in Brighton The Conservative’s attacks on what they obviously perceive to be unpopular public sector IT projects contrasted with the new IT-linked initiatives announced by Labor at its party conference.

Health secretary Alan Johnson, for instance, announced that £29 million will be spent on 30,000 new digital alarms to help curb attacks on NHS staff.

The new alarms are good news for at risk NHS staff; but £29 million is small beer against the huge sums due to be spent on the National Programme for IT in the NHS (NPfIT).

Significantly, the future of this strategic programme - that has until now enjoyed unwavering political support from the government - will now be subject to review.

And in London

This is a significant volte face that has occurred since Gordon Brown became prime minister. As recently as the summer, the Treasury rejected the Commons’ public accounts committee’s call for an independent review of NPfIT, saying there had been plenty of scrutiny, progress was encouraging and where there had been problems lessons had been learned. "Lord Darzi’s initial report praises the national N3 infrastructure that has connected every hospital and GP surgery, and says patients are benefitting from new digital x-rays and scans known as Picture Archiving and Communications Systems."

Last week, however, Lord Darzi, the practising surgeon appointed by Mr Brown to the Lords as a health minister, published an interim report into the future of the NHS. In it he said that a review of England’s NHS IT programme is required to ensure it “delivers real clinical benefits.”

The Darzi review

Lord Darzi’s initial report praises the national N3 infrastructure that has connected every hospital and GP surgery, and says patients are benefitting from new digital x-rays and scans known as Picture Archiving and Communications Systems.

“But I believe more work is now needed to ensure that the NHS Connecting for Health programme delivers real clinical benefits, and I will be considering in the second stage of my review how best to achieve this,” says Lord Darzi in his report.

This is carefully modulated stuff, but the line about ensuring the programme delivers real clinical benefits potentially exposes the Achilles heel of NPfIT (which the agency NHS Connecting for Health runs). While a lot of important infrastructure foundations have indeed been put in place, the delivery of clinical systems has so far been far slower and more patchy than planned.

Lord Darzi stops a long way short of pledging a root-and-branch review and instead appears to signal something more akin to a re-focusing of efforts. And behind the scenes, a widespread re-think of the programme is already underway, with the NHS Local Ownership Programme gathering some steam and local service provider contract ‘re-sets’ underway.

Election fever

With a general election possibly looming, Lord Darzi’s promise of a review may be an effective way of deflecting opposition criticism of NPfIT. But it is just possible that it could also signal a shift in what has been remarkably solid political support for NPfIT over the past five years.