Connecting for Health (CfH) has confirmed that it is advising its suppliers to develop standalone versions of their applications, not reliant on the NHS Spine, in order to prevent further implementation delays.

A CfH spokesperson told E-Health Insider that the spine remained an "important component of the strategy that the National Programme for IT is implementing and LSP products are being designed to link to the spine". CfH confirmed, however, that it was also working with suppliers to develop stand-alone or ‘spineless’ versions of their systems.

"We have been working with suppliers to enable clusters to receive the benefits of new IT systems supplied by LSPs without having to interrupt their implementation programme to take the next version of the spine until required," said the spokesperson.

Only a handful of spine-connected systems have yet been implemented under the national programme. New systems that have been implemented have largely been stand-alone systems, not connected to the spine. For instance, neither of the two early PACS implementations, identified recently in the NHS chief executive’s annual report as early successes, are connected to the spine.

The spokesperson said that reviewing the architecture of the programme was in line with best practice: "As such, from time to time, implementation sequences are altered and architectural components are amended."

As previously reported by E-Health Insider, the implementation of the spine, which provides national infrastructure and services such as user authentication, security and data encryption for the Care Records Service, has been experienced serious teething problems and delays.

Problems reported at early sites using elements of the spine have included reliability and the basic user log-in and identification process, which takes minutes rather than seconds. In January, a National Audit Office report stated that technical problems with Choose and Book had included an intermittent fault with authentication through the NHS Spine that had "prevented access to e-booking and other IT systems”.

It was partly problems with the spine-based services that led to the development of Interim Booking Services at the beginning of 2005, to try and ensure progress against the target for Choose and Book to be implemented by the end of the year.