The NHS IT community has echoed the House of Commons health select committee’s criticism of the government’s latest reorganisation of PCTs, expressing unease about the future roles of IT departments within the new order.
The health committee slammed the government policy, Commissioning the Patient Led NHS, which will see the number of PCTs and strategic health authorities drastically reduced in a bid to save £250m, in a report last week, saying government plans to reorganise primary care were ‘ill-judged’ and unnecessary’.
MPs concluded: “The risks of the proposals are high and there is little evidence that the costs will be outweighed by the benefits. The Department must more carefully consider the impact of its proposals on its staff, which are its most valuable asset … Major changes to the NHS have large costs and should not be embarked upon lightly.”
The committee warned that the proposed reorganisation could take three years to deliver tangible benefits but in the meantime there would be a significant upheaval that could damage patient care.
Although the report does not focus specifically on IT issues, it does warn that a major reorganisation will shift PCTs’ attention away from their current agenda, including implementing the national IT programme.
It also addresses the issue of whether the reforms will deliver improved commissioning.
It says: “Debate… has focused almost exclusively on the shape of future organisations, the morale of staff, and the consultation process, largely ignoring the critical issue of how commissioning can actually be improved in the NHS. In order to improve commissioning, PCTs need better skills and better information systems.”
The reorganisation is causing unease in the IT community. EHI has spoken to one IT manager who is being made redundant in a bid to deliver his PCT’s cost savings.
The manager, who asked to remain anonymous, said: “IT projects always suffer from expediency; when there is a cash-flow problem they are the first to go.”
Ewan Davis, chairman of the British Computer Society’s primary health care specialist group, said: “The proposals are significantly unsettling people.”
There was a risk of planning blight, he said, as PCT chief executives and senior managers concentrate on protecting their jobs.
However, a number of informatics services are likely to be relatively protected as they operate across a number of PCTs already. He cited Leeds, Nottingham and Wolverhampton as examples.
“In many places PCTs agreed to keep their informatics service as a single unit in the last reorganisations. It just shows how if you sit still it will all come full circle in time.”
Mark Davies, clinical director for Choose and Book, agreed.
He told EHI Primary Care last month: “One of the inevitably worries is planning blight. However, lots of PCTs have gone down the route of shared services so IT support is provided to groups of GPs. It (the reconfiguration) may not have as much impact as we fear.”
The head of an IM&T shared services department serving multiple PCTs, who asked not to be named, told EHI Primary Care: “The department here did not change with the last reorganisation in 2002. We never split up into five departments but worked as a shared service across the five PCTs.
“So, unlike other areas such as public health and commissioning, we are not talking about merging four or five departments into one. The reconfiguration will impact us on us less than others.
“However, we all know that one of the major reasons for this reconfiguration is to save money and that will be applied on a blanket basis. I am nervous that someone will come knocking on my door asking for 15% of the IM&T budget back. That means that there is an edginess in this department and makes it difficult to plan.
“My gut feeling is that I will be able to make savings in my staff budget without compulsory redundancies. We have around 18 months and I am sure there will be opportunities as people move on.
“We are finding ways around the constraints that the human resources plan has put on us. We cannot create any new posts but we do have some projects we want to get on with alongside our trusts. We have agreed that the acute side will host joint posts for the time being.
“The real conflict for me is between the reconfiguration agenda – which is all about saving money and efficiency and one that I naturally support – and the Richard Granger/NHS Connecting for Health agenda. That’s all about investing and getting the manpower in. It is far more exciting and interesting and what I want to be doing but does not fit with a 15% cut in my budget.”