The government has rejected calls by the Commons Health Select Committee for NHS Connecting for Health to hand over greater contractual power to trusts and strategic health authorities as part of the NPfIT local ownership programme.
The government’s stance appears at odds with the far-reaching contract renegotiations currently underway with the local service providers, to redefine how and when the core clinical systems can be delivered by the late-running £12bn IT programme.
Charlotte Atkins, Labour MP for Staffordshire Moorlands, a member of the Health Select Committee, told E-Health Insider that the greater moves to local ownership and responsibility must be accompanied by decision making powers: “Local ownership and local buy-in are very important, but responsibility without power has little benefits.”
Atkins told E-Health Insider: “There has to be some sort of central status for CfH, but it is important that local hospitals, and all the users in these hospitals, can ensure that the system they are getting is the right one for them without it being imposed on them.”
The Health Committee recommended in its September report that CfH’s role should switch as soon as possible to focus on setting and ensuring compliance with technical and clinical standards for NHS IT systems, rather than presiding over local implementation.
They called for a stop to SHAs, PCTs and hospital trusts holding responsibility for NHS IT without power to change the centrally negotiated contracts inherited from CfH.
However, in its written response to the Health Committee, the government made it clear that this will not happen: “There is no intention to change the contractual arrangements”.
The response added: “The central procurement exercise and management focus are the foundations for the work done so far and the value for money that contracts offer, as well as the technical requirements for interoperability.
“Through the National Programme for IT Local Ownership Programme (NLOP), the Department of Health will ensure that SHAs, PCTs and trusts, working together with NHS Connecting for Health, are in a position to hold their local service providers to account and participate fully in negotiations with them.”
The response gives an indication that despite the transition to NLOP, CfH is still envisaged as maintaining a central role on contracts. Stressing Connecting for Health’s continuing role, the document states: “NHS Connecting for Health remains responsible for commercial matters within the governance of the South, London, and North, East and Midlands Programme Boards.”
Outlining how NLOP will work the government’s response states: “SHAs now have accountability for managing implementation of the IT systems provided by local service providers. In respect of national applications, accountability remains with NHS Connecting for Health.
“Devolvement of accountability to SHAs for implementation of the National Programme’s systems means that NHS Connecting for Health is no longer presiding over local implementation.”
Ben Bradshaw, the Health minister responsible for CfH, this week defended the NHS IT programme in the House of Commons, describing progress to date as “good”. He went on to state that where suppliers had failed to deliver, they had been replaced.
Asked by Liberal Democrat MP John Pugh to make a statement on the effectiveness of CfH, Bradshaw replied: “Progress with NHS computer systems is measurable in hospitals, general practices and pharmacies across the NHS in England. Despite the challenges associated with all large IT programmes, the Connecting for Health system is bringing benefits to doctors, nurses and, most importantly, patients.
Bradshaw added: “Progress is good, as the Health Committee accepted in its recent report. There have been delays, but any cost overruns are being borne by not the taxpayer, but the private suppliers. When the private suppliers have been unable to deliver the goods, they have been replaced by other private suppliers.”
In their report, the government said the delays ‘are in many instances the consequences of taking longer over consultation and stakeholder engagement rather than simply delays in the production of the software’.
Atkins said of the delays described in the Health Committee’s report: “These delays are simply extending the cause of concerns for all NHS patients and should be curbed as quickly as possible. I am pleased that the government seems to have recognised their shortcomings and I would hope to see the Health Select Committee continue to follow through with our investigations into the electronic patient record.”
Links
Health Committee report on the Electronic Patient Record
The Government response to the Health Committee report on the Electronic Patient Record