Local health communities have been instructed to move towards “information-led rather than service-led planning” and to create new structures to plan and deliver the IT needed to do it.

Informatics Planning 2009-10, a document published alongside the Operating Framework for the NHS in England 2009-10, further shifts attention from the National Programme for IT in the NHS to the systems and capacity needed to deliver Lord Darzi’s vision of higher quality health service with more choice for patients.

It says informatics planning needs to be set in the context of Lord Darzi’s Next Stage Review of the NHS, the Health Informatics Review and the World Class Commissioning agenda, and it places the responsibility for leading planning with primary care trust commissioners.

It also says local health communities should work with “components from NPfIT and other solutions as required”; although it still envisages “strategic” solutions being delivered eventually.

Local plans should “include a roadmap for achieving the Clinical 5 for secondary care as soon as possible, and demonstrate how community services will be supported in a more integrated way with primary care and other local services,” it says. “The roadmap should include both interim solutions and the strategic care record solution, with the relevant implementation timescales.”

The Clinical 5 was a term coined by the Health Informatics Review for the key elements for secondary care systems, which include a patient administration system with “sophisticated” reporting, order communications, coded letters, scheduling and e-prescribing.

Informatics Planning 2009-10 appears to envisage a new structure for planning, based around “natural groupings” of health service organisations and “appropriate non-NHS providers.” It says PCT commissioners will provide “leadership” for local health communities (LHCs) in drawing up informatics plans, which should cover at least three years.

Provider organisations will be expected to contribute to the plans, while maintaining their own. Strategic health authorities will “provide assurance” that the plans have been properly prepared and that they are “appropriately reflected” in the detailed implementation plans developed by regional programmes for IT (PfITs).

NHS Connecting for Health will be assured by SHAs that this has been done. All NHS organisations are expected to establish “effective and transparent governance structures” for IT, with chief executives “demonstrably” functioning as senior responsible owner for their organisation’s plans.

In addition to new systems, the plans will “establish that the local technical infrastructure will effectively and robustly support the deployment and utilisation of the planned informatics solutions” and that there is the capacity and money to deploy them.

However, the guidance puts far less emphasis on cash and efficiency savings than the Operating Framework, which is pre-occupied by the need to plan for a tight settlement in 2010-11.

Informatics Planning 2009-10 brings the major, national programmes run by CfH within the new structure. It says LHCs should plan to roll out the NHS Summary Care Record, Release 2 of the Electronic Prescription Service, GP2GP record transfer and use of the NHS Choices website.

It also places considerable emphasis on improving technical infrastructure and improving information governance and data quality. In particular, it says the NHS Number “is an underpinning safety imperative” so all NHS organisations should ensure its consistent adoption.

The detailed implementation report promised by the Health Informatics Review is barely mentioned, although the guidance says it will “identify actions to deliver informatics-enablement of service transformation” in line with the Darzi report. E-Health Insider understands this report will be published in the New Year.


The Operating Framework for the NHS in England 2009-10, Informatics Planning 2009-10, PCT allocations and other supporting documents are published on the Department of Health website.