NHS informatics in England will move from a “replace all” to “connect all” philosophy, the Department of Health has announced.

Informatics planning guidance for 2010-11 says an updated strategic direction for informatics will be developed over the coming months to reflect the change in emphasis.

The guidance says a new direction has also been agreed for the National Programme for IT in the NHS, which will give the NHS more involvement in decision-making on the scope and timing of implementations.

It also sets out a series of expectations that local community operating plans for 2010-11 must deliver. The guidance says these have updated from previous years because compliant software is now more widely available. The expectations include:

• Risk-assessed plans of how and when each of the Clinical 5 will be used by all the clinicians in a local health community and whether the systems will be procured via local service providers or the Additional Supply Capability and Capacity framework.

• A timeline for the creation of Summary Care Records at all SCR-complaint GP practices in the 2010-11 financial year.

• Plans to complete NHS COnnecting for Health preparations for the implementation of Release 2 of the Electronic Prescription Service.

• Plans demonstrating how digital capabilities are being actively developed to support improved patient experience, such as promoting the use of NHS Choices and providing tools to help clinicians and managers use feedback to improve quality.

The informatics planning guidance reflects the themes of the Operating Framework for the NHS In England 2010-11, which was issued by NHS chief executive David Nicholson last week.

Looking beyond the final year of growth in NHS funding, this stressed that the health service needs to get the most out of the technology that it already has. 

The guidance says all organisations should move to NHSmail and that plans for any additional expenditure on locally hosted email services should be supported by a business case covering the cost and benefit compared to NHSmail.

It also says organisations should make increasing use of products available via NHS enterprise wide agreements and only make local purchases when there is no suitable product or service covered by an EwA.

The guidance also echoes the operating framework’s concern with costs. It says the cost of implementing Clinical 5 systems should be transparent, with annual figures for 2010-15 for all NHS providers.

NHS bodies are also urged to consider the most efficient and effective models for delivering informatics and technology services to local communities. They are advised to consider larger scale health informatics management, such as a health services informatics approach to back office technology services.

Since the summer, ministers and DH officials have been urging NHS managers not to adopt a "slash and burn" approach to delivering cost savings and to follow the quality, innovation, productivity and prevention (QIPP) agenda instead.

On QIPP, the guidance says strategic health authority chief information officers have already identified their top priority informatics initiatives. It says SHAs will want to sponsor and lead regional informatics initiatives to address these priorities.

It also says communities will be expected to make significant progress on the use of mobile technology to improve quality and productivity.

The DH also wants operating plans to set out how local communities will achieve compliance with widespread use of the NHS Number, the information governance toolkit, standards set by the Information Standards Board for Health and Social Care and the National Infrastructure Maturity Model (NIMM).

NHS organisations are expected to publish their current position on the NIMM and aim to achieve at least Level 3 and ideally Level 4 across the priority elements of their technical infrastructure within the next 12 months.

This year local communities are required to include their informatics planning as part of their mainstream plans, not as a separate document.