The effective end of the National Programme for IT in the NHS at a time of economic constraint is likely to mean fewer big EPR deployments and more focus on integration.

An E-Health Insider telephone poll of trusts in the North, Midlands and East of England, suggests that many will focus on ehnancing existing clinical functionality and business cost reduction.

EHI conducted the poll to guage reaction to the Department of Health’s announcement that a ‘national’ approach to IT is no longer required and that the future lies in more local procuement and module deployment.

The majority of trust IT directors contacted said that they would be implementing clinical portals and business intelligence systems.

Stephen Parsons, IM&T project manager at Trafford Healthcare NHS Trust, told EHI: “We cannot keep waiting on something not knowing what it’s going to be. For us the investments we’ve made we’ll continue to work on and enhance what we already have.

"We have a stable EPR, the pressure on us is not so much on clinical records but more on cost reduction in business and improving quality.”

John Thornbury, director of ICT for Worcestershire Health, added that his acute trust would now continue to develop its existing products, after taking the decision to opt out of Lorenzo.

“Because of the delays to NPfIT, like most trusts our key thing is to keep clinicians engaged. We have had a dual approach, with the programme being our long term approach and our clinical portal being our interim.

"Now our clinical portal has become our long term strategy, which fits more with interoperability rather than with rip and replace,” he said.

Moving ahead with such systems may mean that the large electronic patient record suppliers that were shut out of the programme may still be left out in the cold.

Andy Jardine, IT director at Newcastle upon Tyne Hospitals NHS Foundation Trust, which recently went live with a Cerner Millennium deployment by UPMC, said: “If the Lorenzo programme is unlikely to deliver, then with the current economy I suspect there will be an increase in the development of cheap, best of breed solutions that can rapidly deliver EHR – like portals using pre-existing applications.”

Christine Walters, associate director of IM&T at Pennine Acute Hospitals NHS Trust, agreed, saying: “It’s more about bringing in systems to support the clinician, such as EDM and portals.

"There isn’t the money out there to go and spend on new EPR systems, only a few brave souls will do that. However, building on existing systems will be positive and encourage much more collaborative working."

Read more in our analysis feature, Stick with the programme?