The Department of Health will take a “pragmatic approach” to the procurement of IT systems big and small, Christine Connelly told the final session at eHealth Insider Live 2010.

In a session that was mainly given over to questions from the audience, the NHS director general of informatics reiterated that health service is moving from a ‘replace all’ to a ‘connect all’ approach to IT.

She also spelled out the DH’s vision of an information revolution – as outlined earlier in the day by health minister Simon Burns – and said it was time to start looking beyond the National Programme for IT in the NHS.

“We expect to move to a world where we connect up multiple systems in different places," she said. "Evolving to where we want to go will be different depending on where you are geographically. We are trying to be as pragmatic as possible.”

Asked how this approach would work while the nationally-negotiated contracts for electronic care record systems were still in place, she said: “I hope trusts will choose systems that you are already contractually committed to. But we are committed to an environment where trusts have choice.”

Trusts who do not want to use LSP products would not be forced to do so, she said. And trusts in the South of England that did not want to take part in the ASCC procurements would not have to do so, either.

“I want to see trusts committed to upping the quality of the systems they run. Until we get better systems in place, we will not see the improvements we need to make.

“If the products you want are not on the ASCC framework then we will have to ask why and revise the framework,” Connelly added.

Asked about standards for interoperability – a hot topic in Birmingham – Connelly said she was looking to the informatics community for guidance on the standards to mandate and the approach to take.

She said: “We are committed to building in international standards where they exist but we do not want to wait until all these standards have been adopted.”

She also reminded her audience that the NHS white paper, ‘Equity and excellence: Liberating the NHS’ said that the new NHS Commissioning Board will set standards for health.

However, she said she would expect to advise it. The board will have to address not only data sharing within the NHS but also between the public health function and social care, she added.

Taking other questions, Connelly said that the consultation document on a new information strategy for the NHS, ‘Liberating the NHS: an information revolution’, had deliberately not focused on IT.

Asked why there was no mention of open source in the document, she said: "The reason open source is not in there is we did not put IT things in the document.

"The goal is an information revolution, and the means to achieve that is IT; not to develop IT and to do things with it."

She also tackled the issue of what the consultation meant by giving patients "control" of their records. She said it meant more than access, and that patients would be able to download their records and give them to third parties.

Asked whether the governemnt would relax the security requirements on NHS records to allow them to be taken offshore, she said it would not. However, she said that if patients wanted to take their own records offshore they should be able to do so.

“My expectation is that if I take a copy of my record, I can decide where I store it and it is up to me to assess if it is secure enough for me.”

The consultation would find out what people wanted to do with their records, she added. “Personally, if I have control of my records I want not just the information but also to transact,” she said.

Among other issues, Connelly acknowledged the frustration experienced by both trusts and smaller suppliers at the difficulty of running procurements for innovative products.

She said prime minister David Cameron had addressed the issue of supporting small and medium sized businesses in a recent speech; and said the interoperability toolkit projects showed that setting standards for interoperability might help in the NHS.

“I am not sure what I can do about it, but it is on my list and on David Cameron’s list – and those are good lists to be on. Work on the interoperability toolkit is a start on how we make this possible.”

Small and large companies have taken part in ITK proof of concept projects for messaging, kiosks, discharge summaries and other specific NHS workflow issues.

“There are benefits for both," Connelly said. "If you are a big company it is hard to bring every innovative idea in. By opening up, you can create a much more compelling proposition and deliver benefits much faster.”

The head of the DH technology office, Paul Jones, told EHI last week that there would not be another round of ITK projects.

However, in a statement issued to EHI this week, the DH clarified that this did not mean the ITK had been scrapped. "ITK is now ‘business as usual’ and will very definitely NOT be axed," it said.