The Department of Health is working on a plan to keep informatics services working during the latest shake-up of the NHS.

In his latest letter to NHS chief executives on “making the transition” to the set-up outlined in the ‘Liberating the NHS’ white paper, NHS chief executive Sir David Nicholson says strategic health authorities and primary care trusts have been asked to detail their current IT systems and informatics capabilities.

The information, which was collected last month, and will be refined and finalised by March, has “created a baseline that will be used to form the transition plan.”

The letter also says that a “working hypothesis” for the “future state” of informatics has been developed and is being tested with stakeholders.

“The model includes dedicated informatics teams in each part of the organisation, as well as arrangements to share scarce skills and improve efficiency,” the letter says, suggesting that there could be a focus on more shared services for GP commissioning consortia and community providers.

The letter adds that “one major issue identified is the need to clarify how National Programme for IT in the NHS services currently delivered by the SHAs and PCTs will be maintained during the transition.” This will be discussed by the National Programme Board; although the letter does not say when.

Last week, the BMA’s GP Committee told GPs that it is working to make sure they continue to receive the benefits of the GP Systems of Choice initiative during the transition.

The GPSoC scheme was negotiated for four years from 2007 to enable GPs to use a system of their choice, with central funding based on rates negotiated with six leading suppliers. The framework, due to expire this year, has been used by more than 7,000 practices in England.

The GPC has also said GP practices could experience problems if PCTs are planning changes to the way they deliver services such as IT support and maintenance.

Such services underpin GPSoC, so PCTs must continue to deliver their obligations under the PCT-practice agreements that set out what a PCT is required to deliver on IM&T. Most current PCT-practice agreements expire between January and March 2012.

Overall, Sir David’s letter attempts to keep the NHS focused delivering on core business – such as the 18 week referral to treatment time, which is a right under the NHS Constitution – while dispelling some “misunderstandings” about the reforms and restating the timetable for introducing them.

It says that primary care trusts should have formed into just 35 clusters by June, and that clusters should “identify staff whose future role will be to support commissioning” or help them to find other roles, for example in creating social enterprises.

The NHS Commissioning Board should be in place by October, and will be based in the NHS Executive’s old headquarters in Quarry House in Leeds and in Maple Street in London.

The letter also indicates that the Department of Health has set up a work programme to realise health secretary Andrew Lansley’s promise to patients of “no decision about me without me.”

The Transforming the Relationship Across Citizen and Service Programme will look at how to support shared decision making, encourage multi-channel services, make information available and visible, and at “the technical infrastructure to support greater access to personal information.”

The letter recognises that “information and information technology are essential components to deliver the ambitions outlined in the white paper” and says that a “strong informatics capability is necessary to deliver on our intent.”

Nevertheless, a survey by EHI Primary Care last year revealed considerable uncertainty among staff working in SHAs, PCTs and health informatics services about the future, and about the loss of skills and investment as the latest reforms are worked through.