Thoughts on the NHS National Programme for IT

What will the NHS National Programme bring to London Acute Trusts in 2009?

As the final months of 2008 came to a close, David Nicholson, the NHS Chief Executive, acknowledged that the Care Records Service was at a ‘pivotal point’. Nicholson then went on to say this could lead to a “major rethink if progress is not made soon”.

To many senior managers in Acute Trusts in London, this has not come as a surprise. Acute London deployments are on hold until spring 2009, whilst BT, Cerner and LPFiT look to regain ebbing confidence by resolving issues in the most recent LC1 deployment at the Royal Free, leading to a viable product – and means of deploying it - for London in the future. This means not only plugging the well publicised functionality gaps, but also implementing a new deployment model, aimed at giving greater flexibility back to the hands of individual Trusts – an open admission that the ‘one size fits all’ deployment model has not been achievable and individual Trusts must be given greater control in how, what and when to deploy – based on local priorities, capability, capacity and budgets.

The current uncertainties over exactly how the new deployment model might work, or if the Royal Free can become a success story through functionality fixes, are not likely to be resolved until sometime in February, at the earliest. Assuming that a workable solution is found, there then remains the challenge of the contract reset – and for those of us who have been there before, it would be fair to conclude that the time taken to reach agreement on complex, multi-stakeholder commercials should not be underestimated.

So in the midst of all of this activity, some Trusts continue to plan for a delayed deployment, on the assumption that functional, implementation and contractual difficulties will all be resolved in a realistic timeframe, whilst others are starting to seek alternative options – not least because of the concerns expressed by Nicholson himself.

The challenge faced by many Trusts is knowing how to plan for an uncertain future in a financially turbulent time when operational pressures place ever more demands to deliver high performing information systems, and increased competition and VFM in health markets. This gives rise to a number of key questions: How best to keep a balance? How best to make use of existing legacy systems? How best to develop an overall IS strategy that provides long term flexibility whilst delivering short term operational needs? How best to plan for engaging in the new deployment model? How to minimise risks in all aspects of delivery? How to develop a meaningful and justifiable Business Case for the chosen route?

Methods doesn’t have the answers to all questions, but we do have experience and innovative ideas on how to tackle the complex challenges faced. In particular we have a proposed approach based on a progressive iterative and incremental legacy integration allowing for a move to a common enterprise architecture, which accommodates a wide range of existing products and configurations. From a business perspective this minimises risk by ensuring that existing systems and services are only replaced when better systems are available, yet still allowing for the benefits of inter-operability. This approach has been proven in other organisations with similarly complex environments.

For more information on Methods Consulting’s clinical integration services please contact
Dr Karen Ma on 020 7240 1121.