The UK Department of Health (DOH) has decided to drop Britain's National Programme for IT in favor of a more bottom-up and localized approach to health IT for the country's National Health Service (NHS). The shift could produce as much as $1 billion in savings from a program that had been projected to cost as much as $20 billion.
Simon Burns, the UK's health minister, acknowledged that it was essential to improve IT in order to deliver a patient-centered NHS, "(but) the nationally imposed system is neither necessary not appropriate to deliver this," he said.
"We will allow hospitals to use and develop the IT they already have and add to their environment either by integrating systems purchased through the existing national contracts or elsewhere."
What are considered mature applications that the NPfIT has already developed and that are already integrated into the NHS, such as an electronic prescription service and a Picture Archiving and Communications Systems (PACS), will be retained, as will a national infrastructure that was built to accommodate NPfIT systems.
Christine Connelly, the DOH director general for informatics, said the NPfIT had delivered important changes for the NHS that will help provide safe and responsive health care. But, now the NHS is changing, "we need to change the way IT supports those changes, bringing decisions closer to the front line and ensuring that change is manageable and holds less risk for NHS organizations," she said.
The new UK Conservative/Liberal Democrat coalition government formed after a general election in May published a plan (http://programmeforgovernment.hmg.gov.uk/nhs/index.html) for how the NHS would be run, which included the likely dumping of the NPfIT and a redirection of resources towards doctors and nurses "on the front line" .
Under the plan, general practitioners will be given primary control for the treatment their patients receive.
The government said it was also "committed to reducing duplication and the resources spent on administration, and diverting these resources back to front-line care."
Even before the new government was voted in, however, the long-term prospects for the NPfIT were doubtful. In April the NHS' chief executive for the London strategic health authority, admitted that it would no longer be possible (http://spectrum.ieee.org/riskfactor/computing/it/the-npfit-is-dead-long-...) to provide hospitals, ambulance service or GP offices with the comprehensive electronic health record that was envisaged at the beginning of the NPfIT in 2003.
The new, modular approach that the government now favors will allow the various organizations within the NHS to introduce smaller and more manageable change, in line with their business requirements and capacity, the DOH believes.
