The government has announced a new direction for the National Programme for IT, changing its focus from a national approach to a more locally-led plural system of procurement in a bid to save £700 million.

Following a review of the programme, which has been beset with problems and attracted much criticism since its birth in 2002, the Department of Health said it has decided to take a more “modular” approach to allow individual NHS organisations to instil smaller, more manageable changes to their IT systems that are better suited to local needs.

The shift to a more plural system of IT instead of the old centralised, blanket approach is underpinned by the core assumption of ‘connect all’ rather than ‘replace all’ systems, reflecting the coalition government’s “commitment to ending top-down government and enabling localised decision-making”, it said.

But elements of the NPfIT already in place - such as Choose and Book and the Electronic Prescription Service - will be retained, albeit under new supervision, as they will no longer be managed as projects but as IT services under NHS control.

According to the DH, its plans will free up around £700 million, which can be redirected into improving patient care and help plug the predicted £20 billion funding gap the health service is facing.

Explaining the changes, Health Minister Simon Burns said a nationally imposed system of IT is “neither necessary or appropriate” to improving IT to better deliver a patient-centred NHS, and that allow hospitals to use and develop the IT they already have makes practical and financial sense.

“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 organisations,” added Christine Connelly, Director General for Informatics.

Cautious support

2020healthorg has broadly welcomed the government’s new direction for IT, but added that the plans are short on detail and leave many questions unanswered. “The brevity of the announcement leaves several key issues unclear”, it said, such as “what elements of a centralised NHS IT organisation will remain to set strategic direction, set standards and ensure the IT implications of new NHS policy are reflected in implementation plans?”

Frances Blunden, senior policy manager at the NHS Confederation, said “the announcement that more freedom will be given to NHS organisations to find their own solutions to information technology challenges is welcome but it is important to remember that removing some elements from the national programme is likely to shift cost to local providers”.

And the British Medical Association was also cautious in its support of the plans. Dr Chaand Nagpaul of the BMA’s GPs’ committee, said handing over more choice of IT systems to NHS organisations makes sense, “but we also need to be aware of the problems that could arise from a more localised approach”.

“It is important that successful national IT initiatives are not lost, and that innovation is not stifled”, he stressed and noted the need for some “central accountability” in order to secure “consistent and equitable delivery, manage local implementation, avoid wasteful duplication of effort, and support local decision-making”.