Hospitals policy has obscured IT strategy

The government is sending out mixed messages about the impact of its foundation hospitals policy on centralised NHS IT programmes.

The Department of Health (DoH) has denied reports that it has changed plans for the mandatory national roll out of 'shared service centres' to streamline health trusts' financial processing.

'The advent of foundation trusts has not changed our objective for shared services across the NHS... It was never intended to roll out shared services nationally,' said a government statement.

But a letter, seen by Computing, that was sent by a DoH official to NHS trusts contradicts the official line.

'Progress on the national policy to develop Foundation Trusts means that the department's thinking on mandatory roll-out of shared financial services following successful evaluation of the Shared Service Centres has changed,' it said.

Responsibility for the project lies with the NHS Shared Services Initiative (SSI), which has been asked to develop a business plan based around a 'trading unit' funding model. If the change went ahead SSI would be funded on a more commercial basis and would market its 'product' trust by trust.

The re-thinking of shared services has huge implications, says Laurence Harrison, healthcare programme manager for supplier trade body Intellect.

'This is not a good example of joined up government and it looks like the DoH is missing a trick,' he said.

'Not mandating this to foundation hospitals loses the potentially huge efficiencies to be gained from having national shared services.

'And it is unclear what the tensions and obstacles between the two objectives will be - locally autonomous trusts and the National Programme for IT.'

Conservative health spokesman Chris Grayling said: 'There is a lack of clarity and direction - are we going for centralisation or de-centralisation?

'The bottom line is that if the government starts to scrap national IT initiatives it calls into question the future shape of the National Programme.'

Another of NHS SSI's nationwide projects - to develop a national staff record and human resources system - is delayed by up to two years and will not be rolled out until 2006.

An SSI spokeswoman says the design and build phase is taking longer than expected because of the scale and complexity of the project.