Progress report: NHS IT gets a check-up

The National Programme for NHS IT is one of the most ambitious technology projects the UK public sector has ever attempted.

With a £2.3bn budget for the first three years, it is also one of the most expensive and in one of the most politically and socially sensitive sectors.

Computing believes the project demands balanced, intelligent coverage, which is why we launched The Real Story campaign soon after the National Programme was launched.

Our NHS Monitoring Group met for the first time in July to provide constructive input on potential dangers currently threatening the strategy's success.

Members were drawn from across the public and private sectors - some with direct experience of NHS IT, some without - to provide the broadest possible basis of views.

What united everyone was the need for improved communication.

Many of the criticisms of the programme either focus on or result from a lack of clear information about what the it is, how the negotiations with suppliers are progressing or what the position is on key policy issues such as security.

At this stage, in the run-up to the signing of the first deals and the start of implementation, Computing has put together a Special Report on NHS IT. The aim is to put a stake in the ground, filling in all the background to the programme's current position. And to lay out the concerns of the Monitoring Group, filling in answers where they are available, calling for progress where they are not.

These are the points raised by the group:

• At the broadest level, communication is a question of vision. Most people in the NHS are not interested in the National Programme as such, only in what it will mean for them and their patients. This big picture has not been clearly articulated so far.

• The government also have a responsibility to lay out how the National Programme systems will help NHS professionals meet clinical targets - until that disconnect has been removed, on-the-ground support will be hard to develop
• Little of what is in the National Programme is actually new, it is just a question of scale. There are examples of IT innovation and success already in place all over the country, and as the National Programme moves into implementation there will be more. Publicising what is already out there would help make best use of existing experience
• Who will be responsible for what at the various levels of the programme? There are so many different people involved - NHS IT staff, existing suppliers, Local Service Providers (LSPs) responsible for regional implementation, LSP sub-contractors, National Application Service Providers building the central applications, the Department of Health's National Programme office. Until the structure of who is responsible for what is clear, confidence that every 'i' has been dotted and every 't' crossed will be hard to foster. And absolute responsibilities for any future problems will be easier to shirk
• The technical security measures around handling of sensitive patient data and the overall policy governing who gets access to what are yet to be published. Public opinion will respond very badly if further down the line there are problems around the handling of data and there is either no clear policy in place or no established chain of responsibility

Some of the answers to these questions have already been provided. Some are yet to come.