On Monday 9 March 2009, the Channel 4 Dispatches programme broadcast How They Squander Our Billions, a documentary on government projects including the NHS’s National Programme for IT (NPfIT). The NPfIT had an initial announced cost of £2.3bn which rose to £6.2bn and later £12.7bn. A key objective of the NPfIT is the introduction of something known within the NHS as the Spine which is part of the NHS Care Records Service (NHS CRS). Check out the NHS Connecting for Health Spine Factsheet which includes the following information:

What is the Spine?
The Spine is part of the NHS Care Records Service, which is creating an electronic care record for all England’s 50 million plus patients.
Each patient’s electronic NHS Care Record comprises full local records, held on computer where treatment is provided (such as the GP surgery or hospital) and a summary record of important details both demographic (eg: name, address) and medical (eg, allergies, medication, test results) held on the Spine.
The Spine is a national, central database where summary patient records are stored. When fully implemented, local records will automatically upload important information to the summary patient record on the Spine.
Why have a Spine?
Once the NHS Care Records Service is fully implemented, having each patient’s summary record stored on the Spine will mean that wherever and whenever a patient seeks care from the NHS in England, those treating them will have secure access to summary information to assist with diagnosis and care. The summary record will also point clinicians to where full local records are held. This should provide safer, more joined up care.
What will the Spine do?
The Spine will:
• store personal characteristics of patients, such as demographic information
• store summarised clinical information which may be important for the patient’s future treatment and care, such as allergies, visits to A&E and adverse reactions to drugs
• ensure the security of systems required to restrict access to the national and local systems
• provide a secondary uses service, using anonymised data for business reports and statistics for research and planning purposes
• interface with all the local IT systems within the National Programme.
And so on.

Less than a year ago I attended a training course on this very system designed to ‘interface with all the local IT systems within the National Programme’ in order to provide ‘safer, more joined up care’. Well, it all sounds lovely and efficient, except that I have worked enough years and in enough different departments of the NHS to know that trying to get the countless and different in-house IT systems already in use within the country’s hospitals, clinics and surgeries to ‘interface’ in the way described above remains a very long way off.

Which is why I was entirely unsurprised last Autumn that my mother’s cancer care was interrupted for 6 weeks while her paper records were transferred from one NHS Trust to a second NHS Trust, via a central records depot in a third NHS Trust, before her details could be entered onto the second NHS Trust’s local IT systems and management of her disease could be recommenced at her new address.

If there’s a better example of how easily the NPfIT is providing this safer and more joined up care after 6 years and so many billions of pounds, I’d like to see it.

Skeletons in the cupboard. is a post from: Anna Raccoon