National Programme for Information Technology - Essay Example

 National Programme for Information Technology (NPfIT) Summary of the Case Project According to Richard Granger (2004, p. 3), as the director general, the NPFiT project was implemented to improve service delivery through the efficient use of Communication Technology. The aim of the project is to improve the convenience, quality and safety of patient-centred care by ensuring that those who give and receive care have the right information, at the right time. The introduction of IT focuses on minimal to zero needless harm, inaccuracy enhancement, avoiding needless clinical tests, approximations, inefficiency as well as avert needless bureaucracy processes. An agency, NHS Connecting for Health, was placed in charge from the department of health which was mandated with the delivery of this multibillion pound investment which was started on 1 April 2005 and was intended to span for the following 10 years. Its purpose is to bring modern computer systems into the NHS as this will improve patient care and services by connecting over 100 000 doctors, 380 000 nurses and 50 000 healthcare professionals in England to almost 300 hospitals as well as give people access to their personal health and care information The implementation of the NPfIT is a huge undertaking because of its size and complexity as compared to previous large scale health service IT projects in the UK and other countries, such as Australia and the USA, that proved very difficult or have failed because of organisational, sociocultural and technical factors. Despite the anticipated range of benefits from the NPfIT to patients, staff and the NHS, there has been much criticism and scepticism regarding the largest and most mostly healthcare development programme in the world. In undertaking this project, the NHS Connecting for Health aims to introduce modern computer systems into the National Health Service (NHS) nationally to integrate patient care with the technological advancement of the 21st century. The project will have a care records service comprising a collection of national and local database. An understanding of the engagement with clinicians and representatives from the RCOG will be paramount in the successful development of the National Programme for Information Technology (NPfIT) in maternity care. Evaluation of the Effectiveness of the Project The NPFiT programme is designed to be in ten years and deliver key elements that are concerned with NHS care record service (National patient Record Spine and Local Service Providers), electronic bookings, electronic transmission of prescriptions and underpinning IT infrastructure and network. The implementation of the program will involve new technology and information systems are being implemented in planned phases both at national and local levels. National Application Service Providers are responsible for purchasing and integrating IT systems common to all users nationally whereas locally, this will be provided by Local Service Providers across ten strategic health authorities in England grouped into three regional programmes. Their mandate is to ensure that the local systems that exist or being put into use go hand in hand in meeting the national standards that will also facilitate the flow of data nationally and locally, (Duggleby et al. 2004, p. 272). This program has key components set up to deliver the new IT systems and services that include the national network providing infrastructure and broadband connections for the NHS to enable patient information to be shared between organisations. Care records service ensures every patient will have his individual record easily accessible to him and health professionals hence reduce administrative and clinical errors. A national central database – referred to as Spine – will is the backbone of the project as it has a summary of patient records and key data such as NHS numbers, demographic details, drug allergies, medications and significant diagnoses or problems. It will also point clinicians to where more detailed information is held, including contacts of care providers. According to Duggleby, et al (2004, p. 9), an electronic booking service – referred to as Choose and book – provides people requiring specialist referral with a choice of at least four hospitals or clinics commissioned by their primary care trust and people are able to book initial outpatient appointments at a time, date and place that suit them. Using the directory of services better enables consultants to ensure the right person is booked into the right clinic and hence reduce the lengthy wait between a person’s visit to the general practitioner and the hospital appointment, as well as reducing the number of ‘did not attends. The Electronic prescriptions service allows a prescription to be sent directly from the general practitioner or hospital doctor to the pharmacy, making prescribing and dispensing safer, easier and more convenient for patients. The Quality Management and Analysis System (QMAS) — provides general practitioners and primary care trusts with feedback on the quality of care delivered and this service also enables an efficient method of transferring health records when a person changes their general practice. The NHSmail is a central email and directory service for the NHS, enough to enable efficient transfer and exchange of patient information as the Secondary Uses Service (SUS) provides anonymous patient data for purposes other than direct clinical use, including studying public health trends, efficacy of treatment and planning that NHS needs, such as numbers of hospital beds and members of staff Evaluation of the Effectiveness and Limitations There are certainly many benefits to patients, clinicians and the NHS with the introduction of this programme such as easier access to comprehensive patient details that will enable a link between community or primary health care and secondary care to be set up. This will improve communication between healthcare professionals and promote a multidisciplinary approach, speeding up referrals and handover of patient care as well as reduce the number of hospital admissions and increase the level of care within the community. The program brings about a patient centred approach where health care providers as well as patients have access to their medical records and are in a position to make the necessary changes as well as initiate changes to their medical records, an initiative that places the patient in charge of his health, (Proudlove, & Boaden, 2006, p. 471) Harrop, & Gillies, (2007, p. 279) asserts that archiving and Communication System, images such as obstetric scans requiring advice from a foetal medicine specialist can be transferred electronically from secondary to tertiary care, securely and without delay as additionally, with input of patient information directly into a national maternity database, healthcare professionals can access women’s details from any unit in England as this will provide accurate, up-to-date information as well as reducing the need for administrative work. When arranging an in utero transfer, for example, the receiving obstetric unit will have access to information regarding care, together with vital details, even before the woman is transferred, hence the receiving clinician can, therefore, have much more information prior to agreeing transfer On the other hand, Cresswell, Worth, and Sheikh, (2011, p. 320) say that there has been much criticism and scepticism regarding this project such as the progress in the NHS Connecting for Health programme is already behind the government’s target in certain areas and one of the key components of the programme, Choose and Book, has missed its target of universal electronic booking by the end of 2005. Secondly, there is a need to replace existing software in NHS organisation with ‘Spine compliant’ systems, supplied under centrally funded arrangements by Local Service Providers as NHS Connecting for Health is delivering two secondary care software systems. These need to be interfaced with existing systems in some cases since different hospital Trusts are at different stages with the NHS Connecting for Health programme. Some of the Trusts are being installed with advanced technology and services whilst others are still waiting, in addition, hospital Trusts that are already struggling financially have difficulty devoting resources into training and hardware for the new IT systems Further, there have been delays in the arrival of new software to be installed forcing some local Trusts to procure new systems outside the NHS Connecting for Health programme and this may result in problems with software compatibility. Nevertheless, common user interface computer programs have been written to produce a consistent look and feel so that healthcare professionals working with different computer services and technology will find it easier to navigate through the different systems safely and indeed, it is fundamental to service delivery and service reform and to enable NHS Trusts to thrive in a competitive environment Conclusion and Recommendations on the Effectiveness of the Project Acute hospitals are going through a period of considerable change, largely driven by the progressively tightening National Health Service Plan performance targets. Further major change in operating practices will be necessary to reaches the final stages, and to implement planned national initiatives including Booked Admissions, Patient Choice and Financial Flows. The importance of operational information systems has been recognized, and the major national information systems programme (the National Programme for Information Technology) specification includes many features that will support operational management, and “extend the chain” through the whole healthcare system. The ambition and scale of this programme will allow a much greater emphasis on integrated patient flows than current bed-management information systems, through the new information technology infrastructure and electronic whole-system integrated care pathways, (Khong, Currie, & Eccles, 2008, p. 9). However, the timetable for required hospital service improvements is shorter than for the new generation of information systems, and many Trusts are considering what can be done in the interim. Whilst fundamental to service improvement in only a few Trusts, notably those where the cultural attitude to compliance has changed, there are some very promising bed-management information systems in use. None of the existing bed-management information systems described includes all the key features drawn out whereas The National Programme for Information Technology specification includes all of them. However, some of the existing bed-management information systems have capabilities more advanced than those called for in the specification, supporting patient shuffling if schedules have to be revised in response to unusual levels of emergency pressure or very urgent elective demand. It would be a shame if this type of expertise were lost in the process of standardisation. No information system can be successful without the commitment of the users. This is a particular problem for “management” information systems requiring use by clinical staff. Experience from Trusts with a record of sustained bed management information system compliance should also be exploited. References Cresswell, K., Worth, A and Sheikh, A. (2011). Implementing and adopting electronic health record systems. Edinburgh, UK The University of Edinburgh. Clinical Governance: An International Journal 16(4) p. 320-336 Duggleby, J et al. (2004). Innovative practice in the use of ICT in education and training: learning from the winners. Education and Training.. 46(2) p. 269-277 Granger, R. (2004). The national programme for IT in the NHS in England (NPfIT). Available at (Accessed 12th Dec 2013) Harrop, N & Gillies, A. (2007). IT, Culture, Context: Emergency Department modernisation can inform the NHS information programme. Emerald Group Publishing Limited. International Journal of Public Sector Management. 20(4) p. 272-284 Khong, Y.S., Currie, I & Eccles, S. (2008). Risk Management. NHS connecting for health and national programme for information technology. Available at (Accessed 12th Dec 2013) Murthy, T.A.V., Chandrakar, R. & Kushwah, S.S (2004). IT at Agrilibnet 2003: Report of the Second Phase. 21(2) p. 9-10 Proudlove, N.C. & Boaden, R. (2006). Using operational information and information systems to improve in-patient flow in hospitals. Manchester, UK. Manchester Business School, The University of Manchester. Journal of Health Organisation and Management 19(6) p. 466-477 Read More