Abstract

The National Health Service (NHS) in England is in the middle of an Information and Communications (ICT) revolution. The NHS National Programme for IT (NPfIT) has been described as one of the world’s biggest IT projects, costing £6.2bn. ‘Over the next ten years, state‐of‐the‐art computer systems will be installed across the NHS. Once the work is complete, those systems will, for the first time, connect more than 117,000 doctors, 397,000 nurses and 128,900 other healthcare professions in England.’ The improvement of services through the application of ICT surrounds our everyday life, whether at the bank, in supermarkets or in the entertainment industry. Whilst major technological advances have taken place in medical imaging, diagnosis, treatment and surgery, the same level of advancement in information and communication management, across the whole organization, has proved far more elusive.The concept of the Electronic Patient Record (EPR) in the NHS was first introduced to readers of this journal in 2000. The idea of using information management and technology to ease the burden on NHS staff had been developing for years, with some success in what Brennan described as ‘pockets of excellence’, but on the whole these initiatives had not achieved the revolutionary change sought and were regarded as a ‘frustrating failure’. The Department of Health (DH) therefore seconded Frank Burns from one of the successful EPR sites, Wirral NHS Trust, to develop a strategy to take the NHS towards the vision of an integrated, computer‐savvy health service.Three years later, Brennan was back in these pages with an update. The vision of Information for Health and its spin‐offs had led to disappointment, missed targets and, ultimately a major re‐think. Apart from the failings of Information for Health, the DH was also having to respond to a number of other influential publications; Building the Information Core: Implementing the NHS Plan, Jan 2001; Delivering the NHS Plan;6 and Securing Our Future Health: Taking a Long‐Term View, April 2002 (commonly known as the Wanless Report).

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