What are the options for electronic patient records in the NHS after NPfIT?

It is a common assumption that the NHS can’t do IT. This is untrue: most GP surgeries are computerised, the health services of the UK’s constituent nations have decent technology infrastructure including secure networks and email, and many hospitals departments have good specialist IT. What is true is that many hospitals lack comprehensive electronic patient record (EPR) systems. In England, this can be blamed on the disastrous £12bn National Programme for IT (NPfIT). In The blunders of our governments, a survey of government disasters including numerous IT projects, authors Anthony King and Ivor Crewe describe NPfIT as “the veritable RMS Titanic of IT disasters” and “doomed from the beginning”.

If an NHS trust has ambition, money and a set of systems it wants to replace wholesale, it may choose to follow Cambridge University Hospitals NHS Foundation Trust, which last October went live with brand-new software from US EPR supplier Epic. It is not a route for the faint-hearted. Part of Cambridge’s £200m eHospital project, which also includes a massive hardware upgrade, the introduction of Epic took 18 months. More than 100 of the trust’s staff took exams to qualify as application analysts, allowing them to adapt Epic’s software to Cambridge’s processes, work which involved around 1,000 staff in total – before general staff training.

The trust expected to spend £40m of the eHospital budget with Epic, with a further £20m for its own costs. The system went live on the weekend the trust planned to do so, but has since experienced teething problems with areas including poor quality discharge summaries (sent by the trust to GPs on patients’ treatment) and clinic letters. Such problems are hard to avoid with such a large project, however much preparation is carried out...