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The government should avoid any more large, central and inflexible contracts and instead give local trusts the power to purchase systems
Conservative- commissioned review of NHS IT
The Conservative Party has promised to dismantle the centralised IT system being introduced in the NHS.
Shadow health secretary Stephen O'Brien has set out how the Tories will make the National Programme for IT (NPfIT) more localised and more focused on the patient.
The party has promised to halt and renogotiate Local Services Providers (LSPs) contracts, dismantle the IT central infrastructure and allow health trusts to make their own decisions, be that to continue with legacy systems or choose their own suppliers.
O'Brien's policy announcement is based on the findings of a Conservative-commissioned 'Independent Review of NHS and Social Care IT' by a panel made up of members of the King's Funds, doctors, nurses and health informatics experts.
Their review, which states that the NPfIT will have many benefits and "should not, therefore, be abandoned, as some are suggesting it should be", said witnesses had complained that the "the presence of local service providers in the National Programme for IT was a key factor inhibiting delivery".
LSPs, a number of which have dropped out of their contracts with the NHS, act as intermediaries between health trusts and hardware and software suppliers.
"The government should avoid any more large, central and inflexible contracts and instead give local trusts the power to purchase systems," the review added.
Instead, the review group advised, trusts should be allowed to negotiate with suppliers directly, choosing from a catalogue of suppliers who have met central government standards on pricing and interoperability.
Reviewers suggested that suppliers could include personal health databases such as HealthSpace, HealthVault and Google Health. "The government must no longer foot the cost for the design and development of software solutions; they should look to purchase finished products that are already fit for purpose as part of the architecture of the NHS," the review stated.
Overall, Department of Health involvement in IT should be kept to a minimum, the reviewers warned. "Those responsible for defining policy should monitor the effectiveness of NHS strategy but they should not be involved in the methods of implementation or the detailed definition of datasets."
Such a localised approach would allow the IT system to be far more focused on the patient than it is currently, the review group argued.
"The dataset mentality - where the bulk of data collected bears no relevance to patient care - should be abandoned. Clinical systems should be built to focus on the patient, not the disease, procedure, specialty or service providing care", was the reviewers' first recommendation.
The Conservatives envisage patients being able to review and amend their records, and use their records to find other patients with similar conditions.
O'Brien said: "Giving patients greater control over their health records is crucial if we are to make the NHS more patient-centred.
"Labour's attitude to our personal data is misguided. They seem to think they own it and, all too often, they have been appallingly careless in looking after it.
"The government's monolithic and costly IT system doesn't involve patients at all. Yet in patients' hands, health records could do so much more.
"We would have a clearer picture of our health and our care and we would be able to add information to help doctors treat us better.
"This could make a huge difference in helping us understand how to live healthier lifestyles."
Responding to the Conservative's review, health minister Ann Keen questioned how patient confidentiality would be protected.
"The Tories need to make it very clear how their plans will ensure patient confidentiality," she said.
"We have already set out our plans to give patients greater access to health information, for example through Healthspace where patients can see their summary care record."