The impact of the national IM&T programme on primary and social care premises

The Wanless report (published in April 2002) on securing the future health service recognised that "without a major advance in the effective use of ICT, the health service will find it increasingly difficult to deliver the efficient, high quality service that the public will demand. This is a major priority which will have a crucial impact on the health service over future years".

The national IM&T programme (as described in 'Delivering 21st century IT support for the NHS') provides guidelines on national standards and specifications for IM&T systems in the NHS, including their procurement and management.

The key elements of the national IM&T programme for delivery between now (2003) and 2006 are:

• Infrastructure – deliver broadband access to the ‘NHS net’ for NHS clinicians and support staff by April 2004. This will be a single national procurement of a new NHS network. Strategic Health Authorities and trusts should be aware of the national procurement and make arrangements for local networks.
• Booking – implement electronic booking by December 2005. The chosen architecture is decided upon and early adopters (enterprise communities) are developing. Local communities should respond to the national roll out programme.
• National prescriptions service – this will be 50% implemented by December 2005 and 100% by December 2007 with full clinician and patient functionality. Pilots are being conducted in order to define a specification for a national programme. Local communities will need to respond to the national programme.
• Electronic records – implement key elements of electronic records by December 2005. There will be a national health records infrastructure accessible nationally for out-of-hours reference and an electronic staff record. Existing systems and new procurements will need to be made part of the Integrated Care Records Service, the specification of which is out to consultation.

All primary care organisations – as part of their LDPs – will need to implement the national IM&T programme. They should identify their IM&T requirements and develop plans in conjunction with key local stakeholders. For further guidance see the PCIMP. At the core of the national IM&T programme is strategic outsourcing. This means selectively outsourcing major components of the programme with delivery of some components at national level via the NHS Information Authority (NHSIA) and the use of national framework contracts for other services. The PFU has issued guidance on ‘IM&T and build’ (entitled ‘Handling IM&T within Build’). This provides useful guidance on the practical issues associated with developing ‘IM&T and build’ solutions for large PFI projects. The guidance aims to assist trusts in ensuring that new or refurbished facilities have appropriate IM&T support and services. Certain minimum requirements will apply in procuring ‘IM&T and build’. These are:

1. All build schemes must include IM&T infrastructure, which is defined as cabling, power points and any accommodation necessary for IM&T equipment (such as PCs). This will have an influence on the build design stage. IM&T infrastructure may also include telephony, unless that is being procured as equipment.
2. The partner must be made responsible for delivering, as a minimum, key elements of IM&T; these are defined as those upon which the build is in some way dependent.
3. Within the context of the build there continues to be the goal of ensuring that the IM&T necessary to support the build is available and performing acceptably when the new or refurbished facility is in use.
4. Contractors must be aware that they will have to consider how their IM&T proposals will fit into any wider IM&T picture – e.g. if an electronic patient record is being delivered across several organisations.