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Q&A: Electronic care records


The electronic care records system is back in the headlines again. The scheme was launched in 2002 with the aim of revolutionising the health service in England, but the National Audit Office is now saying it will struggle to meet its objectives and is not providing value for money.

What are electronic records?

image captionE-care records are part of a wider IT upgrade

Currently, the NHS still relies heavily on paper files. Under the electronic records system, details will be loaded on to a database allowing details to be accessed wherever a patient is being seen.

There are two parts to the project - the summary record and detailed record. The summary record just contains basic information such as medications and allergies.

The detailed record - the complicated bit which has been looked at by the NAO - includes everything else from test results and X-rays to the types of treatment a person has had.

The project is the key part of the entire NHS IT project, which also includes digital X-rays and fast internet connections.

Wasn't this system meant to be working by now?

Yes. The original plan was to have electronic care records up-and-running by 2010. But that deadline was missed after a range of problems.

There has been controversy over patient confidentiality - patients now have the chance to opt out of the summary care record part.

The detailed care record has been designed to be only used locally by those NHS staff that are directly involved in your care, whether it be in hospital, at a GP practice or in a community clinic.

Suppliers have also encountered problems fulfilling the original demands of the detailed care records side of it. Two ended up pulling out, leaving BT and the US firm Computer Sciences Corporations responsible for the entire project.

Their contracts are coming to an end and by 2016 the entire scheme should be completed, although the NAO is now raising doubts over whether this will be achieved.

So how much will this cost?

The entire NHS IT programme is expected to cost £11.4bn. Some £7bn of this is going on the electronic records system and the technology needed to support it.

However, the problems that the project has encountered has not led to an increase in overall cost.

Originally, it was expected about £8.6bn would be spent. However, the fall has only happened because the system has been scaled back.

In London and the south of England, where the contracts have been renegotiated, the majority of hospitals are no longer taking part.

This fall in costs has not been proportionate with the scaling back, meaning the NHS is getting less for its money.

What is happening in those places that have pulled out?

They have been told to come up with their own solutions locally.

This was partly done because some hospitals had started investing in technology to replace their creaking systems because of the delays in the national programme.

For those with good systems in place, it is possible they will be able to link up with the national systems.

However, for many others electronic records are likely to remain a distant dream.

What happens next?

Roll out is continuing, but the change in government has prompted suggestions that the entire scheme may be scrapped.

Some critics have argued this would be the best solution for what everyone admits has been a troubled project.

A group set up by the Treasury and Cabinet Office is due to start reviewing the programme soon.

However, the Department of Health, which has taken a lead on the programme, is adamant it will still provide enough benefits to justify the expense of continuing.

Doubts also remain as to whether cancelling contracts will be realistic as compensation may have to be paid.