The British government has announced a fundamental change of direction for IT in the health service.
Following a Department of Health review into the National Programme for IT (NPfIT), minsters have said that "a centralised, national approach (to computer systems) is no longer required.
In a "back to the future" move, ministers are promising "a more locally-led plural system of procurement should operate, whilst continuing with national applications already procured."
Health minister Simon Burns said, "Improving IT is essential to delivering a patient-centred NHS. But the nationally imposed system is neither necessary nor appropriate to deliver this.
"We will allow hospitals to use and develop the IT they already have and add to their environment either by integrating systems purchased through the existing national contracts or elsewhere.
Burns said, "Moving IT systems closer to the frontline will release £700 million extra in savings."
The government is promising a modular, standards based approach, to health service IT with a "core assumption of 'connect all', rather than 'replace all' systems."
Minsters said that a national infrastructure for some elements of the National Programme for IT will remain -- including applications such as Choose and Book, Electronic Prescription Service and PACS, the medical image systems.
Some of these, very successful programmes were originally outside the scope of NPfIT and were brought under its wing when core systems suffered delays.
However, the bulk of the NPfIT will no longer be run as a centralised programme, the government said, though it added, "existing contracts will be honoured and it is vital that their value be maximised."
The decision will have profound financial and organisational implications in local NHS organisations, and on the suppliers of core NPfIT systems, who may find that their customer base has dried up.
Ministers also said a separate review of the Summary Care Record was currently underway, looking at what content the summary electronic record should hold and make available for sharing across the health system; and whether the processes by which patients are able to withhold their consent are as clear and simple as possible.