Suppliers advised to develop standalone software

Tags: CfH Choose and Book encryption iS LSP NHS Spine Office PACS Security Spine

26 May 2005

Connecting for Health (CfH) has confirmed that it is advising its suppliers to develop standalone versions of their applications, not reliant on the NHS Spine, in order to prevent further implementation delays.

A CfH spokesperson told E-Health Insider that the spine remained an "important component of the strategy that the National Programme for IT is implementing and LSP products are being designed to link to the spine". CfH confirmed, however, that it was also working with suppliers to develop stand-alone or ‘spineless’ versions of their systems.

"We have been working with suppliers to enable clusters to receive the benefits of new IT systems supplied by LSPs without having to interrupt their implementation programme to take the next version of the spine until required," said the spokesperson.

Only a handful of spine-connected systems have yet been implemented under the national programme. New systems that have been implemented have largely been stand-alone systems, not connected to the spine. For instance, neither of the two early PACS implementations, identified recently in the NHS chief executive’s annual report as early successes, are connected to the spine.

The spokesperson said that reviewing the architecture of the programme was in line with best practice: "As such, from time to time, implementation sequences are altered and architectural components are amended."

As previously reported by E-Health Insider, the implementation of the spine, which provides national infrastructure and services such as user authentication, security and data encryption for the Care Records Service, has been experienced serious teething problems and delays.

Problems reported at early sites using elements of the spine have included reliability and the basic user log-in and identification process, which takes minutes rather than seconds. In January, a National Audit Office report stated that technical problems with Choose and Book had included an intermittent fault with authentication through the NHS Spine that had "prevented access to e-booking and other IT systems”.

It was partly problems with the spine-based services that led to the development of Interim Booking Services at the beginning of 2005, to try and ensure progress against the target for Choose and Book to be implemented by the end of the year.

Readers Comments

"Spineless"

26 May 05 07:42

I am not sure that "spineless" is the best term to use for the work being carried out by CfH and suppliers mentioned in this article. On the other hand...

specification

26 May 05 09:33

I suggest for the spineless version they develop them based on the specification of a politician

Spine fracture

26 May 05 14:15

'The Spine' covers a multitude of sins, notwithstanding growing scepticism they will ever be committed. Exactly which Spine services are delayed or moribund.. some or all of them?

Recent stories suggest that both (unexpected) technical and (wholly predictable) data cleansing issues are dogging the PDS (Personal Demographics Service). If the demographics services fail, the state of everything else is academic.

Meanwhile debate about the confidentiality of the NCRS data rages uninformed (indeed it seems uniformable) by technical detail.

Off the record questions between NHS, LSPs and suppliers about PSIS (Personal Spine Information Service) delivery are greeted with Delphic smiles, while enquiries about the status of the Clinical Spine Application are met with barely stiffled hilarity.

Where does this story sit with the 99%+ availability that 'the Spine' has had since Dec 2004? http://www.connectingforhealth.nhs.uk/operational

What is going on here?

[Post edited by EHI]

Risks of re-sequencing

27 May 05 07:08

Advising suppliers to press ahead with stand-alone developments may get something of benefit to patients delivered out to the NHS more quickly (just as continuing the ongoing procurements that stopped when NPfIT embarked on the NCRS might have done) but does anyone know of an instance in health IT where a number of systems developed independently have later been linked to a central repository without a great deal of expense and upheaval?

In this case "altering implementation sequences" and "amending architectural components" (could this be code for fire-fighting in the face of mounting delays?) might prove to be a fundamwental change rather than a minor tweak.

Interested Observer

27 May 05 11:24

Observing

in the know

29 May 05 23:33

As someone working in the program this is a vital thing to do. As this negates the need for bussines change if the practice/ hospital have moved to a system as they are already use to how it works then to move it to a central system is simple for the clinician and they will odserve only less work for themselves. and as for companys needing to develop stand alone most of them already have stand alone systems as that where they came from and its the centralised systems that are causing problems for the development. As for the spine I feel thats its wise to get the systems that feed to the spine up to scratch first before the spine becomes fully functional as the big bang always has problems.

hypothetical situation

01 Jun 05 11:34

Giving the go ahead for non-spine enabled systems would be required if one (say) wanted to open the door to a late entrant supplier.

Playing Spine 'catch up' is unlikely to be much harder than being in from the start. Those experienced in the joy of attempting to implement the NPfIT Message Implementation Manual can warrent that one begins again almost from scratch with each new version anyway %-(

Earlier Payment Possible

Derek_Bain@expn.com

20 Jun 05 18:36

The objective of the spine is to make the demographic and clinical records of 50,000,000 patients in England available to 18,000 NHS sites via N3 so that GP's and hospital consultants may access this information on a 24/7 basis. Allowing the private sector suppliers to deliver stand-alone systems will enable earlier payment to them thereby benefitting their cash-flow.