National Programme for IT and the Local Service Providers

There are four local-service providers who have been appointed under NPfIT to support the five geographical clusters of the NHS in England. They are responsible for making the NHS Care Records Service functional at local levels.

In order to have a homogenous and co-ordinated approach the systems and services needed have been prioritised into three main groups:

• core bundles
• additional bundles
• future bundles

The scope of the LSP’s remit has become reasonably clear as a consequence, with the emphasis being clearly around clinical systems.

Core service bundles

These cover the first of a trust’s operational (administrative and clinical) systems which need to connect to the patient records on the national database (the Data Spine).

There are 13 core bundles (Table 1). They are funded by the NPfIT. The LSP consortia have the exclusive right to supply them if it is necessary for new systems to be installed.

Services provided by core bundles

• Patient registration, recording clinical notes, clinical correspondence;
• recording assessments, managing integrated-care pathways across disciplines and organisations;
• management of care delivery across all settings (bed state, admissions, outpatients and community activity);
• scheduling of appointments, visits, transport, other resources;
• electronic booking (but not into primary care settings);
• order communications and results reporting;
• electronic prescribing;
• access to online libraries and knowledgebases;
• support for maternity services in community and acute settings;
• emergency care support (A&E and out-of-hours primary care);
• management of surgical interventions (theatres, critical care);
• support for primary care needs (as in GP systems);
• link ambulance services to control centres and to A&E departments;
• support services (reporting, data quality, interfaces, disaster recovery, etc);
• supporting existing prevention, screening and surveillance (eg child health, breast screening, etc);
• clinical support systems;
• connectivity, messaging, access (PSIS, Spine Directory, ebooking);
• information for secondary purposes;
• alternative options for GPs.

Additional service bundles

There are 12 additional service bundles (Table 2), and these are not funded by the NPfIT. LSPs do not have the rights to be exclusive providers. A trust may purchase these additional systems/services either as a member of a group, using a call-off facility provided by their LSP or another cluster’s LSP, or on its own from any other third party of choice.

Services provided by additional bundles

• Radiology and hospital laboratory systems;
• hospital pharmacy stock-control systems;
• PACS — imaging systems;
• ebooking to primary care services;
• advanced decision-support and expert clinical systems;
• document-management systems;
• support for social care;
• support for dental-care services;
• ehealth and telemedicine applications;
• helpdesk support;
• operational-IT support including infrastructure services;
• new prevention, screening, surveillance (of long-term medical conditions);
• business-process change and IT-implementation support;
• financial payments;
• project management;
• supplier management;
• change management;
• benefits realisation and identification;
• training.

PACS

A basic/skeletal picture-archiving and communications system, paid for by the NPfIT and procured by LSPs, is being offered as an option to NHS trusts needing to acquire such a system. Additional features/capabilities will need to be paid for by the trusts. Trusts are still free to procure an entire PACS from any supplier of their choice in the established way, provided it meets CRS interoperability standards and that they can justify not buying through an LSP.

Future service bundles

These are the services and systems that do not appear in either of the two previous lists.

Additional and future service bundles are to be funded by NHS trusts, which may make these purchases from any suppliers of their choice. The DoH expects that NHS trusts in England will spend around £900m this financial year on ICT.