General comments on the National Programme

There was a wide consensus amongst clinicians that professional engagement was severely lacking
Repeated concern was expressed about putting cart before horse, or building roof without foundation
There was still uncertainty about what would actually be contained on the Spine.
Maternity systems need to be integrated with the Patient Administration System and there were widely varying timescales for PAS.
The award of contracts meant that there was no competition, and the monopoly situation of LSPs in their cluster was a serious source of concern
The delivery of IT for GPs has recently been widened to allow choice between systems rather than being restricted to a single provider. Why can a similar principle not apply to Maternity.

Datasets and definitions

Phil Godfrey (formerly Protos) and Janet Browne (formerly Euroking) emphasised that maternity systems and the data collected need to be seen as medicolegal documents.
Rupert Fawdry emphasised the importance of appropriate datasets as a foundation for any electronic patient record.
The standard maternity dataset is not expected to be ready and signed off by the Information Standards Board for another 18 months

Interim Systems

The timelines for roll out of NPfIT compliant maternity systems has slipped substantially. It was unlikely that there would be a fully integrated system up and running before 2010.
There was concern about the suitability of currently contracted interim solutions. Representatives of a unit which had recently implemented the Protos/Evolution ‘Emergency Bundle’ reported that it appeared to be out of date.
Clinicians felt there was an urgent need to provide the best possible interim system. This should be a ‘best of breed’ of what is currently available, which would also make the transition to the eventual common solution straightforward.

Systems and pathways

Participants felt the need for full accountability and engagement to ensure that uptake was successful
The involvement of clinicians was patchy and there was a need to map the activity and representation in each cluster.
Working groups / best practice seminars require substantial clinician input to build a new system from bottom up. Currently each cluster is working on their own rather than together and are likely to be duplicating efforts.
There was a call to bring together current initiatives from different clusters to try to work together nationally.

Summing up

Dr Muir Gray, who had recently been appointed by NPfIT to foster professional engagement, stated that he welcomed the comments and this type of Forum which allowed this feedback to be provided.
He said he would like to apply the ‘Do Once and Share’ principle to find solutions for the problems presented. This should include the sharing of initiatives and the work clinicians are already undertaking in the various clusters. As a first and immediate initiative, a scoping exercise will be undertaken to assess what is needed, and what systems are available and suitable to provide a better interim solution until the full programme is delivered.
The co-chairs stated that there was a clear message that IT for Maternity should follow the same standard for the whole country, rather than be developed piecemeal.

Summary action points

PI to develop webpages with presentations, summary conclusions and discussion board