NHS: Ict

Health written question – answered on 21st March 2007.

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Photo of Norman Lamb Norman Lamb Shadow Secretary of State for Health, Liberal Democrat Spokesperson (Health)

To ask the Secretary of State for Health what the costs of (a) the Personal Demographic Service, (b) the Personal Spine Information Service, (c) the Transaction Messaging Service, (d) the Secondary Uses Services, (e) the Clinical Spine Application, (f) the Spine Directory Service and (g) the access control framework; and what the projected costs are in each year until implementation is complete for each.

Photo of Caroline Flint Caroline Flint Minister of State (Department of Health) (Public Health)

The spine is the colloquial name given to the national database of key information about patients' health and care. It forms the core of the national health service care records service (NHS CRS). It also supports other key elements of the national programme for information technology, such as choose and book, the electronic prescriptions service (EPS), and 'GP to GP' record transfer, each of them using the spine's messaging capabilities as part of their own services.

The contract to set up and operate the spine under the national programme for information technology in the national health service is held by BT. Accounting information does not separately identify costs incurred in respect of the individual spine applications, and the information requested could be provided only at disproportionate cost.

Up to 31 December 2006 total expenditure under the contract amounted to £310.7 million, made up of £232.8 million in set-up costs, and £77.9 million in revenue costs. Set-up (capital) costs are incurred in phases as functionality is added to the spine through staged software releases over the implementation period. The ongoing service (revenue) costs average around £45 million a year, although this will fall in a range between £30-60 million in any particular year. These sums are in line with the contracted value of the work concerned, which is some £620 million over nine years.

On a typical working day the spine database is accessed by around 50,000 authenticated unique users, and processes; approximately 1.3 million personal demographic service queries, 16,000 choose and book bookings, and over 100,000 electronic prescription messages.

Growth in these volumes is rising dramatically with the increase in functionality across the NHS CRS and continuing roll out of the various elements of the system. The spine is already the world's biggest structured healthcare messaging system whose cost represents an investment of no more than about one pound per NHS patient per year over the life of the contract.

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