That was 2011, that was

It was the year that the government failed to implement its health bill, unveil an NHS information strategy, or finish off some of the unfinished business of the National Programme for IT in the NHS.

But plenty of other things did happen. Managing editor Lyn Whitfield looks back through EHI’s newsletters.

January:

2011 got underway to a chorus of warnings from think-tanks, unions and management bodies that the NHS was in for an “exceptionally testing time”, with massive savings to make and a reorganisation to negotiate.

The Department of Health closed its consultation on an ‘Information Revolution’ for staff and patients, promising that an information strategy to implement the plans would be along shortly. Respondents hoped it would grips with the legacy of the National Programme for IT in the NHS and get away from the idea that the ‘revolution’ could be self-financing.

Freedom of Information Act requests to trusts across Yorkshire found that a third had caught staff unlawfully accessing private information. University Hospitals Bristol NHS Foundation Trust issued a tender for a new electronic patient record system.

February:

Prime Minister David Cameron and health secretary Andrew Lansley took to TV sofas and newspaper columns to make the case for their health reforms, as the Health and Social Care Bill reached its second reading in the House of Commons.

Public Accounts Committee member Richard Bacon continued to raise concerns about whether the deals signed with BT in 2010 to keep NPfIT going in London and the South had been good value for money. And CSC missed yet another deadline to deliver Lorenzo in the North, Midlands and East of England by failing to get the 'strategic' records system live at Pennine Care NHS Foundation Trust.

The Treasury gave the go-ahead for an Additional Supply Capability and Capacity procurement for acute trusts in the South not covered by the BT deal; while CSC apparently won a similar procurement for community and child health systems, bidding TPP.

March:

Chancellor George Osborne failed to cheer the nation with a Budget that committed the government to more spending cuts, while Andrew Lansley admitted that he felt some “anxiety” about his reforms. A special representative meeting of the BMA expressed different emotions; mainly fear and fury.

Otherwise, March was dominated by industry news. The month opened with an announcement from McKesson that it was putting in a cash bid for System C, to help both companies prepare to win new business.

Trading in iSoft shares on the Australian stock-market was halted, as it became clear the beleaguered company was likely to change hands. And the UK head of Cerner said he was bullish about his company’s prospects as University Hospitals Bristol shortlisted Cerner and System C for its EPR project.

April:

The government was forced to admit that it would not get its Health Bill through Parliament in the face of growing medical opposition and a rebellion at the Liberal Democrat’s spring conference. Andrew Lansley announced there would be a ‘pause’ for ‘further reflection’ as the bill came to the end of its committee stage.

An EHI Primary Care survey found, unsurprisingly, that the combination of cuts and reform chaos was leading to job losses, uncertainty and demoralisation at IT departments and health informatics services supporting primary care.

Pennine Care plunged the national programme into more turmoil, by withdrawing from the Lorenzo early adopter programme. EHealth Insider learned that the first version of the NHS information strategy had been “shredded” by Christine Connelly; who also got into an unusual spat with Microsoft about the end of its Enterprise-wide Agreement with the NHS.

May:

Pennine Care’s decision looked like bad news for CSC, but the company told a regular investor call that it would get a new local service provider deal for the NME “in the next few weeks.” In response to a question from Richard Bacon, though, David Cameron said no deal would be done until the National Audit Office had issued its third report on the national programme.

When it was published, the NAO’s report was scathing. The integrated care records service promised by NPfIT would never be delivered, the money that had been spent on it so far had not delivered value for money, and the money that had to be spent was unlikely to do so, it said.

Even so, Christine Connelly told a lively meeting of the Commons’ public accounts committee that the CSC deal might be cheaper to keep. And University Hospitals of Morecambe Bay NHS Foundation Trust held out the hope that Lorenzo might yet come good, by announcing that the system was “stable.” Amid the excitement, University Hospitals Bristol announced that it had picked System C.

June:

The NHS Future Forum, which had been set up by the government to conduct a ‘listening exercise’ on the reforms, issued a report that recommended significant changes. The DH accepted its report; which significantly complicated the plans while muddying the role of central and local bodies and co-operation and competition in the new NHS.

The DH also started to reorganise itself so a new NHS Commissioning Board could be set up in Leeds. Christine Connelly became one of a number of director-general departures. She was replaced on an interim basis by Katie Davis, a secondee from the Cabinet Office.

GPs told the BMA’s annual GP conference that they didn’t think much of the new NHS 111 service. But South London and Maudsley NHS Foundation Trust announced that it was going to develop a personal health record on the Microsoft HealthVault platform.

July:

At the end of June, EHI launched its EHI CCIO Campaign, calling for NHS providers to consider appointing a chief clinical information officer to lead on IT and information projects. It was soon backed by health minister Earl Howe, royal medical colleges, professional bodies, NHS IT suppliers – and EHI readers.

Meanwhile, the NHS Future Forum announced that it wanted to do more work, with its chair Professor Steve Field announcing that it would look at the use of information in the NHS. This, naturally, begged the question of what was supposed to be happening to the NHS information strategy.

The DH’s Informatics Directorate started looking to the post-NPfIT future with the release of the second iteration of its interoperability toolkit, focusing on spine mini-services and document management. And as Microsoft appeared to be finding a model for HealthVault in the UK, Google announced that it was pulling out of Google Health because of “limited usage.”

August:

The public accounts committee livened up the start of the holiday season by issuing its report on the evidence session that it held on the NAO report on NPfIT. The committee had some sharp words for the performance of NHS chief executive Sir David Nicholson as senior responsible owner for the programme and the value for money of those BT deals in London and the South.

It had some even sharper concerns about the benefits – or otherwise – of doing a new deal with CSC for the NME. Yet again, however, CSC told investors that it was “on target” to get a new memorandum of understanding; perhaps in September.

Humber NHS Foundation Trust stepped up and announced that it would be taking over from Pennine Care as the fourth early adopter – and first mental health early adopter – of Lorenzo; while Pennine Care emerged as the leader of a seven strong consortium of trusts looking for new IT systems.

September:

With so much bad news about NPfIT over so many months, what government could resist the temptation to grab a few headlines by “axing” it? Even if it had “axed” it before? Not England’s coalition government.

A week before the Labour Party conference it garnered acres of coverage by telling the Daily Mail and other right-thinking papers that NPfIT was to go – without telling close observers anything they hadn’t known for at least a year. What it didn’t say was when the information strategy would emerge; or CSC’s contract negotiations would be concluded.

The DH did launch a ‘fundamental review’ of data returns across the NHS. It also put out an appeal with the Information Commissioner’s Office for the NHS to up its game on information governance. Barnsley became the first of a string of trusts running McKesson legacy systems to go out to tender.

October:

CSC’s chances of getting a new deal were supposed to be tied to a Cabinet Office Major Projects Authority review of the national programme. When this emerged, though, was full of errors and apparently unable to advise whether a deal should be done or not. It also recommended that the ASCC South procurements should continue: even though time was clearly running out.

The NHS Information Centre published the new summary hospital-level mortality indicator that was developed in response to concerns raised at the inquiries into the scandal at Mid-Staffordshire NHS Foundation Trust.

EHI reached a major milestone with its 500th newsletter. RealTimeHealth emerged as the overall winner of the EHI Awards 2011 in association with BT, while James Norman, IT director of Royal Liverpool and Broadgreen University Hospitals NHS Trust, was voted healthcare IT champion of the year.

November:

The first of the ASCC procurements in the South, for community and child health systems, duly collapsed. But hope springs eternal; and the DH announced it was looking to launch some kind of alternative procurement for the eight trusts still interested.

An EHI Primary Care survey discovered that emerging clinical commissioning groups had yet to get funding for IT or IT support in place. Many indicated that they would be willing to look to the private sector for IT and information services. A week later, the BMA complained that DH guidance might force them to. Then it announced outright opposition to the Health Bill.

EHI Live 2011 took place at the NEC in Birmingham, with the first ever EHI Intelligence Market Forecast Report predicting growth driven by delays to NPfIT and the financial and policy pressures on trusts, and the first CCIO appointments being made. Katie Davis closed the show – and warned delegates that the information strategy would not be along any time soon.

December:

The rest of the ASCC procurements in the South duly collapsed. But in a bit of good news for the remains of NPfIT, Oxford University Hospitals NHS Trust managed to get its Cerner Millennium system live; and so did North Bristol NHS Trust.

A massive EPR procurement at Cambridge produced an all US shortlist: with Cerner, Epic and Allscripts in the frame. CSC predicted it was about to get a new deal for the NME – and make £2 billion from it.

The information governance debate took a surprising twist when actor Hugh Grant told the Leveson Inquiry his medical records had been leaked. The DH pushed on with the competition elements of its reforms by launching new GP and 'any qualified provider' information tools.

And with a fine sense of humour, Andrew Lansley confirmed that he had abolished targets in the NHS – by launching 60 new goals for it to meet in a new Outcomes Framework.