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On 5 March, the department said it was taking a further step in trimming the responsibility of NHS Connecting for Health (CfH), the agency created to implement England's NHS National Programme for IT.
Its creation from April of an Informatics Directorate to focus on strategy will remove another responsibility from CfH, following the devolution of local implementation of the programme to strategic health authorities in late 2007.
A number of factors have combined to make it a convenient time for the change. Gordon Hextall, who has been chief operating officer of CfH since 2004, is preparing to leave in April. Some major elements of the programme, such as picture archiving, radiology information systems and the N3 broadband network, have now been delivered.
Also, most of the implementation work is now concentrated on one project, the Care Records System (CRS).
It could be argued that CfH will have its hands full with the challenges around the CRS, such as seeing through the development of the software, how to provide secure tokens for access, deciding on who should be the legitimate users and the different levels of confidentiality.
Once all of this is achieved it would have cause for satisfaction, but it may also be left without a significant role.
The government has an apparent preference for a 'hit and run' strategy in managing big IT programmes. It creates agencies with a limited lifecycle to get the systems in place, allowing them to dissolve rather than provide a longer term role to ensure they actually deliver the desired outcomes.
But healthcare trusts will continue to face day-to-day challenges in using the systems and making improvements, and it would be welcome to see the DoH ensure that CfH will still be around to provide the necessary support.
However, if it does give the agency a longer term brief it could lay the ground for some awkward situations in the future. It will have two directorates whose prime aim will be to use IT to modernise the NHS, and there is a big question over whether they would complement or compete with each other.
The chances of the latter could increase if someone with no experience of working with CfH comes in to run the Informatics Directorate. It could be a case of new ideas not matching the thinking of the established programme, and sowing the seeds of a series of disagreements and disruptions.
The worries are increased by the lack of clarity in the DoH's branding of the two bodies: there is no obvious meaning in 'Connecting for Health', and the Informatics Directorate conveys little about the boundaries of its work. The relative functions of the two are not clear cut.
Of course, this a worst case scenario, and hopefully the two bodies will find the mutual understandings to build a productive, long term working relationship. But as things stand we could do with more clarity to instil confidence in the DoH's new direction.
A version of this article previously appeared on KableDIRECT.
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