Nigel Hawkes, Health Editor of The Times (left), explains iSoft's importance to the NHS's £12.4 billion computer upgrade

What does iSoft have to do with the NHS?

iSoft is one of a number of companies contracted to provide software for the NHS Connecting for Health programme, a £12.4 billion bid to computerise health records, appointments and scans and make them available on screen to 50,000 doctors at the press of a button.

What is the computer system supposed to do and when is it supposed to start working?

There are a range of applications, which are programmed to come in at different times in different regions. It is not supposed to start simultaneously everywhere.

The elements include Choose and Book — where consultants' appointments can be booked from the GP surgery — electronic prescriptions, a central "spine" containing everybody's medical records, and a system for transmitting X-ray and other scans, hospital to hospital. Choose and Book is probably the most advanced, with about a million appointments made so far.

How important is Connecting for Health for the NHS?

The NHS functioned for many years with IT systems that did not communicate with one another. Clearly, this is a concept now long out of date, even though these systems worked well, especially for GPs. The idea of Connecting for Health is widely accepted to be sound, and worthwhile. If it fails, the NHS will not collapse but it will have lost a golden opportunity to move into the 21st century.

What sort of problems has it had so far?

The inevitable teething troubles with such a big project, and, perhaps more importantly, a tendency for the IT bosses to run roughshod over the sensibilities of the clinical staff. There has been too little input from doctors, and experience shows that IT systems imposed without proper involvement from users run a greater chance of failing.

Is there any reason to think that the worst is behind us?

Too early to say — critics would say that we have no evidence yet that the system will work, especially the spine with its 50 million medical records. Patients have yet to find their voice — many will be disquieted to find they have no choice about their records being included, though they can opt out of them being accessible.

This is a huge system, which — the National Audit Office found — has been well-procured. But implementation could prove even more difficult.

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