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All change at the Department of Health. The news that Lord Warner is to retire means that the Connecting for Health is set to lose one of its most steadfast champions. Will his successor prove quite so committed to the current shape of the NHS IT programme as the indefatigable Lord Warner?

The DH operating framework for 2007/2008 this week made clear that the once national NHS IT programme is about to be recast as far more local, with targets pared back to the bone. Strategic health authorities and trusts are now responsible for making the most of the opportunity afforded by NPfIT.

Tellingly the 2007/2008 operating framework only makes the most fleeting mention of the core Care Records Service solutions. Instead the document talks about beginning the first pilots of summary care records, plus more patient administration systems with the addition of order communications. This falls a long way short of the promised integrated electronic patient record systems - the core LSP CRS solutions - that £12.4bn of investment was to deliver.

The news that 100m digital diagnostic images are now stored electronically shows that an ambitious national IT programmes can be a success when they address clear clinical and business needs. Contrast this with the situation on CRS appears as summarised in an October trust board paper from Leeds: "...for the North-East of England, CfH does not have a roadmap for delivering an electronic care record". The indications coming out of the DH are that few there remain confident of CfH's strategy to deliver integrated electronic records either.