"The original vision for the National Programme for IT
in the NHS will not be realised. The NHS is now getting far fewer
systems than planned despite the Department paying contractors
almost the same amount of money. This is yet another example of a
department fundamentally underestimating the scale and complexity
of a major IT-enabled change programme.
"The Department of Health needs to admit that it is now
in damage-limitation mode. I hope that my report today, together
with the forthcoming review by the Cabinet Office and Treasury,
announced by the Prime Minister, will help to prevent further loss
of public value from future expenditure on the
Programme."
Amyas Morse, head of the National Audit Office, 18 May
2011
The rate at which electronic care records systems are being put
in place across the NHS under the National Programme for IT is
falling far below expectations and the core aim that every patient
should have an electronic care record under the Programme will not
now be achieved. Even where systems have been delivered, they are
not yet able to do everything that the Department intended,
especially in acute trusts. Moreover, the number of systems to be
delivered through the Programme has been significantly reduced,
without a commensurate reduction in the cost.
Today's NAO report concludes that the £2.7 billion spent so far
on care records systems does not represent value for money. And,
based on performance so far, the NAO has no grounds for confidence
that the remaining planned spending of £4.3 billion on care records
systems will be any different.
The original aim of the Programme was for every patient to have
an electronic care record by 2010. The systems the Department
contracted its suppliers, BT and CSC, to deliver are now not all
expected to be in place until 2015-16. Even so, based on
performance so far, it is unlikely that the remaining work in the
North, Midlands and East, where just four of 97 systems have been
delivered to acute hospital trusts in seven years, can be completed
by 2016 when the contract with CSC expires. Indeed, in order to
meet the revised deadline, over two systems a month would need to
be delivered in this Programme area over the next five years.
Progress in delivering care records systems varies dramatically
between regions. There has been more progress in London in some
health settings, although no GP practices are now receiving a
system through the Programme and the number of systems in acute
hospital settings has halved.
Where care records systems are in place, they are not yet
delivering what the Department had expected. In acute trusts, the
systems are mainly providing administrative benefits, rather than
the expected clinical ones, such as prescribing and administering
drugs in hospitals. The Department has now changed its approach and
moved away from its intention to replace systems wholesale,
instead, building on and using trusts' existing systems. To do this
the Department estimates it will cost at least £220 million to get
the systems to work together.
Publication details:
HC: 888, 2010-2012
ISBN: 9780102969689