The concept of a national spine of NHS patient records should be reconsidered and the £6bn-worth of National Programme contracts potentially renegotiated, says a think tank.

A report published by open market think tank Aediles and the Conservative Technology Forum criticises the 10-year programme, and proposes a rethink.

'The delays in fulfilling the contracts are beginning to trigger non-compliance penalties on the part of the service providers - this gives an opportunity to renegotiate the contracts,' says the report.

It says that the National Programme has followed the same back-to-front trajectory associated with disastrous government IT projects.

'It began as a top-down exercise (supposedly after a Number 10 seminar chaired by the Prime Minister), bypassed the Gateway review of the business plan, and has a Director General recruited after the event, with a massive budget to "reverse engineer" already published implementation commitments,' it says.

The report also calls for a rethink of the concept of a data spine underpinning national electronic patient records.

'Every system will have to send details of every patient encounter to the spine. This will result in one central repository of patient data with all the risks of security and confidentiality that imposes,' says the report.

A National Programme spokesman said: 'The programme will provide better patient care by ensuring doctors and nurses have the right information in the right place at the right time, and that through access to information patients are given greater choice.'