NHS chief executive David Nicholson told MPs that the £12.7bn National Programme for IT is at a "pivot position", during a House of Commons Health Select Committee yesterday.

He said the programme must make progress soon or it would have to be re-evaluated.

“If we don’t make progress relatively soon, we are really going to have to think it through again," said Nicholson. “We can’t go on and on like this.”

Part of the NHS programme are running four years late. The summary care records project is on hold in London while problems at the Royal Free Hosptial are resolved, no rollout has yet been agreed for the north of England, and the Department of Health is still in negotiations with BT to take over the southern region of the programme, six months after the original supplier Fujitsu pulled out.

Nicholson pointed out that the programme has had successes by putting in digital imaging, electronic prescriptions and broadband networking, but admitted there had been problems with the core care records system (CRS).

He said part of the problem with CRS is that “there are not the products available to do the things we want them to do.”

The Cerner software being used in London and the South was developed in the US and needs to be adapted to the needs of the NHS.

"We’ve got some serious issues around the Cerner system, particularly in London at the Royal Free, and what we’ve said to Cerner and BT is that they’ve got to solve that problem at the Royal Free before we think about rolling it out across the rest of the NHS," said Nicholson.

Despite continued delays, Nicholson said the scheme has not overspent. Most payments to suppliers are dependent on successful delivery of systems.

"We’ve only spent something like 28 per cent of the money available to us for the National Programme for IT. I wish we’d paid more but I do think it has proved a very effective way of taking things forwards," he said.

Asked whether he remained confident the care records system would be delivered by 2015, Nicholson said: “Yes I’m confident we’ll have a workable system by 2015.”