Opinion: NPfIT - a chronicle of a death foretold

By Nicola Brittain
23 Sep 2011 View Comments
Nurses doing administrative work

There have been a lot of words written following the government's announcement that it had "accelerated the dismantling" of the National Programme for IT (NPfIT) yesterday.

So what's new? Well the Daily Mail printed the splash headline "£12bn NHS computer system is scrapped". It, at least, was convinced that this "acceleration of the dismantling" was worthy of a front page.

However, the IT press, which has been following each death rattle of the NPfIT for some time now, has been more circumspect, pointing out that this death has been announced several times already.

Further reading

Let's face it, the following quotes by the Department of Health and the chief executive of the NHS in yesterday's statement could have been issued at any point over the coalition's time in office.

The Department of Health said: "We need to move on from a top-down approach [to health provision] and instead provide information systems driven by local decision-making. This is the only way to make sure we get value for money and that the modern NHS meets the needs of patients."

And Sir David Nicholson, chief executive of the NHS, said: "A modernised NHS needs information systems that are driven by what patients and clinicians want. The NPfIT has provided us with a foundation but we now need to move on if we are going to achieve the efficiency and effectiveness required in today's health service. Restoring local control over decision-making and enabling greater choice for NHS organisations is key."

Last September, a ministerial statement and a release from the Department of Health said that a review of the programme had shown that a centralised national approach was no longer required. This was followed by a number of reports announcing the death of the NPfIT.

And this "localisation of the take-up of services" has been ongoing since the last years of the Labour government, with several trusts admitting to procuring services outside the NPfIT as early as 2008.

In May this year, David Cameron told the Commons, that the NPfIT would be frozen until he had reviewed an NAO report on the programme, a Public Accounts Committee (PAC) report, and a report from the Cabinet Office's Major Projects Authority (MPA) – all since published.

Cameron told the Commons at the time: "There are no plans to sign any new contract with Computer Sciences Corporation (CSC) until these reviews have taken place."

The reports referred to by Cameron have all, unsurprisingly, slammed the programme.

The National Audit Office's report published in May said that the programme will never deliver detailed care records as planned and that its renegotiated contracts have failed to show value for money.

The PAC report last month focused on the failings of the electronic care records system and argued that the government has failed to get value from its suppliers BT and CSC.

Yesterday's statement followed the release of the MPA report, which concluded the NPfIT is not fit to provide the modern IT services that the NHS needs.

However, the MPA did find that there have been substantial achievements, such as the Spine, N3 Network, NHSmail, Choose and Book, Secondary Uses Service and Picture Archiving and Communications Service.

The report said of these achievements: "Their delivery accounts for around two-thirds of the £6.4bn money spent so far and they will continue to provide vital support to the NHS."

The parts of the NHS that the government would really like to dismantle, and as quickly as possible, are the already mentioned contracts with CSC and BT, but termination would probably cost more than seeing them through to the end  – they are due to expire in 2014/2015 – according to ex-NPfIT CIO Christine Connelly.

The point is, this programme will not die, and it is being wheeled out and bashed, like an annoying elderly relative with a strong constitution, for political purposes. One should not forget that the statement comes just ahead of the Conservative party conference to begin next week in Manchester.

What better time to remind party members of one of the major failings of the previous government?

Anyway, back to the initial question, is there anything new in this release?

Well, there is one small thing. The government is due to partner with Intellect, the technology trade association, on health policies going forward. The statement says:  "[The government and Intellect] will explore ways to stimulate a marketplace that will no longer exclude small and medium-sized companies.

It gives no further details on the nature of the partnership.

And although this appears to be new, stating preference for small and medium enterprises, again, is not... But whether this approach will be good for the National Health Service – if indeed it is actually pursued – is an entirely different story.

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