NHS given six months to get IT right

Local trusts must be given autonomy if central approach is still not working in six months, say MPs

The prognosis for NHS IT is not all good

The Department of Health should allow individual trusts to apply for alternative funding for IT systems if the central £12.7bn NHS National Programme for IT (NPfIT) is still failing to deliver in six months' time, according to MPs.

While some parts of the scheme have been implemented successfully, key elements such as the care records system have stalled, and are not expected to be delivered until 2014 - four years late.

"The risks to the successful delivery of the NPfIT are as serious as ever," said Edward Leigh MP, chairman of the Public Accounts Committee (PAC), which has released a progress report (PDF) today on the programme.

"Essential systems are late or, when deployed, do not meet expectations of clinical staff. Estimates of local costs are still very unreliable and, despite action to secure their commitment, many NHS staff remain unenthusiastic."

The programme is split into five regions. In the North, Midlands and East, where CSC is the supplier, Lorenzo care records software has not gone live in a single acute trust and in only one primary care trust.

As of 31 August 2008, new care records systems had been deployed in 133 of 380 trusts, according to the PAC report. But trusts in the North, Midlands and East have been receiving an interim system and will have to go through a further deployment to implement Lorenzo.

Rollout has been halted in London while problems with the Cerner software supplied by BT are ironed out.

The Department of Health continues to search for a new supplier for the Southern region after Fujitsu pulled out last year. Negotiations with BT are believed to be ongoing.

Should discussions fail, the NHS must determine whether the two suppliers can continue to meet their substantial commitments, said Leigh.

"Trusts should not be expected to deploy care records systems that aren't working properly. If there is no improvement to this situation within six months, the department should consider allowing trusts to apply for funding for alternative systems," he said.

"It is also worrying that, if trusts decide not to deploy the patient care records systems, the taxpayer can still be obliged to make payments to the suppliers concerned."

Leigh maintained that there must still be doubts over the ability to deliver the NPfIT programme.

"The original aim was for the systems to be fully implemented by 2010. The truth is that, while some are complete or well advanced, the major ones such as the care records systems are way off the pace," he said.

"Even the revised completion date of 2014-15 for these systems now looks doubtful in the light of the termination last year of Fujitsu's contract covering the South."

Commenting on the report, shadow health minister Stephen O'Brien, said: " This is another scathing account of Labour's incompetence over the NHS IT programme.

"It highlights the lack of delivery, and the problems in the rare cases where systems have been delivered, and the unreliability of the cost estimates. And it raises further questions over the security of the database."