NAO puts NPfIT on critical list

Spending watchdog urges government not to waste more money on NHS IT upgrade

Government spending watchdog the National Audit Office (NAO) has called for spending on the NHS’s controversial £12bn IT upgrade programme to be stopped before more money is wasted.

In a damning report, the NAO said the services it had received to date – some £6.4bn worth as of 31 March 2011 – represented poor value for money and it had “no confidence” that finishing the project would turn things around.

“The original vision for the National Programme for IT (NPfIT) 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 [as was originally planned],” said Amyas Morse, head of the NAO.

The NAO was also scathing about the glacial pace at which electronic care records (ECRs) were being implemented across the NHS. ECRs were supposed to be fully operational across the entire NHS by 2010, but it is doubtful they would be in place by 2016, the NAO said.

“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 report stated.

Earlier this month, Prime Minister David Cameron froze further developments on the patient record system in anticipation of the NAO report.

“We agree change is needed and that the original vision was flawed. This is why last year we announced a move away from a centralised, national approach to IT to localised responsibility and decision-making,” said a spokesman for the Department for Health (DoH).

The new approach should ensure the £6.4bn spent so far would “potentially” deliver value for money, he added.

The programme was originally conceived in 2002, led by then NHS IT chief Richard Grainger, and in 2004, five contracts initially worth £5bn were awarded to four IT services firms for the delivery of local care record systems.

Of the four main suppliers, only BT – responsible for London and a few other hospitals in the south – and CSC – responsible for the north, the Midlands and the east – remain.

The NAO noted that CSC had to date only delivered four care record systems in seven years, making it unlikely that it would be able to deliver the remaining 93 before its contract expires in 2016.

The DoH is currently negotiating with CSC over reducing the number of care record systems and the capabilities of these systems.

CSC took over when Accenture walked away in 2006 after suffering heavy losses. The NHS is still involved in litigation with the fourth supplier, Fujitsu.

Other parts of the upgrade programme, including a national broadband network and system to share x-rays electronically, are nearly complete.

The DoH said it would respond more fully to the NAO report at the Public Accounts Committee hearing on 23 May.