NHS IT ‘in deep trouble’ and mired in secrecy, MPs warn

NHS IT ‘in deep trouble’ and mired in secrecy, MPs warn

Public Accounts Committee demands rapid improvement or end of national care records systems

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The Department of Health and its key IT supplier CSC have been slammed by MPs for a confidentiality agreement surrounding the £12.7 billion National Programme for IT, the world’s largest civilian IT programme.

The powerful House of Commons Public Accounts Committee also told the NHS to “get its head out of the sand” as it flagship IT project remains far off schedule.

Highlights from PAC report

  • Care records remain at least four years behind schedule.
  • They will be delivered in 2014 to 2015, "way off the pace".
  • Cost remains £12.7 billion, but local costs may increase this.
  • Systems need to be improved in six months or local trusts should be able to use alternatives.
  • The NHS and supplier CSC acted in an "unacceptable" manner by signing a confidentiality agreement to bar discussion of their deal.
  • With BT and CSC left as the only lead suppliers, the government could lose bargaining power.

The PAC hit out at civil servants and CSC for agreeing a gagging order over negotiations that took place about care records deployment in the northern, central and eastern parts of the country. CSC is the exclusive lead supplier to those regions.

Responding to the report, the Department of Health said, "New IT systems in the NHS are delivering better, safer and faster care. Current costs have declined because of the delays to implementation due mainly to adding extra functions to the system. Costs are also controlled by the contracts which only pay to providers once the service has been successfully delivered."

However, the PAC said, the care records service, which will provide digital health files for every patient in the country, remains “way off the pace”, and is due to be completed at least four years behind schedule in 2014 to 2015.

Only 133 of the 380 NHS trusts are running the care records systems, as of August last year. The committee demanded an improvement in the rollout and the working of the systems within six months, or, it said, “the department [of health] should consider allowing trusts to apply for funding for alternative systems”.

Under NHS funding regulations, the Department of Health can oblige NHS trusts and primary care trusts to take NPfIT systems, but it does not have the same power to make NHS foundation trusts take systems they don not want.

The NHS is becoming “increasingly devolved,” the PAC noted, which make the necessary organisational and cultural changes for the system difficult to effect.

NHS staff were disillusioned with the systems “because what has been provided to date has not met their expectations”, the PAC said. Health workers would only be reassured when real clinical benefits were delivered by the IT systems.

Trusts in the north, the Midlands and the east are receiving an interim system until their service provider, CSC, implements the iSoft Lorenzo system. But the PAC warned that Lorenzo had not been deployed in any acute trusts, and was only in one primary health trust.

In the south of England, where trusts are in transition following the departure of Fujitsu from the programme, many are awaiting a service provider to install the Cerner Millennium care records system, a competitive product to Lorenzo. They will choose between BT and CSC, under NHS plans.

In London, service provider BT last week warned of substantial writedowns in its large contracts. Its care records contract for the region was originally valued at £1.08 billion.

The rollout of Cerner Millennium software hit major hurdles in London, with the Royal Free Hospital losing £7.2 million in six months attempting to roll out the system.

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