The government has defended slow progress on the NHS’s £12.4bn National Programme for IT (NPfIT) after criticism from Derek Wanless, the architect of the government’s health spending policy.
In a 2002 report for the Treasury, Wanless set out a vision for the future of the NHS, arguing for a spending boost and singling out IT as a crucial area for investment.
But Wanless’s follow-up report, produced for the King’s Fund think tank, notes that IT spending has not matched his original recommendations, while NPfIT has suffered delays, with “most progress tending to relate to systems that were not originally part of the modernisation plan”.
NPfIT lacked a business case setting out how benefits would outweigh costs and should be “comprehensively audited”, Wanless added, calling for “detailed external scrutiny” of NHS Connecting for Health, which runs NPfIT.
But a Department of Health spokesperson denied that patient care or NHS productivity were being harmed by the delays. "We have always believed it is better to take the time needed to get things right for patients and clinicians, than to deploy systems rapidly and get them wrong,” she said.
“Key elements are already working, being used daily by clinicians, and bringing benefits for patients. We make no apologies for this is sensible and responsible management approach."
The DoH also rejected the calls for greater scrutiny of NPfIT and Connecting for Health, saying the programme had been subject to scrutiny “from day one” through the Office of Government Commerce's gateway review process.
The huge computer scheme had more recently been the subject of reports by the National Audit Office and the Commons public accounts committee, while a report from the Commons health committee was imminent, she added.
"We do not consider there are grounds for another independent review of the national programme at this time.”
But the public accounts committee’s heavily critical April report on NPfIT – produced after an inquiry based on the National Audit Office report – also called for an independent review of the business case for the programme.
In its little-noticed response to the committee – buried in a set of Treasury minutes during the parliamentary recess – the government again refused to review the programme.
In the wake of the Wanless report, the DoH spokesperson said the DoH would “develop a programme to ensure the relevant business cases are reviewed and refreshed".
The DoH also defended NPfIT’s procurement through a small number of suppliers – another area criticised by Wanless. The creation of contracts drawn up with a handful of lead contractors was “a key feature of the procurement process so as to avoid the disadvantages, and the expense, of the haphazard approach of the past”, the spokesperson said.
"Although there are just two suppliers of acute patient administration systems, many more suppliers are contracted across the programme as a whole.”