Health CIO Christine Connelly says that money spent on the NHS IT scheme so far - nearly £6bn - has been value for money.
She was speaking at a press conference to announce the end of a centralised, national approach for the National Programme for IT [NPfIT].
When I asked her whether the £5.8bn spent on the NPfIT is value for money she said:
“I don’t know that that is a number I recognise [£5.8bn] but it’s not very far away. The money we have spent so far I believe has been value for money If you go across the world and talk to other people in other countries they are very envious of some of the things we have in place. If you look at digital imaging - PACS - it is a great system. It works very well.“If you look at N3 [national broadband supplied by BT] which we would talk about as something quite simple to do, actually 10 years ago that didn’t look simple to do at all. We take it for granted but it is a great development.”
Connelly said if the NPfIT started in 2010 - it was launched in 2002 - the programme would have been designed differently because “technology has moved on and the world is different”.
The Department of Health now wants health IT to suit the “new health service that is being created”.
“It is important we take that opportunity and we don’t get held back by the decisions we made in the past. We want to make the best of what we have got and leverage it, because [there are ] elements that we would say are excellent.”
Many inside and outside the NHS will be surprised by Connelly's conviction that nearly £6bn spent on the NPfIT is value for money. Some of the main objectives of the programme were:
- Fully integrated information across health and social services
- Active decision support
- Screening integrated
- Community-wide Prescribing (including medicines administration)
- Full clinical noting
- Care planning documentation as by product of patient care
(Source: Delivering 21st Century IT for the NHS)
None of the above has happened. PACS has been a success, though this was not part of the original NPfIT and local deployments were mainly funded by trusts. N3 broadband has been a success, though this represents a small part of the total spend, the original BT contract being worth £530m.
It’s hard to see how PACS and N3, GP to GP transfer, and the limited uptake of Choose and Book and electronic prescriptions justifies a spend of nearly £6bn.
That said, some health officials in the past have, when talking about the NPfIT, gushed forth in wondrous eloquence but rarely convincingly. Perhaps they said what they said because they were expected to eulogize the NPfIT as part of their job.
Connelly is different. She doesn’t gush. She doesn’t indulge in rhetoric. She’s not evasive. She’s self-confident - not overly so - and clearly believes in what she says.
But her belief in the value for money of the NPfIT will convince few in the NHS. Many are more likely to be persuaded by the view of Brian James, the chief executive of The Rotherham NHS Foundation Trust, who said in April this year that the NPfIT has "put back the contribution of IT in the NHS by more than ten years”.
So binding were the NPfIT contracts that the Coalition and the Department of Health have been unable to extricate themselves from the previous government's commitments.
And after a year of negotiations, the Department of Health hasn’t yet been able to persuade CSC, which has £3bn worth of local service provider contracts, to reduce the price of its contracts.
If those in power begin to believe that the NPfIT represents value for money, a programme with a different name and just as poorly thought through could be conceived in five or ten years time, when big suppliers again successfully lobby Downing Street for ruthless NHS standardisation and the appointment, or re-appointment, of a small number of prime contractors.
NPfIT - dead, dying or business as usual? - The Tony Collins Blog