The government’s £12.4bn National Programme for IT in the NHS (NPfIT) is unlikely to deliver significant benefits to the treatment of patients by the end of its 10-year contract, unless there is a fundamental change in the rate of progress on the project.
That is the damning verdict of the House of Common Public Accounts Committee on the four-year old project to use IT to transform patient care in the UK.
The NPfIT is the world’s largest IT project and it is in trouble, the MPs say. “The suppliers to the Programme are clearly struggling to deliver, and one of the largest, Accenture, has now withdrawn,” the report notes.
“The Department (of Health) is unlikely to complete the Programme anywhere near its original schedule.”
The MPs note that four years after the start of the Programme, there is still much uncertainty “about the costs of the Programme for the local NHS and the value of the benefits it should achieve”.
The cost of failure is very high the MPs warn. If the project fails, “it could set back IT developments in the NHS for years, and divert money and staff time from front line patient services.”
The PAC, the most powerful of all the select committees came to a series of stark conclusions:
- The delivery of the patient clinical record, which is central to obtaining the benefits of the programme, is already two years behind schedule and no firm implementation dates exist.
- The Department has not sought to maintain a detailed record of overall expenditure on the Programme and estimates of its total cost have ranged from £6.2 billion up to £20 billion.
- Total expenditure on the Programme so far is over £2 billion. The Department should publish an annual statement outlining the costs and benefits of the Programme.
- The Department's investment appraisal of the Programme did not seek to demonstrate that its financial benefits outweighed its cost.
- The Department is maintaining pressure on suppliers but there is a shortage of appropriate and skilled capacity to deliver the systems required by the Programme, and the withdrawal of Accenture has increased the burden on other suppliers, especially CSC.
- The Department needs to improve the way it communicates with NHS staff, especially clinicians.
The report says: "We are concerned that leadership of the Programme has focused too narrowly on the delivery of the IT systems, at the expense of proper consideration of how best to use IT within a broader process of business change."
The DoH should clarify responsibility and accountability for the local implementation of the programme, it adds.
The MPs also warned that the use of only two major software suppliers may have the effect of inhibiting innovation, progress and competition.
The government has responded by claiming that the MPs' report is based on out of date information.
Key components of the NHS National Programme
The heart of the NPfIT is the NHS Care Records Service, which is designed to replace local NHS computer systems with modern integrated systems and make key elements of a patient's clinical record - NHS number, date of birth, name and address, allergies, adverse drug reactions and major treatments - available electronically throughout England.
Other parts of the programme include electronic prescriptions, email and directory services for all NHS staff, Picture Archiving Communication Systems (computer accessible x-rays), and teh Choose and Book system, a facility for patients to book their first outpatient appointments electronically.