A health service IT project that was highlighted by the prime
minister at last week's E-summit has run into trouble with the
Government's own Gateway review process, which is designed to
eliminate procurement and project failures.
Listing the Government's determination to put IT at the heart of
its modernising agenda, Tony Blair told the E-summit, "In the NHS
we will be investing to create a national Integrated Care Records
Service (ICRS)."
The service is intended to create an integrated record system
across health and social services that focuses on the patient. This
makes it one of the key components of the NHS IT modernisation
strategy.
Yet an Office of Government Commerce stage one Gateway review,
which examined the detailed business case for the project, found
significant problems, although the Department of Health said the
project had not failed the review.
"The first stage of the Gateway review of the ICRS pointed out
areas that needed further work and development. These
recommendations are welcomed and are being acted upon as the
project proceeds to Gateway two," the department said.
Earlier this month health minister Hazel Blears said in a
parliamentary written answer, "The Gateway review process is not an
audit and the key stages of the review process are not, in the
strict sense, pass or fail."
The ICRS review raised concern about resourcing and whether the NHS
would be able to manage and deliver such a large undertaking on
time and to budget.
Uncertainty surrounds core areas of the ICRS project. Funding will
not be made available until next April and NHS IT professionals are
still unsure how much cash chancellor Gordon Brown will ring-fence
for it and other NHS IT projects.
Richard Granger, director-general of NHS IT who took up office at
the end of September, is reviewing the modernisation programme.
This could lead to further delays or changes. One public sector IT
director said, "No one taking up a job like that could come in and
be told, 'This is what you are doing and this is how you will do
it'. They have to make their own evaluation."
There is also a question about whether procurement of the ICRS will
be done centrally or at NHS trust level.
Jeremy Thorpe, director of development at the NHS Information
Authority, has suggested that procurement may be done at a local
level, though the authority insisted that no decision on
procurement has yet been made.
Local delivery of a national programme would raise a series of
organisational and governance issues, said Alistair Maughan,
partner in the technology group at law firm Shaw Pittman.
"If you have multiple procurement and multiple suppliers, how do
you ensure efficiency in the procurement process - that the
contracts looks the same and that the systems work together? How do
you avoid the NHS taking back risk from the contractor," he asked.
Maughan said corporate governance would require close review by any
local NHS IT director or finance director asked to procure
components of a national ICRS system.