tony.collins@rbi.co.uk
Public spending watchdog the National Audit Office has delayed
publishing a report on its investigation into the national
programme for IT in the NHS (NPfIT), one of the world's largest
computer-related schemes.
News of the delay comes as a paper published in the British
Medical Journal, the magazine of the British Medical Association,
heavily criticises NHS Connecting for Health, which runs the NPfIT,
for poor communication and engagement with clinicians who will use
the systems it is deploying.
The delay raises concerns that there could disagreements between
the NAO and Whitehall officials over the evidence to be presented
in the report.
Under Parliamentary convention the factual content of NAO
reports must be agreed with departments before publication.
The NAO announced last year that the report would be published
this summer, but it has confirmed that publication is not now
likely until November. It could be delayed again if there are any
protracted disagreements between the NAO and Whitehall.
There have been hints of conflicts between evidence provided by
trusts and the Department of Health over the NPfIT - for example,
over costs.
An NAO report published in June on financial management in the
NHS said that although the costs of hardware and software on core
services within the NPfIT would be funded centrally, "There will be
considerable additional costs borne by NHS bodies at local
level."
The NAO was told by the Department of Health that the savings
from the introduction of national systems could help to offset
local implementation costs. But the NAO added, "Some NHS bodies
have expressed concerns about possible shortfalls."
NAO officials suggested that the reason for the delay in
publishing the NPfIT report was pressure of the Audit Office's
workload and the fact that reports cannot be published during
Parliament's summer recess.
The NAO is examining the procurement processes used for placing
the contracts, whether contracts are likely to deliver value for
money, how the department is implementing the programme and the
progress made.
The NPfIT aims to create a care records service to improve the
sharing of patient records, an e-booking scheme, the electronic
transmission of prescriptions, the storing and distribution of
x-rays and a broadband infrastructure.
Have we been here before?
In the mid-1990s there were long delays in the publication of an
NAO report into the way the Department of Health managed the Read
Codes scheme to introduce a standard coding system for recording
medical ailments. An NAO investigation began in May 1996 but its
report was not published until March 1998.
When MPs questioned the delay in publishing the report, the then
chief executive of the NHS Alan Langlands initially said that there
were staff changes on both sides which interrupted progress. When
further questioned he said, "It is also fair to say there were
disagreements about some of the evidence."