Four years ago the government announced to a grateful
NHS a national IT programme that would become the world's largest
civil computer scheme.
But after a breathless start, delivery dates for key software
were missed, the full costs of implementation have always been
unclear, and experts are divided over whether the scheme is too
ambitious to ever work as originally planned.
Now the IT community's leading academics have written an open
letter to parliament's Health Select Committee calling for an
independent audit of the national programme for IT. In doing so
they are echoing a campaign launched by Computer Weekly last year
for an independent audit.
Below we publish the letter in full, together with a list of its
signatories. On pages 16 and 18 we summarise our coverage of the
project so far and argue why an independent audit is needed
now.
The national programme for IT in the NHS: The Select
Committee may be aware of the concerns of health professionals,
technologists and professional organisations about the £6bn NHS
national programme for information technology (NPfIT):
- The NHS Confederation has said, "The IT changes being proposed
are individually technically feasible but they have not been
integrated, so as to provide comprehensive solutions, anywhere else
in the world."
- Two of NPfIT's largest suppliers have issued warnings about
profits in relation to their work and a third has been fined for
inadequate performance.
- The British Computer Society has expressed concern that NPfIT
may show a shortfall of billions of pounds.
- Various independent surveys show that support from healthcare
staff is not assured.
- There have been delays in the delivery of core software for
NPfIT.
Concrete, objective information about NPfIT's progress is not
available to external observers. Reliable sources within NPfIT have
raised concerns about the technology itself.
The National Audit Office report about NPfIT is delayed until
this summer, at the earliest; the report is not expected to address
major technical issues.
As computer scientists, engineers and informaticians, we
question the wisdom of continuing NPfIT without an independent
assessment of its basic technical viability. We suggest an
assessment should ask challenging questions and issue concrete
recommendations where appropriate, eg:
Does NPfIT have a comprehensive, robust:
- Technical architecture?
- Project plan?
- Detailed design?
Have these documents been reviewed by experts of calibre
appropriate to the scope of NPfIT?
Are the architecture and components of NPfIT likely to:
- Meet the current and future needs of stakeholders?
- Support the need for continuous (ie 24x7) healthcare IT support
and fully address patient safety and organisational continuity
issues?
- Conform to guidance from the information commissioner in
respect to patient confidentiality and the Data Protection
Act?
Have realistic assessments been carried out about the:
- Volumes of data and traffic that a fully functioning NPfIT will
have to support across the thousands of healthcare organisations in
England?
- Need for responsiveness, reliability, resilience and recovery
under routine and full system load?
We propose that the Health Select Committee help resolve
uncertainty about NPfIT by asking the government to commission an
independent technical assessment with all possible speed. The
assessment would cost a tiny proportion of the proposed minimum
£6bn spend on NPfIT and could save many times its cost.