Seven years after the launch of the National Programme for IT in the NHS, essential technology does not meet the needs of doctors, local cost estimates are unreliable, many NHS staff remain unenthusiastic, and the programme's future is far from certain.
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These are among the conclusions of the Public Accounts Committee, which publishes a report today on the £12.7bn National Programme for IT (NPfIT), the UK government's biggest IT-based programme.
The committee questions the government's policy of awarding £6.2bn worth of contracts to suppliers to deliver to the NHS as a whole. The report of the all-party committee says it is not yet convinced that the Department of Health secured good value for money by letting the contracts.
The chairman of the committee, Edward Leigh, says the aim was to complete the programme in 2010, but even the revised dates of 2014-15 for completion of the roll-out of the Care Records Service may be optimistic. This is because Fujitsu is quitting as the main supplier in the south of England.
The committee also expresses concern that if trust boards decide not to deploy NPfIT systems, the taxpayer can still be obliged to make payments to the suppliers concerned.
Rotherham NHS Foundation Trust has been threatened with paying penalties for choosing to buy its main hospital patient administration system by open tender instead of through the NPfIT.
Leigh says that if there no improvement in the fortunes of the NPfIT in six months, the Department of Health should consider allowing trusts to apply for funding for alternative systems.
Richard Bacon, a member of the committee who has followed the NPfIT for several years, says that trusts should be free to buy what they want subject to common standards. "In its current form the programme is in deep trouble from which it is unlikely to recover," he says.
He adds, "The programme's central aim was to create detailed electronic patients records but this is now so far behind schedule that hospitals are walking away Trusts are refusing to take systems offered by the Programme because they are not fit for purpose."
Leigh says, "The risks to this massive IT project have been heightened by the departure from the programme of two of the original four local service providers [Accenture and Fujitsu]." Leigh questioned whether the remaining suppliers, BT and CSC can "continue to meet their substantial commitments".
Computer Weekly and leading academics in the field of computer science have called repeatedly for an independent, published review of the NPfIT. This could have pointed a new way forward for the programme. But ministers have always rejected such a review, and when interviewed on TV and the radio, and in statements to Parliament, have praised the progress of the programme.
Trusts have stopped deploying new systems while serious problems continue at trusts where the NPfIT Care Records Service has been deployed, including at the Royal Free in Hampstead and Barts and The London NHS Trust.
A statement issued by the Department of Health says, "We welcome the report. New IT systems in the NHS are delivering better, safer and faster care. Current costs have declined because of the delays to implementation due mainly to adding extra functions to the system. Costs are also controlled by the contracts which only pay to providers once the service has been successfully delivered."