News Analysis

Experts strike new NHS warning note

Tony Collins

The government has failed in its attempt to quieten the fears of leading computing academics that the NHS's IT programme may be heading for trouble

At the headquarters in Whitehall of the Department of Health on 20 April 2006, senior officials met leading experts in computer-related sciences and welcomed their call for an independent audit of the NHS's £12.4bn National Programme for IT (NPfIT).

Since then, however, the government has made only too clear it does not want any further independent scrutiny of what is the world's largest non-military IT programme.

Health minister Caroline Flint told the House of Commons on 24 May that the NPfIT was "already the focus of regular and routine audit, scrutiny and review", and needed no further examination.

Flint said the programme had been the subject of gateway reviews - assessments by the treasury's Office of Government Commerce.

But she said the government had no plans to publish any of these reviews, and ministers have also refused to publish the results of other independent reviews of the programme by internal auditors, or by consultancies such as McKinsey.

Flint said: "We remain confident that the technical architecture of the national programme is appropriate and will enable benefits to be delivered for patients, and value for money for the taxpayer, without further independent scrutiny."

Now the academics have written a second open letter to the Health Committee of the House of Commons because their concerns about the programme have deepened.

They are worried about new developments such as Accenture's announcement of a withdrawal from its original £2bn NPfIT contract, and a £383m loss at Isoft, one of the programme's principal software suppliers.

The academics say that since their first open letter to the Health Committee, they have been in almost daily e-mail correspondence with each other about the NPfIT.

The group has also received private communications from clinicians and technical people involved in various ways with the project.

In an e-mail to Computer Weekly, the group said: "The National Audit Office report [on the NPfIT, which was published in June] did not answer any of our concerns and we increasingly felt that the programme appears to be building systems that may not work adequately, and that - even if they worked - may not meet the needs of many health trusts."

It added: "We believe that independent scrutiny is essential, and that the Health Committee is the best body to bring this about."

Members of the group met in London on 28 September and decided that urgent action was needed and that they should write again to the Health Committee and to Richard Granger, chief executive of NHS Connecting for Health, which is managing the IT element of the programme.

The group said, "In keeping with our belief that the NPfIT should be scrutinised openly, we again made our letter to the Health Committee an open letter. The letter has been drafted, reviewed and agreed by e-mail to the whole group."

Members of the committee have indicated they will be holding an inquiry into the NPfIT this autumn.

Open letter to the Health Select Committee

THE NATIONAL PROGRAMME FOR IT IN THE NHS

In April this year, we wrote to you to express our concern that the National Programme for IT in the Heath Service is displaying many of the symptoms that we have observed in previous major IT projects that have subsequently failed.

We suggested that your committee could resolve uncertainty about the NPfIT by commissioning an independent technical assessment with all possible speed.

Your Second Clerk, Eliot Wilson, subsequently asked us to provide more detail of the sort of review that we believed was needed, and we sent proposed Terms of Reference on May 14th, along with further details of the issues that led to our letter.

Since then a steady stream of reports have increased our alarm about NPfIT. We support Connecting for Health in their ambition to ensure that the NHS has cost-effective, modern IT systems, and we strongly believe that an independent and constructive technical review in the form that we proposed is an essential step in helping the project to succeed.

As a review will take several months to organise, conduct and report, we believe that there is a compelling case for your committee to conduct an immediate Inquiry: to establish the scale of the risks facing NPfIT to initiate the technical review and to identify appropriate shorter-term measures to protect the programme's objectives.

If your committee would like more detail of our concerns, we should be very happy to answer any questions orally or in writing, or to help you in any other way we can.

Ross Anderson, Cambridge University;
James Backhouse, London School of Economics;
David Bustard University of Ulster;
Ewart Carson, City University;
Patrik O'Brian Holt, The Robert Gordon University;
Roland Ibbett, University of Edinburgh;
Ray Ison, The Open University;
Achim Jung, University of Birmingham;
Frank Land, London School of Economics;
Bev Littlewood, City University;
John A McDermid, University of York;
Julian Newman, Glasgow Caledonian University;
Brian Randell, University of Newcastle;
Uday Reddy, University of Birmingham;
Peter Ryan, University of Newcastle;
Geoffrey Sampson, University of Sussex;
Michael Smith, University College London;
Tony Solomonides, University of the West of England;
Ian Sommerville, St Andrews University;
Harold Thimbleby, Swansea University;
Martyn Thomas, Oxford University;
Colin Tully, Middlesex University.


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