Officials at NHS Connecting for Health answer most media inquiries – but they have not yet replied to questions about a little-noticed speech in the House of Commons by the health minister Ben Bradshaw on 21 February 2008.
In a debate on the Health Committee’s report on electronic health records, Bradshaw cleared suppliers to the National Programme for IT – NPfIT – of any responsibility for delays. He told the House of Commons that the delays have not been because of problems with supply, delivery or systems.
“We accept that there have been delays, not only in the roll-out of summary care records, but in the whole NHS IT programme. It is important to put on record that those delays were not because of problems with supply, delivery or systems, but pretty much entirely because we took extra time to consult on and try to address record safety and patient confidentiality, and we were absolutely right to do so.”
We put questions about Bradshaw’s statement to NHS Connecting for Health, which runs part of the NPfIT. We wondered whether the statement could affect the NHS’s position in its negotiations with local service providers over a contract reset.
We also pointed out that board minutes of various NHS trusts have reported delays. One local service provider, CSC, has paid penalties which related to “the financial consequences arising from deployment delays”, according to board papers issued by Western Cheshire Primary Care Trust in November 2007.
Indeed NHS South Central said in a board paper which reported progress on its 2007/8 annual plan:
“Ongoing functionality issues with the latest release of the Cerner product is causing delays. These matters are being addressed through the current contract reset.”
We asked NHS Connecting for Health: “Does CfH unequivocally stand by Mr Bradshaw’s comment that delays were not because of problems with supply, delivery or systems?” We also asked: “Was Mr Bradshaw’s brief accurate and comprehensive?”
We put the questions on 22 February 2008. Perhaps the answers are still being prepared.
In January 2008 East Sussex Hospitals NHS Trust reported that negotiations over a contract reset with Fujitsu has “added further delay to the rollout programme” and East Sussex is now scheduled to go live with an NPfIT Care Records Service system in November 2008 – although it could be later still. Delays are likely to result in an extension of legacy system contracts.
The papers say that NHS Connecting for Health is negotiating favourable rates with [legacy] suppliers. It also noted that “the increased number of smaller releases would add to the complexity of the system build, increasing the risk of a product not fit for purpose and the costs of implementation”.
In November last year, the Western Cheshire Primary Care Trust Board reported “major issues” that included the “continuing delays in the availability of the Lorenzo system, which undermines the credibility of the whole of National Programme for Information Technology”.
The board papers added: “In the meantime, existing suppliers continue to develop their products, which make it even harder to persuade Trusts to move onto Lorenzo … The lack of clinical functionality in the current Patient Administration System from CSC means that clinicians are disengaging from the programme and looking elsewhere for clinical solutions.”
NHS Connecting for Health rightly wants media coverage of the NPfIT to be fair, accurate and objective. Its briefings to ministers (and MPs) should also be fair, accurate and objective. When ministerial statements fall short of these criteria, NHS Connecting for Health and the minister should formally advise the House of Commons, and Hansard, of the need for a correction. This has not happened in this case as far as we are aware.
It’s inconceivable that Ben Bradshaw would knowingly mislead the House of Commons. Besides he made his comments with a clear conviction – he believed in what he said, which raises questions about the accuracy or completeness of his briefings. We should be able to trust what ministers tell the House of Commons on the NPfIT.
Leaving incorrect statements to pass as fact will only reinforce the impression that the NPfIT has become too enmeshed in politics to be managed in the dispassionate way a board of directors in the private sector would manage a large and complex IT-based change programme.