Confidential briefing to Tony Blair on the NHS's National Programme for IT


NHS Connecting for Health has published on its website one slide from a “confidential” briefing presentation to the former Prime Minister Tony Blair on the NHS’s £12.4bn National Programme for IT [NPfIT], following inquiries by Computer Weekly.

Other slides in the presentation to Blair, which Connecting for Health hasn’t published, give an insight into how officials wish to counter criticism of the programme.

The PowerPoint presentation to Blair was dated 19 February 2007. On NHS Connecting for Health’s website is a slide from the presentation that depicts parts of the NPfIT as having been completed.

Following our inquiries, NHS Connecting for Health has also published on its website the mathematical workings to explain the slide, though these calculations were not in the presentation to Blair.

What struck me as particularly interesting were some of the slides that NHS Connecting for Health did not publish from the presentation. They sought to marginalise critics and criticism, although listening hard to constructive criticism may be of critical importance when managing a large and complex IT-based project.

One of the slides marginalised the 23 leading academics, many of them professors in computer-related sciences, who have called for an independent review of the NPfIT.

The slide said:

“The largely negative media has shaped public opinion by persistent criticism. An opposition campaign is being well orchestrated. The ‘evidence’ by the 23 academic critics is almost wholly based on media coverage, hostile submissions to the Public Accounts Committee and Select Committee and Parliamentary questions.”

However some of the most pertinent criticism of aspects of the NPfIT has come from the apolitical British Computer Society and a variety of independent voices within the medical and IT communities.

On communications and engagement, a slide had some advice nobody could argue with: “putting more focus on the patients, the NHS and its people at a local, regional and national level”.

The communications strategy also included:

– Showing not telling and getting on the front foot with issues and bad news

– Making smarter use of patients and health professionals as spokespeople, case studies and ambassadors

– Undertaking more intense media engagement

– Participating in regular editorial boards

– Launching a proactive campaign based on the success of the Picture Archiving and Communication System. [This is a success but was not a core part of the original NPfIT].

– Holding an event for Parliamentarians

– Placing in The Guardian public supplement a report on the stakeholder event in January

What none of the slides suggested was tacking criticism by improving, modifying or removing aspects of the programme that were being criticised, or providing good arguments on why things should carry on as they are.


A slide from the presentation to Tony Blair, published on NHS Connecting for Health’s website

BBC: Call for a review of NHS IT upgrade

Website of the 23 academics who have called for an independent review of the NPfIT

Survey of doctors on NHS IT programme

Investigation into “unauthorised” Google sponsored link for NHS Connecting for Health

Government spin – a worrying precedent

Examples of confidential “Major Incidents” reported to the government after go-lives of National Programme for IT systems