NPfIT blog series Part 3 - The future of the NHS National Programme for IT looks hazy

In the foreword to his first annual report of the NHS’s National Programme for IT [NPfIT], Richard Granger gave an account of the scheme’s progress and some of its challenges.

At that time, in 2005, Granger expected that the organisation he managed, NHS Connecting for Health, would publish another annual report a year later.

This was the prediction he made in NHS Connecting for Health’s 2004/5 annual report: “I am confident that our Annual Report for 2005-2006 will contain details of our success in delivering systems which will help tens of thousands of NHS personnel to better serve millions of patients using tools which have been delivered by NHS Connecting for Health”.

But there would be no more annual reports on the NPfIT. And thus no further annual account on the progress NHS Connecting for Health.


In the NHS it had been taken for granted that NHS Connecting for Health would become an arm’s length agency, able to control its own budgets. Several boards of directors of NHS trusts reported in 2005 and 2006 in their minutes that NHS Connecting for Health was already an executive agency of the Department of Health.

The National Health Act 1977, as amended in 2006, specified that NHS Connecting for Health was an “Executive Agency of the Department of Health which is responsible for delivering a unified IT system for the NHS”.

NHS Connecting for Health still describes itself as an agency.

Now Computer Weekly has learned that NHS Connecting for Health has not become an agency of the Department of Health, and the plan has been dropped without any announcement.

One implication is that the government will not require NHS Connecting for Health to produce an annual report of progress and challenges.

The NHS National Programme for IT Annual Report 2004-2005 had given details of progress and funding of the scheme. It reported that despite obstacles, “the progress we have already achieved has exceeded expectations”.

Executive agencies are part of the civil service but they have delegated authority to employ their own staff and organise services.

They have a chief executive who reports to a minister against specific targets. Some are required to publish and lay before Parliament separate accounts.

It’s unclear exactly why NHS Connecting for Health will not now become an executive agency. Whatever the precise reason, the decision to keep CFH within the full control of the Department of Health ties in plans to continue melding the NPfIT with NHS IT in general.

Indeed it’s now possible that whoever replaces Richard Granger, the outgoing lead for the NPfIT, will have a wide role. The new NHS IT head is unlikely to be perceived specifically as a leader of the national programme.

Asked questions by Computer Weekly in July 2007 about the status of the organisation, an NHS Connecting for Health spokesperson said that when it published its first [and only] annual report on the NPfIT, it was operating as a “shadow” executive agency. Until this recent statement nobody outside NHS Connecting for Health had known that it was not an executive agency.

A spokesperson for NHS Connecting for Health, told us:

“The word ‘agency’ was used to describe NHS CFH when it was first established to show that the organisation was operating in shadow executive agency form.

“In the event, NHS Connecting for Health/Department of Health decided not to pursue executive agency status but the term ‘an agency of the Department of Health’ has continued as a way of showing that NHS CFH is part of the Department of Health but with greater delegated responsibilities than a traditional division within a government department.”

The spokesperson said the decision to drop plans for NHS CfH to become an agency was influenced in part by a decision of the NHS’s Chief Executive David Nicholson, to devolve some responsibilities for the NPfIT from NHS Connecting for Health to various parts of the health service including Strategic Health Authorities. This devolution is called NLOP, the NPfIT Local Ownership Programme.

The NHS Connecting for Health spokesperson said:

“The period 2006 and 2007 was a time of major organisational change for the Department of Health and the NHS with the establishment of the new strategic health authorities and significant changes in their responsibilities, including greater ownership for implementation of the National Programme for IT at local level (NLOP).

“In the light of these changes, some of which are still ongoing, NHS Connecting for Health concluded in January 2007 that executive agency status should not be pursued at this time. This recommendation was put to and accepted by the Chief Executive Officer of the NHS and ministers.”

The decision to drop plans for NHS Connecting for Health to become an agency were revealed only after Computer Weekly asked CfH for its latest report, because none had been published since June 2005. This was NHS CfH’s reply:

“As NHS Connecting for Health has not become an arm’s length body, there is no obligation to produce one [an annual report] as the organisation is part of the Department of Health.”

Asked further questions, an NHS CFH spokesperson said:

“The document ‘Reconfiguring the Department of Health’s Arm’s Length Bodies’ published 22 July 2004 (available on the Department of Health website), announced that the NHS Information Authority was to be abolished and its IT infrastructure functions incorporated within the National Programme for IT, which would become a time limited executive agency.

“However, it was decided to proceed to executive agency status in stages. In April 2005 NHS Connecting for Health was established and during the course of 2005/06 operated in shadow executive agency form. An annual report was therefore published as is usual practice for an executive agency.”

Links:

NPfIT blog series Part 1 – The future of the NHS’s National Programme for IT

NPfIT blog series Part 2 – The future of the NHS’s National Programme for IT

NPfIT blog series Part 4 – The future of the NHS’s National Programme for IT

NPfIT blog series Part 5 – The future of the NHS’s National Programme for IT

NPfIT blog series Part 6 – The future of the NHS’s National Programme for IT

NHS National Programme for IT faces a hazy future – ComputerWeekly.com article

The Connecting for Health Annual IT report

What are executive agencies?

Why the NHS’s National Programme for IT can never fail, not in an accountable way at least

NHS National Programme for IT faces a hazy future – ComputerWeekly.com article

NHS IT – are things about to change?

The worst that can happen now is for ministers to go into denial mode – editorial on report of the Public Accounts Committee on the NHS’s £12.4bn National Programme for IT.

NPfIT and the NHS healthcare IT market: an assessment at year four [2006] – Silicon Bridge consultancy

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I thinks theres a huge problem with the transparency of the NHS. This one of the problems that blocks a lot of progess.

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"I thinks theres a huge problem with the transparency of the NHS" I think so, we live same problem too here.

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