In London in May 2007 a senior health official gave an assurance – of sorts – about the future of the NHS’s £12.4bn National Programme for IT [NPfIT].
Andy Burn, head of IM&T planning at NHS Connecting for Health, which runs much of the NPfIT, told the government IT summit: .
“It has three wheels still on, and it is still moving. But things are in hand to a certain degree. They are not in other respects but we are going to get there.”
Not all trust boards of directors are as certain as Burn about the future of the NPfIT. An assessment of the programme by Birmingham and Solihull NHS Trust has raised a question about whether the NPfIT will achieve its objectives
It said, “The NPfIT is an ambitious programme that has experienced delays with current system migrations running two years late, and there are concerns over its achievability.”
The paper, which explained the trust’s IT strategy for the four years from 2007 to 2011, referred in part to the NPfIT plan to give 50 million people in England a reliable and useful medical record – called the NHS Care Records Service – which is running at least two years late. Some trusts are now buying essential systems outside of the NPfIT.
The paper said, “In priority situations, full EU procurements are being undertaken for systems outside the local or national product portfolio.
“The financial impact on national contracts has yet to be resolved, but some trusts may need to pay financial penalties for operating systems outside of the national contracts.”
Birmingham and Solihull NHS Trust is not the only trust to make such an assessment of the NPfIT.
Given the problems with the programme, including concerns in the NHS over the quality and reliability of some NPfIT products installed so far, what is the government of Gordon Brown to do about its future?
Some observers of the NPfIT are likely to see the programme as becoming more indefinable, and accountability more obscure.
The Government, the Department of Health and NHS Connecting for Health are expected to continue refusing calls by Computer Weekly, academics and other independent voices for a high-level, published, independent review of the programme.
So there will continue to be no independent verification of the government’s claims for the success of the scheme.
Meanwhile, at the front line, NHS trusts will face penalties if they do not place a minimum amount of orders with the NPfIT’s local service providers – whether the trusts are enthusiastic about the NPfIT products on offer or not.
Heading towards obscurity?
NHS Connecting for Health’s lack of a separate existence could be part of the political plan to blend the NPfIT with NHS IT in general. And the move away from ruthless standardisation would remove from the programme its distinctive character, a loss that would be compounded by the departure of the charismatic head of NHS Connecting for Health, Richard Granger.
All of which may help to explain why the NPfIT – after a series of ministerial announcements about the programme during its early years of the programme – is hardly mentioned in the latest annual report of David Nicholson, the Chief Executive of the NHS.
But if, as seems the case, some politicians and officials want the programme to head slowly towards obscurity – at least until the next general election – they may be disappointed, especially if suppliers start levying fines on NHS trusts over a lack of NPfIT orders.