NHS Focus: Open Letter: Questions that need to be answered

The IT community's leading academics call for an independent review of the national programme

Four years ago the government announced to a grateful NHS a national IT programme that would become the world's largest civil computer scheme. But after a breathless start, delivery dates for key software were missed, the full costs of implementation have always been unclear, and experts are divided over whether the scheme is too ambitious to ever work as originally planned.

Now the IT community's leading academics have written an open letter to parliament's Health Select Committee calling for an independent audit of the national programme for IT. In doing so they are echoing a campaign launched by Computer Weekly last year for an independent audit. Below we publish the letter in full, together with a list of its signatories.

Open letter to the Health Select Committee


The Select Committee may be aware of the concerns of health professionals, technologists and professional organisations about the £6bn NHS national programme for information technology (NPfIT):

The NHS Confederation has said, "The IT changes being proposed are individually technically feasible but they have not been integrated, so as to provide comprehensive solutions, anywhere else in the world."

Two of NPfIT's largest suppliers have issued warnings about profits in relation to their work and a third has been fined for inadequate performance.

The British Computer Society has expressed concern that NPfIT may show a shortfall of billions of pounds.

Various independent surveys show that support from healthcare staff is not assured.

There have been delays in the delivery of core software for NPfIT.

Concrete, objective information about NPfIT's progress is not available to external observers. Reliable sources within NPfIT have raised concerns about the technology itself. The National Audit Office report about NPfIT is delayed until this summer, at the earliest; the report is not expected to address major technical issues. As computer scientists, engineers and informaticians, we question the wisdom of continuing NPfIT without an independent assessment of its basic technical viability. We suggest an assessment should ask challenging questions and issue concrete recommendations where appropriate, eg:

Does NPfIT have a comprehensive, robust:

Technical architecture?

Project plan?

Detailed design?

Have these documents been reviewed by experts of calibre appropriate to the scope of NPfIT?

Are the architecture and components of NPfIT likely to:

Meet the current and future needs of stakeholders?

Support the need for continuous (ie 24x7) healthcare IT support and fully address patient safety and organisational continuity issues?

Conform to guidance from the information commissioner in respect to patient confidentiality and the Data Protection Act?

Have realistic assessments been carried out about the:

Volumes of data and traffic that a fully functioning NPfIT will have to support across the thousands of healthcare organisations in England? 

Need for responsiveness, reliability, resilience and recovery under routine and full system load? 

We propose that the Health Select Committee help resolve uncertainty about NPfIT by asking the government to commission an independent technical assessment with all possible speed. The assessment would cost a tiny proportion of the proposed minimum £6bn spend on NPfIT and could save many times its cost.


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