The remaining NHS National Programme for IT could be scrapped entirely, as the project's aim to deliver electronic records for every patient has fallen far below expectations, according to a National Audit Office report.
The programme was launched in 2002 and intended to create a fully integrated electronic care records system across the NHS. It is now running five years behind schedule, its initial scope having been successively scaled back.
The National Audit Office (NAO) report slammed the £2.7bn spent so far on care records systems as wasteful. "Based on performance so far, the NAO has no grounds for confidence that the remaining planned spending of £4.3bn on care records systems will be any different," it said.
Margaret Hodge, Chairwoman of the Public Accounts Committee, described such lack of confidence as deeply worrying. "We will want to question officials on whether the programme should be stopped, even at this late stage," she said.
Total spending for the programme now stands at £6.4bn, expected to rise to £11.4bn on completion.
Just £73m has been saved despite a significant reduction in the programme's original scope through the removal of 1,243 GP practices; the London Ambulance Service; and the halving of acute trusts included in its remit.
Even the few systems which have been delivered can not do everything the Department of Health intended, finds the report.
While contracts with its two remaining suppliers, BT and CSC, will not all be delivered until 2015-16, it is unlikely the remaining work in the North, Midlands and East can be completed by 2016 when the contract with CSC expires, the NAO says.
So far just four of 97 systems have been delivered to acute hospital trusts in seven years from these regions.
Over two systems a month would need to be delivered over the next five years to meet the revised deadline of 2016, finds the NAO report.
It is estimated the Department of Health's new approach of building on trusts' existing systems – rather than replacing them wholesale – will cost at least £220m to get the systems to work together, it adds.
"It is sad to see the Department's lofty ambitions continue to be compromised, as the vision of joined-up healthcare gives way to a bunch of local systems which will need even more money spent on them to allow them to talk to each others," said Hodge.
Amyas Morse, head of the National Audit Office, says the department needs to admit it is in damage-limitation mode. "This is yet another example of a department fundamentally underestimating the scale and complexity of a major IT-enabled change programme," said Amyas Morse.