The NHS in Scotland does not know exactly how much it spends on IT and lacks an overarching strategy for IT development, a public spending watchdog has warned.
In a new report, Informed to care: Managing IT to deliver information to the NHS in Scotland, the Audit Scotland watchdog calls for the Scottish Executive to do more to improve the way IT supports the NHS.
The report notes that although there is no exact figure for IT spend, the estimated £65m IT revenue budget and £35m capital budget “falls well short” of the target 3%-4% of total health set out in Treasury guidance.
It adds, “Funding should be based on a sound business case which clearly specifies the justification for the investment over the whole lifetime of the project, and the benefits that the investment will deliver.”
But at present this only happens where capital spend on a project is more than £2m, while a “stage gate” approach – where funding is released on a phased basis when success criteria have been met - is “not routinely in place”.
The auditors also expressed concern at the “limited evidence that expected benefits are identified, monitored and delivered”.
The report warned, “There is not an overarching information framework or strategy to inform the development of integrated IT solutions in the NHS in Scotland.”
It called on the Scottish Executive Health Department (SEHD) to ensure that existing good practice in project and programme management was applied consistently throughout the NHS in Scotland.
The report was published just days after the Scottish health service signed a £300m 11-year IT services deal with a consortium led by Atos Origin. The contract will cover infrastructure services, datacentre services, security management, business continuity, helpdesk services and first-line application support along with the roll-out of Scotland's Emergency Care Summary system.
Audit Scotland noted that SEHD was establishing new national governance and organisational structures for IT, reflecting good practice, but said it was “too soon” to assess whether these were working.
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