NHS chief dismisses fresh call for review

Experts' challenge on £12.4bn IT project is rebuffed once again

NHS chief executive David Nicholson has rejected a fresh challenge issued by 23 leading computer scientists to commit to an independent review of the £12.4bn National Programme for IT (NPfIT).

Nicholson also dismissed a 212-page dossier of the NPfIT's problems, which details the concerns of some consultants and other clinicians over the programme. The dossier was compiled by the 23 academics, who include senior computer experts at leading universities.

His rebuff will heighten concerns among some health experts about what they see as complacency among top-tier management at the Department of Health over the state of the NPfIT.

Speaking at a one-day event dedicated to the National Programme, Martyn Thomas, visiting professor at Oxford University and a representative of the 23 academics, issued the challenge to Nicholson to commit within two weeks to launching an independent, published review of the programme.

But Nicholson, who attended the whole event, repulsed the challenge only hours later. He expressed strong support for programme, while conceding that there were "issues", including a need for the NHS to "pull the programme in its direction".

Nicholson said that the NHS did not respond well to being told what to do and there was a need for "more engagement and more ownership" by the NHS of the NPfIT.

He added that the programme was "not wildly off course" and there was "no evidence which would lead me to believe there is a need for an independent review of the programme".

Issuing his challenge, Thomas told the conference that a primary concern of the academics was whether the NHS's requirements had been correctly identified and agreed with clinicians and patient representatives, as well as being complete, consistent and feasible.

"We also have technical concerns about the system architecture, the security policies, the system usability, the clinical coding standards, and other technical aspects," he said.

"We believe that the professional way to address these risks is for there to be an independent, constructive review that publishes its findings and recommendations."

Nicholson said he was impressed with the way the NPfIT was developing. He said he now wanted the NHS to own, love and understand the programme.

Challenges facing national programme bosses

  • Improving the practice of confidentiality in the NHS
  • Speeding up the spread of good practice in implementations
  • Getting clinicians involved in implementations
  • Increasing NHS leaders' support for the programme
  • Having a more flexible implementation programme - responding to local NHS needs
  • Using technology to increase patients' involvement in their own care
  • Identifying better ways to give staff necessary new skills
  • Setting and communicating expectations at a local level.

Source: Department of Health



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