This is a strong report by the NAO - factual and clear. There have been some achievements - the NPfIT has improved the profile, importance and training of IT staff in the NHS. It has made IT and its potential benefits a talking point at board level. A later add-on to the NPfIT, PACS digital x-ray technology, has been a success, making diagnoses quicker and reducing the need for unnecessary x-rays. The N3 broadband network is a success.
But the NPfIT, if flawed, cannot be sustained by PACS, the N3 network or even the extraordinary commitment of thousands of IT professionals and NHS staff. It cannot be sustained either by the strength of its unarguably well-intentioned objectives. It needed to be soundly planned and achievable. There are doubts about both. The NAO report raises questions about whether the most important part of the National Programme for IT, the plans for England-wide shared electronic medical records, will ever happen.
The NAO says the scheme is feasible, but only if fit-for-purpose software is installed - and there are doubts all trusts, especially foundation trusts, will want to install it. Ministers are discovering that an IT-based scheme conceived at the centre cannot be imposed on a devolved NHS - a lesson that should have been learned from failure of the centrally driven Wessex Regional Health "RISP" programme in the 1990s.
It's unfortunate for the NHS and taxpayers that the National Programme for IT was conceived in secret, without adequate consultation with the medical professionals and without enough independent challenge of assumptions. The government needs to be much more visible in the way it approves big projects - and more open about the progress or otherwise of those schemes.
We're believe strongly that if ministers and Whitehall officials knew at the time they first discussed big IT-based change programmes that all would be revealed about how their biggest IT-based change projects were going, they would think twice before they launched a scheme that was unachievable.