Scrutiny is vital for NHS success

Computer Weekly welcomes the unprecedented open letter calling for an independent audit of the world's largest civil IT scheme, the NHS's national programme for IT (NPfIT).

Computer Weekly welcomes the unprecedented open letter calling for an independent audit of the world's largest civil IT scheme, the NHS's national programme for IT (NPfIT). 

This publication hopes that Connecting for Health, which is managing the NPfIT, will react more positively to the open letter than it did to Computer Weekly's call last year for an independent audit of the programme.

Officials argued then that the NPfIT was already subject to scrutiny, transparency and accountability in the form of an investigation by public spending watchdog the National Audit Office.

Computer Weekly awaits eagerly the results of the NAO's one-off value-for-money investigation into the NPfIT.

But the NAO will not perform a technical audit. It is not expected to say whether it is possible to fully integrate NHS systems across thousands of complex semi-autonomous businesses, many of them with their own ways of working.

In short, the NAO will not answer the question, will the NPfIT work?

Whitehall's health officials will also argue that the scheme is subject to regular independent Gateway reviews. But Gateway reviews did not prevent problems with the introduction of IT-related schemes to support the Child Support Agency, tax credits, or the Criminal Records Bureau.

The NPfIT can succeed if it carries on as it is - with the installation of "tactical" systems that do not share medical records across the NHS.  But in this form the scheme may achieve little more than NHS trusts and GPs would have achieved in the past four years had the NPfIT not existed, given national standards and a lot more money.

There cannot be enough scrutiny of a project of this size and importance to the NHS. And, so far, there has been almost none. Despite the possible adverse impact on patient safety if it goes wrong, the NPfIT was conceived in secret, without any public consultation, and without any discussion in parliament or agreement of MPs of the costs.

Despite everything which counts against the NPfIT, officials at Connecting for Health remain fully confident over the technology and their plans. In which case they will have every reason to welcome an independent technical audit; because from their standpoint it can serve only to prove what they have said all along.

This was last published in April 2006

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