NAO says NPfIT is not value for money
The National Audit Office has issued a coruscating report on the delivery of integrated care records by the National Programme for IT in the NHS.
It concludes that the £2.7 billion spent by the Department of Health and trusts on care records systems and implementation “does not represent value for money”.
“Based on performance so far, the NAO has no grounds for confidence that the remaining planned spending of £4.3 billion on care records systems will be any different,” it adds.
The report - 'The National Programme for IT in the NHS: an update on the delivery of detailed care records systems' - examines the contracts placed and renegotiated for the five English NPfIT regions and the progress made in delivering contracted systems to trusts.
It tells a consistent story of reduced delivery for barely reduced prices, and says that the original vision of an integrated system cannot now be delivered.
Amyas Morse, head of the NAO, said: “The original vision for the National Programme for IT in the NHS will not be realised.
"The NHS is now getting far fewer systems than planned despite the Department paying contractors almost the same amount of money.
“The Department of Health needs to admit it is in damage limitation mode. I hope that my report today, together with the forthcoming review by the Cabinet Office and Treasury, announced by the Prime Minister, will help prevent further loss of public value from future expenditure on the Programme.”
The report says delivery of electronic patient records across the health service has been extremely patchy. Particular criticism is directed at CSC for its failure to deliver the iSoft’s Lorenzo care record system.
This is contrasted with BT’s limited delivery of hospital and community systems in London and parts of the South.
However, the NAO says repeated revisions to the BT contracts have resulted in fairly small reductions in cost for drastic reductions in delivery on what was originally planned.
In the case of Cerner Millennium for acute trusts in London, the report says that prices appear to have increased by 18% - although some trusts in the South are paying around 22% more.
Where care records systems have been delivered, they are not yet doing what the Department had expected.
“In acute trusts, the systems are mainly providing administrative benefits, rather than the expected clinical ones, such as prescribing and administering drugs in hospitals.”
The report questions whether there is any chance the far more limited delivery now intended is likely to happen before the end of the BT and CSC contracts in 2015-16, five years later than originally planned.
“Based on performance so far, it is unlikely that the remaining work in the North, Midlands and East, where just four of 97 systems have been delivered to acute trusts in seven years, can be completed by 2016 when the contract with CSC expires,” it says.
“Indeed, in order to meet the revised deadline, over two systems a month would need to be delivered in this Programme area over the next five years.”
The report notes that the Department adopted a new approach in December 2009, which encourages trusts to build on and integrate existing systems.
However, it says the cost and benefits have not been evaluated. “The Department estimates that achieving interoperability will cost at least £220m.”
Richard Bacon, the MP and member of the Commons’ public accounts committee, who triggered the NAO report by questioning the value for money of the BT deals and subsequently lobbying for a stop on a new NME deal, said: “This report could not be clearer.
“The NPfIT in the NHS will not deliver its central aim of a detailed electronic care record for every patient in England. This was the raison d’etre for the Programme and the main justification for its extremely high price.
“It is perfectly clear that throwing more money at the problem will not work. This turkey will never fly and it is time the Department of Health faced reality and channelled the remaining funds into something useful that will actually benefit patients. The largest civilian IT project in the world has failed.”
However, a DH spokesperson said: “We agree change is needed and that the original vision was flawed. This is why last year we announced a move away from a centralised, national approach to IT to localised responsibility and decision making.
“However we do think the investment made so far in the NPfIT will potentially deliver value for money now that we have a more flexible approach that allows the local NHS to be in charge of its own requirements.”
Last updated: 19 May 2011 17:20
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