NPfIT contracts face further scrutiny

Two inquiries will start next week into the future of the care records element of the National Programme for IT in the NHS, following today's damning report by the National Audit Office.

The Common’s public accounts committee will hold hearings on the report into the non-delivery of detailed care records systems, while the Cabinet Office’s Major Projects Authority will take a “cold hard look” at the programme from a wider government perspective.

Both will ask fundamental questions about the future of the attempt to deliver integrated care records to the NHS, even though this element of the programme was originally slated for completion by 2010.

Margaret Hodge, chair of the PAC, issued a response to the NAO report that said it was “deeply worrying” that the watchdog had found the £2.7 billion spent so far had not delivered value for money so far, and that it had “no grounds for confidence” that the remaining £4.3 billion would be better spent.

"We will want to question officials on whether the programme should be stopped, even at this late stage,” she said. "We cannot and will not sit back and allow more public money to be spent with ever diminishing returns."

And at a press briefing for the report, the NAO’s Mark Davies said that the Major Projects Authority would ask: whether NPfIT makes sense; if it doesn’t, what are we going to do; and if it does, how do we get best value from suppliers?

Today’s report details how, across all five NPfIT regions, the multi-billion contracts for the delivery of detailed care records services to healthcare communities have been renegotiated, so the holders have had to deliver less functionality to fewer sites for almost no reduction in costs.

It says the original vision of an integrated care records service will never be delivered; that it has no confidence the remaining £4.3 billion earmarked for electronic record systems will be better spent; and that there are big question marks about the cost of the ASCC procurement in the South and the new ‘connect all’ approach across the country.

MP Richard Bacon triggered the latest NAO investigation by questioning the value for money of the revised BT contracts for London and the South, and who has been lobbying for a new CSC deal for the North Midlands and East to be halted.

He told this morning’s Radio 4 Today programme the government should “do its best to can the programme” and that it “almost certainly would not” cost more to do this than not.

“The sensible way forward is to find an accommodation with suppliers that allows something to be delivered that is worthwhile,” he said. “Also to point out to suppliers that if you ever want to work with government again it will be in your interests to co-operate.”

However, Ian Watmore, the government’s chief operating officer, who is based in the Cabinet Office, recently warned the PAC that it might not be easy to end the contracts.

In a hearing ahead of the NAO report’s publication, he said the NHS programme was “a classic example of over-ambition by the Department and over-selling by the companies.”

But he said “lawyers have a field day” in disputes, because “it is never black and white” and “one person’s delay and over-run is another person’s change of mind.”

The Department of Health has insisted that the new, more flexible, ‘connect all’ approach outlined towards the end of 2009 means there is the “potential” for the NPfIT contracts to deliver value for money.

On this morning’s Radio 4 Today programme, health minister Simon Burns also said that while it had inherited a “farce” from the previous government, in the form of a “top-down, centralised approach” that had not delivered it was still worth investing in integrated records to support “an improved, modernised NHS.”

He also said the coalition had cut £1.3 billion from the programme, made changes in London to solve problems with BT’s delivery of Cerner Millennium, and allowed trusts to “adapt their systems instead of bringing in new systems.”

He said the Major Projects Review would look at “how we can move forward in a way that is not going to waste taxpayer’s money but will achieve having an IT system for a modernised NHS that actually does serve patients and doctors and nurses who treat them.”

He said the Royal Free Hospital’s deployment of Millennium showed this could be done.

Insider view: Jon Hoeksma says the NAO has provided the government with the ammunition to shoot the integrated care record service. But does it want to load and fire? 

Last updated: 18 May 2011 13:45

Bacon |  Burns |  Connelly |  DH |  NAO |  NPfIT

Lyn Whitfield

18 May 2011

 Newsletter sign-up

Digital Health News
Digital Health Digest