A new report by the Audit Commission concludes that more than half of all NHS trusts in England have diverted ‘hypothecated’ investment money away from projects such as new computer systems, to meet pressing operational requirements and plug financial deficits.
While painting a fairly upbeat picture of progress to date towards NHS modernisation objectives the report, ‘Achieving the NHS Plan’, suggests continued progress may be difficult to sustain if investment funds continue to be siphoned off to meet immediate operational requirements and short-term targets.
Local IT investment is specifically identified as one of the areas from which investment funds are being diverted to balance the books and meet immediate pressures.
Commenting on one geographical area of the NHS, the Commission’s auditors said it was ‘highly likely’ that growth monies would be used to plug deficits. “Furthermore, we identified during our review that 50 per cent of Information Management and Technology funding (£500k) has not been fully invested in this area.”
At another NHS location the auditors noted that modernisation projects would be delayed: “The local health economy is projecting a deficit of some £13m for 2002/03. The Annual Development Plan assumed that growth monies would be used to fund deficits by delaying project starts until near the year end.”
At yet another NHS trust the auditors conclude that 64 per cent of all growth money received – including £97,000 for Information Management and Technology – “has been spent on trying to achieve financial balance in 2002/2003”.
The report stresses, however, that IT investment will be essential to achieve key NHS Plan targets. On booked admissions, for instance, it says that large numbers of acute trusts are at risk of failing to achieve targets.
“The variable development of IT and other management systems were the dominant reasons given for success or failure,” states the report. Commenting on progress on booking systems at one NHS organisation the auditors note: “GPs are not in support of the current systems. IT links are not in place to make GP booking easy.”
Good data quality and effective use of IT, such as investment in priority dispatch systems, are also cited as essential for achieving targets for ambulance service response times.
Overall, the report concludes that significant progress has been made towards many of the targets outlined in the NHS Plan and that the huge effort put into reducing waiting times for outpatient appointments and for hospital inpatient treatment has been paying off. But it stresses that major challenges remain.