FlashlightThe National Programme for IT have released a series of documents requested under the Freedom of Information Act on their website, including the business case for Choose & Book, the NPfIT programme business justification from September 2003, and a register of disclosed interests by individuals working for companies and organisations involved in the programme.

A spokesperson for NPfIT confirmed to E-Health Insider that the files were put online as part of general government policy to publish copies of all documents requested under FOI. The full list of documents is available on NPfIT’s FOI site.

E-Health Insider has looked through the documents to find out whether they tell us anything new.

NPfIT Business Justification

The business justification for NPfIT reveals that in September 2003, the NPfIT was not only considering providing referral options for patients in Choose and Book through the private sector but also "through the Government’s concordat with… the health services of other countries."

Budget estimates dated September 2003, enclosed in the business justification, give a cost figure of only £2.3bn for the programme over three years, with £1.5bn set aside for implementation of the data spine.

An appendix detailing the process for managing risks created by interdependencies of various aspects of the programme, such as the dependence of electronic transmission of prescriptions on the implementation of N3, is referred to but is missing from the document. However, the Choose and Book business case says that early adopters of the system will be chosen for "their infrastructure capacity so that this dependency is removed for go-live and minimised during roll-out."

Report of the Care Record Development Board Ethics Advisory Group 

The conclusions of the Care Record Development Board Ethics Advisory Group were also put online. The report reads: "Where decisions are made concerning the balance of individual and public interests, those making those decisions should be accountable and, except where personal details are involved, the basis for such judgements should be made public."

It concludes that "an appropriate balance between individual and public interests must be maintained. In accordance with the Human Rights Act 1998, public interests should only prevail over individual interests when it is necessary that they should do so."

Other documents

A document detailing the list of bidders for the original NPfIT contracts awarded from December 2003 shows that Fujitsu, McKesson/Capita and SAIC made the original longlist for the National Application Service Provider contracts but "declined to proceed". A total of thirty-three companies put in bids.

The disclosed interests include an individual in the NHSIA who owned shares in BT Syntegra as of December 2003, as well as another whose partner was working for the company last summer. Names have been removed for confidentiality reasons;

The business case for Choose and Book contains a benefits ‘scorecard’, that reveals that the benefits from implementing a new NHS-wide booking management service (BMS) only slightly outweighed those from delivering the system through existing NHS Direct infrastructure. Ongoing costs were judged to be higher in managing the system through NHS Direct than any new system; however, it comes to the conclusion that using NHS Direct as the Booking Management System may be more advantageous.

How to make a Freedom of Information request to a public body

Under the Freedom of Information Act, you must send a written request to the FOI officer of that body containing your name and address, plus a specific description of the information you are looking for. You do not need to know the title of the document you are seeking; if you are specific in your request then the receiving officer must endeavour to help you.

It may be a good idea to first search the publication scheme of an organisation to see if the documents have been requested or already made available. Each body must make a scheme publicly available, although there is no searchable index.

A public body can turn down your request for several reasons; most common of these are that the information is too expensive to collect, that it contains information confidential for commercial or personal reasons, or that details have already been published, are about to be published or are held by another body. Under certain circumstances, you may be charged for your request.

The Act requires that you receive a reply within twenty working days. There is also an extensive appeals process should you receive a negative decision; first a complaint must be issued to the public authority in question, and then the Information Commissioner’s office.


FOI in the NHS
The NHS FOI page, with details of how FOI should be implemented within the NHS

The UK Freedom of Information Act blog
Information Commissioner’s Office