Scotland’s NHS in the dark on IM&T spend

The NHS in Scotland does not know exactly how much it spends on IM&T overall, according to a major report from public spending watchdog Audit Scotland.

In a key recommendation, the report says the Scottish Executive Health Department (SEHD) needs to improve the way it funds IM&T programmes in future by developing business cases, and introducing ‘stage gate’ funding for all projects so that funds are released on a phased basis as projects achieve specified outcomes.

Estimated figures in the report suggest that the NHS in Scotland is not spending as much as it should if it is to reach the more ambitious targets set out in the Wanless Report on health service funding in 2002. 

The Audit Scotland report, Informed to care – Managing IT to deliver information in the NHS in Scotland, says: “Estimated national IT revenue budget of £65m and £35m capital in 2006/07 falls well short of the Wanless target of 3-4% of total health spend.

“This would be over £373 million for 2006/07. Even so the growth in investment is substantial and will continue into 2007/08, when the revenue budget is expected to be over £100m and the capital budget £40m. The challenge is to ensure that it represents value for money and delivers the information that people need to provide services to patients.”

Other chapters in the wide-ranging report deal discuss how IM&T is being led in Scotland’s health service, how work programmes and projects are led and managed and the nature and level of stakeholder involvement.

Main findings other than those on funding are:

• There is no overarching information framework or strategy to inform the development of integrated IT solutions in the NHS in Scotland. The overall IM&T strategy needs to be revised to take account of the full range of information needs and recent policy initiatives;
• The NHS in Scotland needs to do more to involve clinicians, managers and policy makers to ensure that their information needs are met through IT;
• The SEHD needs to ensure that existing good practice in project and programme management is applied consistently throughout the NHS in Scotland. This is essential to identify emerging problems, and inform IM&T investment decisions about what to start, stop or accelerate to achieve overall objectives.