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£12bn NHS IT programme ‘will not be realised’

By Edward Davie

The NHS IT programme is running late, over-budget and may never deliver the kind of comprehensive system needed to improve patient care, say Government auditors.

The report from the National Audit Office report – published today – is highly critical of the the National Programme for IT (NPfIT) begun by the previous Government and finds that it is running five years late, at a cost of £11.4bn and with no end in sight.

In the North, Midlands and East of England the NAO finds that just 1,377 GP practices out of 4,961 have got new systems operational whilst in London around 1,500 GP systems are being provided at a cost of some £54 million under a separate contract, which is funded by the Department of Health (DH) outside of the NPfIT.

The NAO report suggests that it may now be unlikely that a comprehensive patient record system is ever developed under the programme.

'The problems with implementing care records systems identified in previous reports by the National Audit Office and Committee of Public Accounts have continued.'

'Delivery of the contracted number of systems continues to fall well below expectations and fewer systems will now be delivered to NHS organisations,' the report says.

NAO head Amyas Morse said about the report's conclusions: '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. This is yet another example of a department fundamentally underestimating the scale and complexity of a major IT-enabled change programme.'

Choose and Book has been delivered to 95% of GP practices. But only around 52% of first outpatient referrals are being processed through Choose and Book, compared to the 90% originally expected. The estimate for the cost of the system has also risen by £9 million from £145m in 2008 to £154m now.

GP Chaand Nagpaul, a member of the BMA's Working Party on NHS IT, said: 'We cannot turn the clock back, but this report provides useful lessons on how best to use resources in the future.'

'Patient care needs to be supported by reliable information systems, and IT should continue to be a priority for the NHS. The effectiveness of systems in future will depend on clinicians continuing to have a strong voice, and the BMA is keen to help ensure the NHS benefits as much as possible from the benefits IT can bring.'

Chair of the House of Commons Public Accounts Committee Margaret Hodge said: 'The report also raises questions as to who will be responsible and accountable for this huge programme and this massive expenditure after NHS reorganisation.'

'This issue must be addressed urgently. We cannot and will not sit back and allow more public money to be spent with ever diminishing returns.'

NHS Confederation policy manager Frances Blunden also said: 'With NHS funding so tight and all the local and regional structures for implementing new IT being removed, some difficult decisions will need to be made. It is essential to make sure the right support is there to get this project completed as the NHS goes through a significant re-organisation.'

£12bn NHS IT programme 'will not be realised'