Axe The NHS Patient Care Scheme, MPs Demand

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Abandon the National Programme for IT healthcare system, says a PAC report which casts blame on CSC and BT

The House of Common’s Public Accounts Committee (PAC) has called on the government to scrap the NHS National Programme for IT (NPfIT). Contractors are also singled out for a roasting in the Committee’s report on the nine-year old scheme.

The NPfIT looks destined to join several other grandiose government IT schemes that have failed to deliver. The project was meant to provide better communications across the NHS infrastructure based around a central database for patients’ medical records, scans and X-rays.

Waiting For Lorenzo

Lorenzo, the electronic patients’ records (EPR) system, has yet to be delivered and the system at the moment is a fragmented service that would still cost another £4.3 billion to pull together – with no real guarantee that it would be fit for purpose because it would be well over a decade old by the completion date and so many cuts and changes have been made that it is a shadow of its original design.

“The Department of Health is not going to achieve its original aim of a fully integrated care records system across the NHS,” said Margaret Hodge MP, chair of the Public Accounts Committee. “Trying to create a one-size-fits-all system in the NHS was a massive risk and has proven to be unworkable.”

Blame is laid squarely on major suppliers BT and CSC. The report takes a hefty swing at CSC: “CSC has yet to deliver the bulk of the systems it is contracted to supply and has instead implemented a large number of interim systems as a stopgap. The Department [of Health] has been in negotiations with CSC for over a year, and told us that it may be more expensive to terminate the contract than to complete it.”

There also appear to be discrepancies in pricing, the Committee claims: “We noted that the Department is paying BT an average of £9 million for each community and mental health system it is delivering in the South. This compares to an average price of between £1 million and £2 million for systems purchased directly from the supplier, CSE Healthcare, outside the Programme.”

BT, which was brought in to replace Fujitsu three years ago, “has also proved unable to deliver against its original contract,” added the report.

The lack of real progress will, no doubt, figure in any government negotiations that may follow a decision to axe the project. However, the Department of Health (DH) has said in a response to the report that CSC and BT “have been clear that they are not willing simply to walk away”.

The DH has taken legal advice which indicates that there is a “significant” risk that BT and CSC may join Fujitsu in a unified legal action. There is an ongoing legal dispute between Fujitsu and the DH following the termination of Fujitsu’s NPfIT contract in 2008.

CSC will probably also point to other favourable reports, such as this week’s worldwide review of public sector suppliers from IDC.

CSC: IDC’s Leader In Public Service Work

In IDC’s annual MarketScape overview of the top public sector consulting firms, CSC usually shows well. This year’s report is no exception and CSC is highlighted as one of two “Leaders” in the field

“Public sector MarketScape Leaders, IBM and CSC, scored well across a wide range of characteristics setting themselves apart from the other firms in the analysis. This vendor analysis shows that some vendors are better able to produce meaningful results than others,” observed Cushing Anderson, IDC’s programme vice president for Business Consulting Services research.

The view of IDC differs widely from Hodge’s opinion. “The Department has been unable to demonstrate what benefits have been delivered from the £2.7 million spent on the project so far,” she said. “It should now urgently review whether it is worth continuing with the remaining elements of the care records system. The £4.3 billion which the Department expects to spend might be better used to buy systems that are proven to work, that are good value for money, and which deliver demonstrable benefits to the NHS.”

Although CSC comes under fire for only delivering 10 of 166 Lorenzo clinical information systems scheduled for the North, Midlands and East regions, the project has also been respecified and altered several times to keep in line with changing technologies and circumstances. The delays in developing Lorenzo have meant that about 80 interim systems have been delivered in its place.

In a swing at the previous Labour government who pushed the scheme through, the report concludes: “The previous government is, in part, blamed for the NPfIT’s failings for not having “consulted at the start of the process with health professionals”.

Tony Collins, a long-term government watcher and co-writer of the Campaign4Change blog, said, “One of the messages that comes loud and clear from today’s report of the Public Accounts Committee is that the DH cannot be trusted to make the right decisions on behalf of taxpayers and the NHS. The DH cannot even be trusted to tell the truth, to judge from the PAC report.

“The Cabinet Office needs to take control of major DH IT spending. Perhaps the sooner the better,” he warns.

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