Embattled NHS Chief Tries To Defend IT Programme

MPs on the House of Commons government spending watchdog, the Public Accounts Committee (PAC), have given the chief executive of the NHS a rough ride at the hearing into the failings of the multi-billion pound National Programme for IT (NPfIT) project.

The  high-profile initiative has not delivered its key objective of giving doctors instant access to the medical records of any patient they have to treat, despite spending so much of the taxpayers’ money.

Strong Feelings Of Animosity Surface

Devised in 2002, the project was originally estimated to cost £2.4 billion but, almost a decade further on, and with little to demonstrate significant progress, the costs have ballooned to £11.4 billion. Small wonder that the MPs sitting on PAC’s Major Projects Authority Review are feeling belligerent.

Sir David Nicholson (pictured), chief executive at the NHS and senior responsible officer (SRO) for the NPfIT project, was in the hot seat but, prior to his appearance, Sheri Thureen, president of UK healthcare for Computer Sciences Corporation (CSC), did not help the mood of the day with her evasive answer to questions from Margaret Hodge, chair of PAC.

The CRC contract to install iSoft’s Lorenzo electronic patients’ records system is under review and in danger of being terminated. Thureen said she thought CRC was on track to deliver the programme and that it had reached the point where base functionality was in place and installation would now pick up speed.

“You believe you can deliver a fully integrated electronic care record system, available to all, at all times, in all NHS settings by 2016?” queried Hodge, Labour MP for Barking.

At the third time of asking, all Thureen would say was to repeat that she believed the foundation was in place to provide much of what was required through a connected approach using the existing IT infrastructure versus a replace all. But she did not commit to the 2016 deadline.

Nicholson was questioned closely by the committee on the risk assessment that was undertaken when the project was originally planned.

When asked by Anne McGuire, Labour MP for Stirling, which third parties had been consulted during the risk assessment, Nicholson had to be prompted by Christine Connelly, CIO for Health, who listed KPMG, Gartner and Partnerships UK.

“I think you may well have destroyed the reputations of those organisations you’ve mentioned given the situation we’re facing now,” McGuire retorted.

“Were Ministers made aware of the risks?” she continued. “Anybody who dabbles in technology thinks it can do wonderful things but, as we were told by one of the previous witnesses here today, this is the biggest IT project in the whole world – if not the universe. And yet we appear to be in the situation where, if a risk assessment was undertaken it certainly doesn’t appear to have been particularly valid”

A High Risk, High Profile Project

At this point Richard Bacon (pictured), Conservative MP for South Norfolk and a major critic of NPfIT, steamed in: “Sir David, can you remind us what was the risk score in the original document 21st Century IT?”

Nicholson admitted that he did not know and Bacon informed him that it was 53 out of 72 “which makes it very high risk”. He also pointed out that this assessment was removed from the MPs’ final draft and asked Nicholson if he could confirm that – to which he replied that he could not at that point.

This made the questioner sizzle and in a long invective, reduced here for brevity, Bacon said, “Why not? You’ve been living and breathing it for five or six years and you’ve been the SRO since 2006. Why not? Why not? You should know this stuff. I do and I have 50 other things to do.

“…I remember seeing 21st Century IT, which was produced by Sir John Pattison after the February 2002 breakfast meeting where he was given 10 minutes to present, and he was asked how long it was going to take and he drew in his breath and said ‘Maybe three years’ and the prime minister of the day [Tony Blair] said, ‘How about two?’. This is what happened – and you’re telling me that you don’t know the risk score? Why not?”

Nicholson replied, “I did say that I felt the system and the contract was high risk and you’ve reinforced that by what you said. I knew it was risky when I took it on”

“The point is that just how risky it was, was concealed at its inception,” said Bacon.

Cuts Will Be Based On PAC Findings

The hearing continues and will report back to prime minister David Cameron when a decision will be made whether to impose a cut of £500 million in the project’s budget.

The PAC hearings follow a scathing report from the National Audit Office (NAO) earlier this month which concluded that NPfIT was unlikely to complete by the end of the contract term in 2016. It also points out that reductions in the scale of the project have not delivered any cost reductions.

The coalition government’s dissatisfaction with the inefficient way public sector IT is procured is engendered in the NPfIT project. At the hearing, Connelly revealed that terminating the contract with CSC could cost more than the contract’s £1.3 billion value. Although the project has been severely delayed and heavily criticised, there is a chance that the company would sue the NHS for much more if the contract is cancelled.

Eric Doyle, ChannelBiz

Eric is a veteran British tech journalist, currently editing ChannelBiz for NetMediaEurope. With expertise in security, the channel, and Britain's startup culture, through his TechBritannia initiative

View Comments

  • I have never understood why companies like CRC can say that they will do a project for x amount and in y time. Then go back and say that they want more money and it will take longer and there does not seem to be any penalty. I would say to CRC this was your cost and time scale keep to it or we will sue you.

  • Today’s PAC committee hearing and last week’s NAO report provide a damning picture of the National Programme from initial concept through to execution. By now the UK should have had among the best nationwide electronic patient record systems in the world. All that was needed was to set national standards and demand high levels of interoperability, then let trusts choose their own solution. This would have given smaller, more innovative suppliers the chance to provide hospitals with systems that worked and which met their real needs.

    Instead we seem to be in a position where – like the banks – the NPfIT contracts are seen as too big to be allowed to fail, and everyone else has to pay the price. This has left the Government trying to salvage a project which should have been abandoned, or completely re-engineered, long ago. The NHS and its patients have been severely let down.

    If the Government really wants an Information Revolution it should revitalise the drive for a nationwide electronic patient record systems and ease the terms and conditions so that bespoke suppliers in healthcare can compete, which ensures that clinicians have access to all relevant patient data in real time. There have been warm words about encouraging greater choice and creating more opportunities to new suppliers, but swift and decisive action is needed. If savings can be made from the remaining NPfIT contracts the money should be reinvested into helping trusts find the IT solutions they need. This relatively small-scale financial stimulus would do much to help patients, hospitals and the healthcare IT sector.

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