UK Government To Dismantle NHS IT Programme

The world’s largest public sector IT project has officially failed, but experts say nothing has changed

The UK government has announced that the the £12.7 billion NHS Programme for IT will be “urgently dismantled”, giving local health trusts the power to choose their own systems. However experts say nothing will change in the lifetime of the current suppliers’ contracts.

A review by the Cabinet Office’s Major Projects Authority (MPA) has found that the scheme, which aimed to create a fully integrated care records system across the NHS, is unachievable. Health Secretary Andrew Lansley and Francis Maude, the Minister for the Cabinet Office, announed the decision to accelerate its demise.

“This Government will not allow costly failure of major projects to continue,” said Maude (pictured). “The National Programme for IT embodies the type of unpopular top-down programme that has been imposed on front-line NHS staff in the past.

“Following the Major Projects Authority review, we now need to move faster to push power to the NHS frontline and get the best value for taxpayers’ money,” Maude added.

Local decision-making

The MPA review was carried out in response to a damning report by the House of Common’s Public Accounts Committee (PAC) earlier this year, which said that trying to create a one-size-fits-all system in the NHS was a massive risk and has proven to be unworkable. Blame was laid squarely on major suppliers BT and CSC, which the Department of Health (DoH) said had failed to deliver against their original contracts.

Through a new partnership with the technology trade association Intellect, the DoH will explore ways to stimulate a marketplace that will no longer exclude small and medium-sized companies from participating in significant government healthcare projects.

“We need to move on from a top down approach and instead provide information systems driven by local decision-making,” said the DoH in a statement. “This is the only way to make sure we get value for money and that the modern NHS meets the needs of patients.”

Despite the damning report, Sir David Nicholson, chief executive of the NHS, hailed several positive achievements of the National Programme for IT (NPfIT) including the Spine, N3 Network, NHSmail, Choose and Book, Secondary Uses Service and Picture Archiving and Communications Service. The delivery of these projects accounts for around two thirds of the £6.4 billion spent so far.

These IT projects will “continue to provide vital support to the NHS,” according to the DoH. However, Nicholson acknowledged that the NHS needs to move on if it is to achieve the efficiency and effectiveness required in today’s health service.

Nothing new?

The NPfIT was set up by the Labour government in 2002, and has come under continuous criticism for rising costs and dubious management. A report in the Daily Mail newspaper, which has seen a leaked copy of the MPA report, said that the money spent on the NPfIT would pay for 60,000 nurses for a decade.

The coalition first announced it would pull the plug on NPfIT – thought to be the world’s biggest civil IT programme – in September last year, claiming that a centralised, national approach was no longer required.

Today’s news suggests that the process will be accelerated, but Campaign4Change blogger and long-term government-watcher Tony Collins reckons that nothing has changed.

“The signs are that the scheme will be dismantled brick by brick – and will be almost completely dismantled by the time the NPfIT contracts with BT and CSC expire in 2013 and 2014,” wrote Collins. “The coalition has achieved a PR coup with the Daily Mail story because the public has the impression that in these austere times a £12bn NHS IT scheme initiated by Labour has been scrapped.”

In fact, adding together the £6.4 billion has already been spent (and achieved some results) and the fact that a substantial amount is also committed in the suppliers’ contracts, there is little the government can change at this point, says Collins.