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Richard Bacon MP said today that the health service would be better off without Connecting for Health, the Department of Health agency responsible for the national programme for IT in the NHS.
Mr Bacon was speaking as the Commons public accounts committee published a
damning report on the multi-billion pound programme which concludes that “at the
present rate of progress it is unlikely that significant clinical benefits will
be delivered by the end of the contract period”.
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Richard Bacon MP has called
for NHS Connecting for Health, the
agency running the £12.4bn NHS
computer programme to be scrapped |
He has called for the agency to be wound up, with
most of its budget handed over to local hospital bosses and any
remaining functions handled by the Department of Health.
Mr Bacon, a member of the
committee, said: “Connecting for Health has produced exceptional anger and
frustration among doctors, nurses, and hospital managers. It is a nightmare
organisation and I think the NHS would be better off without it”.
“The bulk of the programme
should be handled by local hospital chief executives in consultation with
their own clinicians, who all have a direct interest in delivering IT that
works. Local hospitals should have freedom to buy from a wide range of
suppliers whose technology conforms to national standards. Functions such as
setting common standards could be transferred to the Department of Health.
There is no need for an expensive separate agency”.
“This is a truly grim tale.
The NHS IT programme has already cost over £2 billion, with five times more
than that in the pipeline, and yet the programme is unlikely to deliver
significant clinical benefits by the end of the contract. There have been
six bosses in five years. The programme has left doctors, nurses and
hospital managers spitting with rage. Most GPs think the appointment
booking system is a joke. And three fifths of the programme is dependent on
a software supplier, iSoft, which is under investigation by the Financial
Services Authority and whose flagship software product, ‘Lorenzo’, does not
yet exist even though the company said it was available three years ago, and
which in the meantime has been merrily selling old software which pre-dates
the national programme. You just couldn’t make this up”.
“The limited deployment of
administrative systems which has taken place so far has caused havoc in
various hospitals, leading to significant delays in providing inoculations
to children, waiting list breaches, missing patient records, extended shut
downs of some systems and the inability to report activity statistics”.
“The central problem arises
from a set of huge contracts which were signed in great haste, before either
the government had understood properly what it wanted to buy or the
suppliers had understood what it was they were expected to supply. It is
impossible to avoid the conclusion that this project has been an expensive
failure. It will continue to fail unless there are drastic changes”.
The report calls on the
Department of Health to commission and publish an independent assessment of
the business case for the Programme in the light of the progress and
experience to date.
In view of the slippage in
the deployment of local systems, the MPs also recommend that the Department
of Health should commission an urgent independent review of the performance
of Local Service Providers against their contractual obligations.
You can read the Public
Accounts Committee's report
by clicking here
17 April 2007
Further Information
See below for
key references in the Report to the following topics:
-
Clinical benefits
unlikely to be delivered by end of contract
-
No firm dates for
development of patient clinical record
-
Clinicians not
persuaded of benefits
-
Frequent changes of
leadership
-
High costs yet no
detailed record of overall expenditure
-
Concern over of
software supplier iSoft, which is under investigation and which is
selling old software which pre-dates the Programme
-
MPs call for
independent assessment of business case for the Programme
-
MPs
recommend urgent independent review of the performance of Local Service
Providers against their contractual obligations
1. CLINICAL BENEFITS
UNLIKELY TO BE DELIVERED
-
At the present rate of progress it is
unlikely that significant clinical benefits will be delivered by the end
of the contract period. SEE PAC
REPORT PAGE 6, PARAGRAPH 9.
-
No published plans exist for implementing
shared electronic patient clinical records in line with the original
vision for the Programme. SEE PAC
REPORT PAGE 13, PARAGRAPH 10.
-
The report notes that the delivery of
phase 1 of the programme, the least important from a clinical point of
view because it contains mainly administrative functionality, is already
late with no published dates for its completion; and concludes that the
implementation of phases 2 and 3, which are the key to the delivery of
clinical benefits and which were the core of the business case for the
high cost contracts, may scarcely have begun by the time the Local
Service Providers were originally contracted to have implemented
completely all three phases to all hospitals and Trusts in England.
SEE PAC REPORT PAGE 22, PARAGRAPH 34.
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2. NO FIRM DATES FOR
PATIENT CLINICAL RECORD
-
The delivery of the patient clinical
record, which is central to obtaining the benefits of the programme, is
already two years behind schedule and no firm implementation dates
exist. By now almost all acute hospital Trusts should have new NPfIT
patient administration systems (PAS) as the essential first step in the
introduction of the local Care Record Service. As of June 2006 the
actual number was 13 hospitals. In June 2006 the Department wrote to us
stating that by October 2006 there would be a further twenty-two. So far
as we are aware, up to the end of February 2007 the number has increased
by only five acute hospitals. The introduction of clinical as opposed to
administrative software has scarcely begun; indeed, essential clinical
software development has not been completed.
SEE PAC REPORT PAGE 5, PARAGRAPH 1
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3. CLINICIANS NOT
PERSUADED OF BENEFITS
-
The Department has failed to carry an
important body of clinical opinion with it. In addition, it is likely that serious
problems with systems that have been deployed will be contributing to
resistance from clinicians. SEE PAC REPORT PAGE 6, PARAGRAPH 5.
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4. FREQUENT CHANGES OF
LEADERSHIP
-
The frequent changes in the leadership of
the Department’s work to engage NHS organisations and staff have damaged
the Programme and convey that the Department attaches a low priority to
this task. SEE PAC REPORT PAGE 6,
PARAGRAPH 6.
-
Leadership in securing support from NHS
staff and organisations has changed several times over the life of the
Programme: at the time of our examination, responsibility for this task
had passed between six Senior Responsible Owners.
SEE PAC REPORT PAGE 20, PARAGRAPH 26.
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5. HIGH COSTS YET NO
DETAILED RECORD OF EXPENDITURE
-
The National Programme has already cost
taxpayers at least £2.074 billion
SEE PAC REPORT PAGE EV 82; AND PAGES
14 AND 15, PARAGRAPH 16.
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The Department has not sought to maintain
a detailed record of overall expenditure on the Programme and estimates
of its total cost have ranged from £6.2 billion up to £20 billion.
SEE PAC REPORT PAGE 5, PARAGRAPH 2.
Note that £20 billion was quoted by
Lord Warner in an interview with the Financial Times on Tuesday 30 May
2006, although the £20 billion figure was later qualified. Connecting
for Health has separately acknowledged that costs could rise to £15
billion.
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6. CONCERN OVER ISOFT
-
The company is now under investigation by the
Financial Services Authority, while its former directors and former
auditors are under investigation by the Financial Reporting Council’s
disciplinary body, the Accountancy Investigation and Discipline Board.
Although iSOFT has received loan support from its banks, there is a
continuing risk to the National Programme if it is overly dependent on
the future stability
-
We are concerned in particular that
iSOFT’s flagship software product, ‘Lorenzo’—on which three fifths of
the Programme depends—is not yet available despite statements by the
company in its 2005 Annual report that the product was available from
early 2004. PAC REPORT PAGE 6,
PARAGRAPH 8.
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At the time of our hearing in June 2006,
some 13 acute Trusts had had their Patient Administration System (PAS)
replaced, which itself provides no care record functionality beyond what
they already had. In those regions where iSOFT is the main software
supplier, the replacement has been an old iSOFT PAS which pre-dates the
Programme because the PAS element of the new system, Lorenzo—which is
being developed for the Programme and which the company stated was
available from early 2004 — is not yet available.
PAC REPORT PAGE 13, PARAGRAPH 10.
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SEE ALSO iSOFT GROUP
PLC 2005 ANNUAL REPORT AND ACCOUNTS, PAGE 6, PARAGRAPH 2, where it
states that the Lorenzo software system was “available from early 2004”
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There are five regional clusters each with
a main regional contractor or ‘Local Services Provider’. iSoft is the
main software supplier for three of the five main clusters. See below
for the five clusters and their main suppliers:
|
REGIONAL CLUSTER |
LOCAL SERVICE PROVIDER |
MAIN SOFTWARE SUPPLIER |
|
North West &
West Midlands |
CSC |
iSOFT |
|
North East |
CSC
(previously Accenture) |
iSOFT |
|
Eastern |
CSC
(previously Accenture) |
iSOFT |
|
London |
BT |
Cerner
(previously IDX) |
|
Southern |
Fujitsu |
Cerner
(previously IDX) |
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7. CALL FOR INDEPENDENT
ASSESSMENT OF BUSINESS CASE
The Department should commission and publish
an independent assessment of the business case for the Programme in the
light of the progress and experience to date.
SEE PAC REPORT PAGE 5, PARAGRAPH 3.
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8. URGENT REVIEW OF
CONTRACTORS’ PERFORMANCE AGAINST CONTRACTUAL OBLIGATIONS
In view of the slippage in the deployment of
local systems, the Department should also commission an urgent independent
review of the performance of Local Service Providers against their
contractual obligations. SEE PAC REPORT
PAGE 5, PARAGRAPH 4.
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PARLIAMENT:
NHS CfH invites bids from new computer suppliers
