NHS Gateway Reviews damn £13bn IT decisions

The government has published 31 Gateway reviews into the highly troubled £12.7 billion National Programme for IT.

The material, covering the period from the inception of the programme in 2002 up until 2007, was released in response to a Freedom of Information Request. Gateway reviews, which are designed to test the business case for projects at various different stages of their lifecycle, are not normally published.

The documents revealed that stakeholders and health officials have long had doubts about the NPfIT suppliers – of which only BT and CSC are left – and have questioned whether the programme can ever deliver value for money.

Nearly a third of the 31 reviews are so severe that they gave a ‘red light’ to elements of the programme, which means there was a need for immediate remedial action and serious reconsideration of the NPfIT progresses.

Since the start of the programme the British Medical Association, representing doctors, has repeatedly questioned the systems being used and the management of suppliers.

Dr Grant Ingrams, in the NHS IT working group at the BMA, today told Computerworld UK: “From the start we said that it was an ill conceived programme, that single unified systems were not workable, and that interoperability of local systems was better. Then they created local monopolies with only one lead supplier in each area.”

“Until 2004 the NHS didn’t even want talk to us,” he said. “Look at all the lost opportunities, that’s the biggest pain of it all.”

Ingrams said, however, that things were improving and that the NHS is “now trying to catch up”. But he argued the NHS is wrong to claim that summary care records will save lives in emergency situations.

“Will doctors wait in an emergency to boot up systems and trawl through a summary care record, before they do anything? No they won’t. Is it going to save lives in an emergency? No it isn’t. Connecting for Health spins things.”

In April, the NHS issued an ultimatum to remaining suppliers BT and CSC, insisting a workable patient administration be ready by November. But Ingrams cautioned against this approach.

“You could end up with a system still not fit for use in the NHS,” he said. “Just having anything working is not a solution.”

A spokesperson at the Department of Health said it was an “ambitious and difficult programme” that was making progress.

“The delays involved in implementing the Care Records Service in the acute sector are regrettable, but it is important to point out that these have not been at any cost to the taxpayer,” the spokesperson continued. “Contracts with suppliers are paid on delivery.”

Copyright © 2009 IDG Communications, Inc.

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