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The NPfIT – the saga continues

Friday November 4th, 2011

By Morven MacNeil, GO Content Editor

The Treasury has published a document in response to the Public Accounts Committee (PAC)’s earlier findings regarding the National Programme for IT (NPfIT) in the NHS.

The PAC report, published in August, was based on evidence from the Department of Health and its contractors BT and Computer Sciences Corporation (CSC), and examined the delivery of care records systems under the NPfIT in the NHS.

This report was concerned with a central part of the NPfIT, where the aim was to create a fully integrated electronic care records system, which is expected to cost around £7 billion.

The original objective was to ensure that every NHS patient had an individual electronic care record which could be rapidly transmitted between different parts of the NHS, in order to make accurate patient records available to NHS staff at all times.  The Department of Health (DH) has subsequently accepted that it is unable to deliver this original vision of a uniform care records system with an electronic record for every NHS patient.

HM Treasury has agreed in full with the majority of the PAC’s key criticisms and conclusions on the care records aspect of the NPfIT, but argued that some of the applications which have been delivered under the project are now “essential” to the NHS. The Treasury said the NPfIT has successfully delivered a number of national applications and essential infrastructure upon which the NHS now relies.

However, it acknowledges that the “top-down” approach to implementation of local systems has not delivered the benefits expected and that the NHS has not been sufficiently engaged in the delivery of local care records systems

HM Treasury also said it does not accept the PAC’s conclusions about the DH failing to secure a good deal in its contract negotiations with BT. It said that it believes that the DH made clear in its evidence to the committee earlier this year that the price of Cerner Millennium’s care records system in the south was 47 per cent higher than in the London region was not comparing like with like, since the baseline used to determine this figure was “inappropriate”.

HM Treasury explains that it partially agrees with the PAC’s conclusion that weak management and oversight of the programme have resulted in poor accountability for project performance. But it argues that savings of £1.3 billion have been made against the original estimate for the programme and that the items delivered and operating successfully account for a substantial amount of the £6.4 billion spent to date.

The DH recently confirmed that it intends to wind down the programme to allow for a more locally led approach.

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