Response: The NHS computer system can still provide joined-up healthcare

Expenditure so far is less than expected, and the benefits for patients are already clear Andy Beckett's article on the NHS's £12.7bn IT programme was too negative ( Systems failure? , 9 July). "The National Programme for IT is five years behind schedule," he says. "As the delays have built up, so has the impression of a government IT scheme, like many before it, gradually sinking into a swamp of technical difficulties, ethical disputes, incompetent contractors and Whitehall over-ambition and careless spending." The project has a number of key systems, for example a system for patients to book their first appointment to see a hospital consultant; a system to transfer prescription details between GP, pharmacist and paying agency; a broadband network; and an x-ray archiving system for different healthcare staff to see. To install the above in one business location would be straightforward, but in any huge geographically dispersed organisation, it is difficult and many say impossible. The NPfIT project is being implemented in 330 NHS trusts across England, including hundreds of hospitals and clinics. Consequently, there are hundreds of separate projects. As Beckett says, it's "probably the biggest and most controversial civilian computer project in the world". This project is too big for the NHS to do. Therefore it was outsourced to four world-class organisations; Accenture, BT, CSC and Fujitsu. It is wrong to say that the entire programme is five years behind schedule. The four systems described above are making good progress, and many elements were completed on or ahead of schedule. A fifth system – the electronic patient record (EPR) system – is years late. To be fair, such systems in acute hospitals have caused problems all over the world. But the EPR system is crucial, and it may have put confidence in the whole NHS project at risk. "Careless spending" is not an issue. Richard Granger, the former leading executive on the NHS project, instituted a hard but sensible procedure: payment only for systems that work. At the public accounts committee in 2006, MP Edward Leigh asked: "Were the four main suppliers showing strain because of these arrangements?" and conjectured that when Accenture withdrew from the project, it had spent perhaps $450m on systems for which it could not charge because this work was incomplete. Granger replied: "Better they [the suppliers] are feeling the strain, than the taxpayers." Expenditure to date is significantly less than was expected.

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Response: The NHS computer system can still provide joined-up healthcare

Medical privacy: Dr Google will see you now

Essential in life, Google may soon play a part in death.

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Medical privacy: Dr Google will see you now

New £12.7bn NHS computer system on brink of failure, warn MPs

Key parts of a £12.7bn programme to upgrade the NHS's information technology are on the brink of failure, a powerful cross-party group of MPs warned today. The Commons public accounts committee (PAC) said recent progress in deploying a new care records system to hospitals across England was "very disappointing". The system was supposed to link 30,000 GPs to nearly 300 hospitals across England, providing NHS staff with instant access to the medical notes of 50,000 patients at every stage of diagnosis, treatment and discharge. The NHS is currently forecasting a completion date of 2014-15 - four years later than originally planned. But the MPs said even this revised schedule looks over-optimistic. By the end of last year, no hospital was yet able to use the Lorenzo version of the care records software, which had been due to operate throughout the north, Midlands and east of England. The committee said: "There must be grounds for serious concern as to whether Lorenzo can be deployed in a reasonable timescale." Plans to instal an alternative Millenium system in the south of England were also in doubt after the government terminated the contract of the service provider Fujitsu. The committee said: "The programme is not providing value for money at present . . . Unless the position on care records system deployments improves appreciably in the very near future (ie within the next six months), the Department of Health should assess the financial case for allowing [hospital] trusts to put forward applications for central funding for alternative systems." The MPs also called on the department to spell out how it will punish staff who breach the security procedures that are supposed to stop patients' confidential medical information falling into the wrong hands. They said: "Ultimately data security and confidentiality rely on the actions of individual members of NHS staff in handling care records and other patient data. To help provide assurance, the department and the NHS should set out clearly the disciplinary sanctions that will apply in the event that staff breach security procedures." Edward Leigh, the PAC's Conservative chairman, said: "It is worrying that, if trusts decide not to deploy the patient care records systems, the taxpayer can still be obliged to make payments to the suppliers concerned." Responding to the committee, the NHS Confederation said hospitals are frustrated by delays in introducing the care records system. Nigel Edwards, the policy director, added: "The time is quickly approaching to make tough decisions on what the future of the project should be ... Many of our members still do not know if they are going to get a system that works or does the things they want it to." The Department of Health defended the IT programme. It said: "New IT systems in the NHS are delivering better, safer and faster care. Current costs have declined because of the delays to implementation due mainly to adding extra functions to the system. Costs are also controlled by the contracts which only pay to providers once the service has been successfully delivered." NHS Health Health policy Inside IT Computing Politics and technology guardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds

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New £12.7bn NHS computer system on brink of failure, warn MPs