The House of Commons’ Public Accounts Committee will publish a report on the NHS’s National Programme for IT detailed care records systems on Wedneday 3 August.
The report is likely to be critical of Sir David Nicholson, the Senior Responsible Owner of the NPfIT who told the committee’s MPs that 80% of the total programme has been delivered.
MPs believe that the programme has been a failure, with poor value for money for the systems delivered so far, which have cost about £6bn.
Sir David Nicholson has been overall senior responsible owner of the NPfIT since 2006. He was not responsible for initiating the programme, which happened under the Blair government in 2002, but he accepted responsibility for making the NPfIT a success. He turned down a call by academics for an independent review of the NPfIT.
Detailed care records systems are only part of the NPfIT – but they were the main reason for the programme’s introduction. Staff at the National Audit Office, which has investigated aspects of the NPfIT three times, say they are not convinced that the national programme is under control.
The PAC have come to the same conclusion that the rest of the media / IT Healthcare industry had come to some time ago. Assuming the report states what the majority hope it will state i.e. no more expenditure on the program as is, it leaves us with the thorny question of what next. Given the amount of money already spent and the principled benefits of up to date (in information terms) central information systems which can be accessed my multiple local information systems, how do we proceed? From my perspective its straight forward.
• Don’t go down the ITK2 route – I mean by this, do not generate yet more specifications on how to glue third party systems to the central systems (SPINE / CAB / SCRS). Instead actually build the software that was described to the PAC. A black box which on the one side communicates with the central systems and on the other provides public facing (over N3) web services which any systems supplier can consume.
• Do not preclude companies from supply on the basis of some arbitrary turnover figure.
• Do not preclude companies from supply on the basis of some arbitrary technology requirement i.e. must be web based or open source or not as the case may be. This tosses the baby out with the bath water as well as in some cases the bath along with it.
• Ensure solutions are truly fit for purpose from day one, much harder I know but Lorenzo was claimed to be a success before any of it basic PAS functionality was in place, moving to such a solution for a Trust who already had such functionality was a massive step backwards.
• Hold to account those people within the NHS’ SHA’s who applied significant pressure to Trusts to take NPfIT solutions even though the Trusts did not want to nor have to. This had led to Trusts, especially in the South, taking solutions so that BT would not invoke fines on the SHA’s which would then be passed on to the Trusts (which the SHA’s can not do contractually).
• Publish the LSP’s contracts, warts and all, so we can all see exactly the degree to which the nation was fleeced and shed light on the real motivation behind the current LSP’s
The other issue which needs to be looked at is the proposed / actual acquisition of iSoft by CSC. Once again I say, an LSP is not permitted to supply software it has partial or total ownership of. This is why BT / Fujitsu / Accenture did not buy any software companies. Why / how can CSC be allowed to proceed on such terms.