It's the world's largest health IT project, its projected cost has doubled in its lifetime to £12.7bn, and parts of it are running four years late: welcome to the National Programme for IT (NPfIT).
While the NHS's NPfIT has already outlasted several heads of IT, its chequered track record is not surprising given the ambitious scale of the project: replacing an ageing patchwork of 5,000 different computer systems with a nationwide infrastructure connecting more than 100,000 doctors, 380,000 nurses and 50,000 other health professionals.
Find out more about the 10 key NHS IT projects
♦ NHS Care Records Service
♦ Choose and Book
♦ The Electronic Prescription Service
♦ N3 national broadband network
♦ Picture Archiving and Communications System (Pacs)
♦ The Spine
♦ The Quality Management and Analysis System
♦ GP2GP record transfer
♦ NHSmail- a central email and directory service for the NHS
♦ Secondary Uses Service
The NPfIT faced considerable scrutiny since its inception. A National Audit Office report in May this year highlighted serious delays in introducing the electronic care records system at the heart of the scheme due to technical challenges, while suppliers Accenture and Fujitsu pulled out of delivering the system and one trust halted implementation of the care records service.
Meanwhile, technical issues in implementing the Cerner and Lorenzo patient administration systems (PAS), which will be the basis of the future rollout of the care records service, have resulted in only 130 PAS being deployed in 380 health trusts.
Richard Bacon, a member of the parliamentary spending watchdog the Public Accounts Committee, said of the project's missed deadlines and immature systems: "The programme is a reflection of the poor project management as a whole when it comes to government IT. A lot of public money has been squandered on the National Programme for IT."
The NHS IT body Connecting for Health (CfH) counters that the programme is more focused on making sure systems work properly rather than rushing them in to meet deadlines.
CfH says the programme is already starting to pay for itself, citing the £1.1bn savings expected by 2014 highlighted in the NAO report.
A spokesman for CfH said: "Collectively, the early adopter trusts, strategic health authorities, NHS CfH and CSC recognise the need to achieve the necessary quality criteria for go-live and view this as more important than a particular date."
Paul Cundy, former chairman of the British Medical Association's IT Committee, believes the project has overall been a mixed blessing for UK healthcare.
"It is a real mixed bag - those projects that worked very well have been clearly defined as delivering the best benefits to users, where the users have had input and where there has been political support for them.
"The ones where there is bad political interference, where there is no user input into design or are doing things that users do not want, those are the ones that predictably fail," Cundy told silicon.com. "The key is to ask people what they want."
silicon.com first put the core NHS IT projects under the microscope in early 2006.
Much has changed since then, however, and silicon.com has decided the time is ripe to revisit each of the major projects in the programme to get the latest on their highs and lows, and find out just how far away the NHS is from its interconnected dream.
Clink on the links below for more details of each of the main NHS IT projects - and their progress so far.
The projects:
NHS Care Records Service
Choose and Book
The Electronic Prescription Service
N3 national broadband network
Picture Archiving and Communications System (Pacs)
The Spine
The Quality Management and Analysis System
GP2GP record transfer
NHSmail- a central email and directory service for the NHS
Secondary Uses Service
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