The 10 projects at the heart of NHS IT

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

* - Article from Silicon.com

NPFiT - Making Progress?

Delivering the NHS Connecting For Health National Programme for IT is proving to be an enormous challenge, says the National Audit Office.

All elements of the Programme are advancing and some are complete, but the original timescales for the electronic Care Records Service, one of the central elements of the Programme, turned out to be unachievable, raised unrealistic expectations and put confidence in the Programme at risk. Today’s progress report on the Programme by the National Audit Office concludes that the original vision remains intact and still appears feasible. However, it is likely to take until 2014-15 before every NHS Trust in England has fully deployed the care records systems, four years later than planned. In the North, Midlands and East area, the software has taken much longer to develop than planned, so some Trusts have had to take an interim system. Completing the development of the system and introducing it in this area are significant challenges still to be addressed.The estimated cost of the Programme is £12.7 billion. The costs of the main contracts have remained broadly unchanged, aside from the purchase of increased functionality. Because of the delay in deployments, actual expenditure to date (£3.6 billion by 31 March 2008) has been much lower than expected. Planned ‘go live’ dates were missed for many of the first Trusts to take the new care records systems and the NHS and suppliers are now increasing their emphasis on establishing realistic timelines for deployments, reflecting the circumstances of each individual Trust.According to today’s report, the success of the Programme will depend on the commitment of NHS staff. The Department’s latest survey, conducted in spring 2007, showed that 67 per cent of nurses and 62 per cent of doctors expected the new systems to improve patient care. Identifying and realising the benefits of the systems are essential to raising confidence further and convincing all staff of the value of the Programme. The Department reported on the benefits of the Programme for the first time in March 2008.Tim Burr, head of the National Audit Office, said today:"The scale of the challenge involved in delivering the National Programme for IT has proved to be far greater than envisaged at the start, with serious delays in delivering the new care records systems. Progress is being made, however, and financial savings and other benefits are beginning to emerge. The priority now is to finish developing and deploying care records systems that will help NHS Trusts to achieve the Programme’s intended benefits of improved services and better patient care."

* Article from http://www.publictechnology.net/