The NHS is having a lot of problems lately, what with scathing reports from the Cabinet Office’s Major Projects Authority and the public accounts committee (PAC), as well as the National Audit Office. In the PAC report, as outlined in the Guardian last week, the findings showed that NHS has no sure way to link the electronic care records delivered through its National Progamme for IT (NPfIT) with those delivered from local sources.
That report also says that though NHS trusts will have the responsibility for care records systems, they don’t know what the ongoing costs will be, since they do not have a clear contractual agreement with existing suppliers. One such supplier, CSC, is under contract with NPfIT but hasn’t delivered the majority of the systems promised; instead the DH paid for interim systems that are not adequate for the job. Another supplier, PAC said, was blatantly overcharging the DH to implement systems that the NHS could have gotten for much less.
NPfIT was set up in 2002 with a government mandate allowing it to operate independent of the public sector in areas such as its systems network, patient ID numbers and service contracts. It was also allowed to sidestep reviews by the Office of Government Commerce that came in response to complaints about IT performance in the public sector.
Now that latitude is going to be curtailed, and NHS will have to abide by the policies and strategies that apply to the rest of government IT operations. NHS will be required to share existing systems instead of buying new ones, and that restriction may involve canceling the unsatisfactory contract with CSC, though NHS claims such a move would be more expensive than continuing their negotiations with CSC for reduced costs.
At this point the logistics of an overall reform of the NHS’s systems are rather daunting; it’s clear that changes are needed but implementing them poses more problems. The government is searching for a viable way to integrate NHS and private sector systems, and working with a severely reduced budget.
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