The computerisation of the National Health Service (NHS) is the most ambitious public sector IT programme ever undertaken. The new system – due for completion in 2014 – will connect hundreds of thousands of doctors, nurses and other health professionals, creating an integrated electronic patient management network.
The project is also the largest investment ever made in IT by the UK government: the procurement costs alone were £6.2 billion, and the final costs will rise further as implementation and training costs are added. The final figure could rise to as much as £20 billion.
But while there is little debate about what the overall objectives of the NHS IT project are – ultimately saving lives through increased efficiencies – the enormous size and scale of the project has attracted plenty of detractors.
Doctors have complained about a lack of consultation, and concerns about patient confidentiality in an electronic system accessible by any health professional in the UK have not yet been resolved.
The decision by Accenture, one of the world’s largest consultancy groups and a primary contractor to the project, to walk away has fuelled the debate over its supposed shortcomings even further. In a question to parliament recently, Shadow Minister for Health Stephen O’Brien said: “Yet again this poses embarrassing questions for [Health Minister] Patricia Hewitt about the future of the NHS IT programme. If Accenture are willing to cut their losses, that seriously undermines confidence in the whole programme.”
Richard Granger, CEO of Connecting for Health, the UK government agency responsible for the implementation, has taken a hard line in dealing with contractors not able to meet deadlines.
After Accenture’s exit, he announced that CfH will tender for extra suppliers to increase capacity and ease its reliance on sub-contractors.
Ultimately, whether Granger’s hard-line stance is viewed as good vendor management, or overly-aggressive bullying, will depend on the success of the project.
The experts' response…
Richard Holway, director at Ovum, believes there is little doubt that the programme will be looked upon throughout the world as a model to be followed.
But achieving this objective will cause pain. Anybody who has ever been involved in any project knows that. NHS IT is the most advanced example of ‘multi-sourcing’ – not putting all your eggs in one supplier's basket – and Accenture’s failing and CSC picking up the pieces is an example of the benefits of this approach, not of its failure.
Richard Granger has tried hard to minimise the cost to the tax payer of any failures. How many times have ‘one-source’ suppliers extracted huge extra sums from HM Government to correct their own failures?
The government has missed a golden opportunity to rethink its NHS IT upgrade, says MP Richard Bacon, member of the Commons public accounts committee.
By passing the baton to CSC with indecent haste, the government has missed a golden opportunity to think again and to give more control to hospitals locally. I feel very sorry for hospitals who will have to put up with more delays and with systems that just don't work properly. Many hospitals would now be better off if they had never taken part.
The last few months have seen a succession of disasters for the NHS national programme for IT. The list of failures and delays grows ever longer. Two and a half years in, the programme is two years late.