The pressure continues to mount on NHS IT suppliers CSC and (to a lesser extent) BT with publication of the Commons' Public Accounts Committee (PAC) report on the delivery of care records systems under the £11.4b National Programme for IT in the NHS (NPfIT) today. The report echoes many of the themes in May’s damning National Audit Office report (see here), concluding that Department of Health has been unable to demonstrate what benefits have been delivered from the £2.7b already spent and calling for an urgent review of whether it’s worth continuing with the remaining elements of the care records system.
Once again, it is CSC that comes out of the report particularly badly. The report concludes: “We are concerned that CSC should not be rewarded for its failure with an effective monopoly in the provision of care records systems in the North, Eastern and Midlands cluster, since this could leave many Trusts with little choice but to continue with outdated interim systems that could be very expensive to maintain and to upgrade.”
The supplier, which completed the acquisition of its main subcontractor on the Programme, iSOFT, last Friday, must now be even more nervous about the outcome of its ongoing negotiations with the Department of Health. It should also be concerned that its ability to secure future public sector work may be compromised with the report recommending the government review whether CSC has “proved itself fit” to tender for future government work. We think this is actually rather harsh on CSC, which has done all it can to stick by the NHS despite mounting problems with the contract, many of which were beyond its control.
Margaret Hodge, Chair of the Committee, went on: “The £4.3 billion which the Department expects to spend might be better used to buy systems that are proven to work, that are good value for money and which deliver demonstrable benefits to the NHS”. This will surely be music to the ears of the many suppliers of electronic patient records that have been knocking on the NHS’ door in recent months (the likes of System C Healthcare (now McKesson), InterSystems, Cambio Healthcare Systems, and Alert). But will anything actually come of it?
CSC’s ongoing contract negotiations with the Department of Health will now be closely scrutinised by the Cabinet Office’s Major Projects Authority. With the Cabinet Office’s Katie Davies taking the IT helm at the DoH (see UK CIO for Health resigns) the likelihood of CSC coming under real pressure increases further. But the DoH has been in negotiations with CSC for over a year and conceded to PAC that it may be more expensive to terminate the contract than complete it. (Don’t forget the DoH is still involved in a legal battle with former supplier Fujitsu after it exited the Programme in 2008). So, while we’d like to think the government will bite the bullet and get tough with CSC, it is just as likely that the whole saga is allowed to rumble on.
CSC isn’t the only one to be criticised in the report. BT, the other main supplier of care record systems under NPfIT, is also scolded with PAC concluding the DoH is “clearly overpaying BT” to implement systems after its contract was renegotiated. According to PAC, under the latest agreement BT is paid £9m to implement systems at each NHS site, compared to a price tag of under £2m for the same systems outside the Programme.
The DoH is also singled out for some stinging criticism for its weak programme management skills and the poor accountability for project performance under Senior Responsible Owner Sir David Nicholson. Given his significant other responsibilities as NHS Chief Executive that is hardly surprising. All in all, the DoH, and the government in general, have some important lessons to learn from this latest ‘IT disaster’.