Second full NAO review of NPfIT to be carried out

Tags: A Audit Government iS NAO NPfIT

26 Apr 2007

The Commons Public Accounts Committee has ordered a second full review of the NHS IT programme to be carried out public spending watchdog the National Audit Office, to check that the recommendations of its report into the NHS IT project are followed.

Chairman of the PAC Edward Leigh said he planned to "call the Government's bluff" after health minister Lord Hunt said that the Government was already acting on the PAC's recommendations.

Last week's PAC report provided a detailed highly critical analysis of the management and progress of the £12.4bn programme which said "suppliers are struggling to deliver" shared electronic medical records and made recommendations including a call for an urgent independent review and annual review of progress.

The government responded last week by saying many of the recommendations were already being acted on, adding that the report was based on out of date information, based on last summer's NAO report. This despite the PAC taking detailed new evidence and calling its own witnesses.

Speaking in the Commons on 19 April, Edward Leigh, chair of the PAC, said: "I notice that the Government's response this week says, "Well, excellent report by the PAC, but we're doing all this—it's an out-of-date report.

"I am going to call the Government's bluff. I have talked to the Comptroller and Auditor General about the matter and, following my encouragement, we are to have another NAO report on the NHS computer in the next year so that we can have an update to check whether all the excellent recommendations of the NAO and the PAC on this £12 billion computer system—that amount is equivalent to the entire cost of the Olympic games—are being carried out."

Links

PAC says NPfIT suppliers are 'struggling to deliver'

PAC report brings brickbats and bouquets for NPfIT

Readers Comments

Who is the Audit Commission customer

27 Apr 07 12:53

Before CfH adopt such an outlandish plan as to delay next year's report by another year, then claim it is out of date, could I just ask. Who will get to 'agree' the content, and will any revisions that are made in consequence be balanced by reflecting these back in the service this time ?

Also, will time be made to look at the woeful state with the LSP arrangements, which was too much detail for the last NAO review ?

And at the lack of fit with original vision, never mind the current aspirations and direction of the NHS.

And also whether we are getting good value from the overhead that is CfH, and all the management consultants in their employ.

Questions needed to be asked

27 Apr 07 12:57

Some questions NAO need to ask and have answered

1. How was it that when measuring OBS responses for the LSP contract and its suppliers was it that some product evidence was virtual, whilst some suppliers had hard evidence to reference their product sets.DoH instructions were to score responses based on evidence and not verbal guarantees that some products had been ok?ed in the design lab. Yet certain products (Lorenzo) had the evidence bar lowered to accommodate what we now know to not exist, and certainly not back then.

2. Why can you procure LSP offerings cheaper locally than CfH did?

3. Where is the architecture for joining-up electronic records, if not nationally but at the boundaries of domains or LSP's?

4. Why is PACS so expensive and does not include all imaging modalities in NHS such as Medical Illustration, Pathology, Endoscopy, theatres, Dermatology, Ophthalmology, Cardiology etc

5. Why does PACS/LSP contracts not allow LSPs to accept ISTC images for NHS patients?

6. Why is the change process in CfH/Clusters so cumbersome and setting best practice back 10 years?

7. Why does N3 not supply enough bandwidth for all NHS requirements and GP's in particular?

Question 8

30 Apr 07 07:57

Following on from a previous comment, can I suggest a crucial 8th question?

Would the NHS be any worse off if NPfIT was abandoned immediately?

And following on again......

30 Apr 07 11:22

Perhaps now is the time for CfH to halt the current progress and look to setting minimum standards of data collection, data storage and data submission at the local level, ready to share with the core NHS databases. This way local Trusts could choose the most cost effective way of collecting local data, and at the same time acknowledge the individual practices of Trusts, their departments and the networks in which they reside.

Perhaps this would cost less and promote a greater level of acceptance from clinicians and nurses, who may find the current proposed solutions difficult to use. This would also allow a more staged approach to the electronic record, and allow greater local autonomy.

Audit Commission does not equal NAO

t-haslam@audit-commission.gov.uk

30 Apr 07 11:55

Can I just point out in reply to the previous comment that the Audit Commission and National Audit Office are not the same entity. The National Audit Office is solely responsible for the review of NPfIT. Central government does not fall within the Audit Commission's remit, which is local government and local NHS.

Joined up audit required

01 May 07 14:31

Since the National NHS has imposed NPfIT and CfH on the local NHS, perhaps Audit Commission +NAO should = more than the sum of the whole, and if both worked together on this, we would not have the ridiculous situation of the last report where the evidence was undermined, and central explanations accepted without cross referencing with the service.

Or would that be too much like joined up governance of the government ?