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Tuesday, April 11, 2006

Top UK IT experts call for audit of NHS (NPfIT) programme

Leading computer science experts are this week writing to parliament calling for an independent audit of the NHS national programme for IT (NPfIT). The signatories, 23 of the UK's top academics in computer-related sciences, are concerned about the technical feasibility of a fully integrated national programme. Their open letter to the House of Commons Health Select Committee echoes a call last week by Computer Weekly and Health Direct for an independent audit of the project.

The letter is unprecedented. Suppliers say they have been warned off speaking about the NPfIT, and IT directors in the NHS fear being victimised if they openly express critical views. Academics, who are independent of the NHS, can express their concerns without fear of repercussions.

The letter said, "Concrete, objective information about NPfIT's progress is not available to external observers. Reliable sources within NPfIT have raised concerns about the technology itself.

"The National Audit Office report about NPfIT is delayed until this summer, at the earliest; the report is not expected to address major technical issues. As computer scientists, engineers and informaticians, we question the wisdom of continuing NPfIT without an independent assessment of its basic technical viability."

The open letter was sent to the Health Committee by Martyn Thomas, visiting professor of software engineering at Oxford University and expert witness in legal cases involving complex software engineering issues. He has served on the advisory group for the government's Foresight programme on intelligent infrastructure systems.

The letter is endorsed by senior figures in the IT community. Alan Stevens, chairman of the medicine and health panel for the Worshipful Company of Information Technologists, supports the proposed review.

He said, "It seems to me that the government should welcome a thorough independent technical review of the NPfIT to help allay the tide of concern being expressed by doctors and other front-line healthcare professionals that their work lives and, indeed, patient care may not be enhanced by the new systems."

Tom Brooks, a long-standing member of the Parliamentary IT Committee, who for several years helped members of parliament with their scrutiny of NHS IT development, said a thorough fundamental independent review of the NPfIT was now overdue.

He said, "A number of informed parliamentarians and many senior managers in NHS trusts have lost confidence in the implementation plans and programme and in its management."

Brooks said that he would write to members of the Health Select Committee to express support for the open letter and an independent assessment of the NPfIT's basic technical viability.

He will also urge the Select Committee to "obtain and examine a complete financial plan for implementing NPfIT to 2013, including full trust costs" and explore whether the costly "top- down approach is the right priority at this point in time".

There is widespread support for the objectives of the NPfIT, especially its aim to allow the sharing of electronic medical records on 50 million patients in England. But four years after it was launched, the programme has a record of delays in the delivery of fully integrated systems that are central to the programme's original objectives.

Ministers had announced that a "full national health record service" would be "implemented, and accessible nationally for out of hours reference" by the end of 2005. But the widespread exchange of patient files is not expected to happen in the near future.

Connecting for Health, which is managing the NPfIT, says there have been thousands of deployments. But the agency's critics say the national plan has largely turned into interim systems and local initiatives that are reminiscent of some schemes underway before the NPfIT was conceived. Meanwhile, suppliers working to deliver fully integrated systems are facing problems.

Two weeks ago Accenture, the main supplier to two of the five NHS "clusters" in England, announced a predicted write-off of £260m on the contract. The share price of its main subcontractor iSoft, which supplies three of the clusters, has more than halved since it warned at the end of January that its profits on the NPfIT would be lower than forecast.

Another major supplier, BT, has been fined more than once for poor performance. A fourth, CSC, has announced significant job losses and put itself up for sale.

In their letter the academics urge the commissioning of the review "with all possible speed".

Connecting for Health declined to comment.

http://www.computerweekly.com/Articles/2006/04/07/215309/TopUKITexpertscallforauditofNHSprogramme.htm

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