A US company contracted to provide IT technology for the National Health Service is set to receive a £2 billion extension despite the failed project being abandoned.Computer Sciences Corporation (CSC) has reportedly informed Wall Street that it expects its contract to provide electronic patient records across the NHS to be extended.

Taxpayers are now facing an estimated £2 billion bill, despite the company already failing to deliver a fully functional version of its software, The Times reported.

The £11.4 billion National Programme for IT, set up in 2002 by bliar, was at the time spun as the world’s biggest civilian computerisation project.

It aimed to give doctors instant access to patient records wherever they were being treated and CSC had signed a deal to computerise records in most of England.

Digitising the medical records of the country’s 62 million people was the core objective of the National Programme for IT in the NHS, accounting for £7 billion of the total estimated cost.

Andrew Lansley, the Health Secretary, announced in September that he was abandoning the scheme to create a national patient database because it had “let down” the health service.

He made the decision to “urgently dismantle” the failed project after criticism it was not value for taxpayers’ money.

Yet the company stated in official US papers that it was in talks with the British Government for its contract to be extended until 2017, at a cost of up to £2 billion.

Computer applications installed as part of the scheme have also failed or been scrapped.

However, £250,000 in bonuses has been paid by the DoH to 80 people involved in the scheme as a reward for “an exceptional contribution to delivery”.

CSC, one of the world’s biggest IT providers, had been contracted to provide patient record software, known as the Lorenzo system, to 166 NHS hospitals. But it has delivered on 10 projects. None of those systems is fully functional.

CSC has signed deals worth hundreds of millions of pounds with Royal Mail, Identity and Passport Service and UK Atomic Energy Authority.

The Coalition’s Major Projects Authority, established to review Labour’s financial commitments, found the scheme was not fit to provide services to the NHS.

A cross-party committee of MPs concluded the programme had proved “beyond the capacity of the DoH to deliver”.

Katherine Murphy, of the Patients Association, said it was “shameful” to pour more money into a failed initiative.

The controversial NHS medical records database system would allow patients to check their medical documents online and raise any inaccuracies or problems with their doctor, however concerns have been raised over the security.The announcement was buried in documents released with the Chancellor’s Autumn Statement ahead of the results of a public consultation due to be published next year.

Patients should be given greater access and control over their medical information, the consultation said.

However, there are worries over the security of the system and that the information will be passed on or sold in so called ‘technology and data markets’.

Patients could be pressured into giving third parties, such as insurers access, to their record or to disclose details contained in it, it was warned.

In documents released with the Autumn Statement, it said: “All patients in the NHS will have online access – where they wish it – to their personal GP records by the end of this Parliament.

“GP practices that can already provide online access are encouraged to do so as soon as possible.

“These measures will help to position UK companies in the development of a personal information market, which is likely to be the next stage of development on from the growth of social networks.

“Online access to one’s own personal data enhances personal control and participation in public services. It also fuels innovation and growth in the supporting technology and data markets.”

Concerns were raised last year that the Summary Care Record was being rolled out too fast with patient records being uploaded to the national system unless people directly opted out.

The roll-out was halted but it now appears that it is to be restarted again and all patients who have already been contacted will have an online record by 2013.

The summary care record is part of a wider online medical records database to allow NHS staff to access brief medical records of patients they may treat outside their home area. However, in pilots, it was found that staff were passing access ‘key cards’ to each other breaching security rules.

Guy Herbet, general secretary of the campaign group No2ID, said: “The problem is this is a Trojan horse for the continuation of the Department of Health’s continuing centralisation of all medical records, and its seeming desire to share them with its friends in the pharmaceutical and medical technology industries.

“That’s a real threat to privacy and medical confidentiality. And the government has continued the previous administration’s work of taking records out of the hands of clinicians who have a direct duty to you.”

Gus Hosein, Executive Director of Privacy International, said: “In theory, this system is a positive development; everyone should have access to their own information.

“The problem is that the NHS is insisting on building a multi billion pound computer system to store records containing our most intimate and potentially compromising information.

“At best, it will fail, as large government IT systems have historically tended to do. At worst, it will create a data protection nightmare. The benefit of giving patients access to their medical records is vastly outweighed by the huge expense of the system and the significant threat to privacy.”

Chaand Nagpaul, the British Medical Association’s GP IT lead, said: “The BMA does believe that patients should be given the option of accessing more information online so that they can make informed decisions about their care.

“However, take-up has been very slow in those areas where patients have been offered access to their records online.

“It is essential that further work is undertaken to assess the level of demand amongst the public before further investment is made. With the NHS being asked to make efficiency savings of £20 billion, we must not waste money on expensive systems that patients will not use. It is also important any electronic system has built in confidentiality and data security safeguards.

“The UK’s research base and wider NHS could benefit from plans to publish datasets more widely and open up new channels of communication between different parts of the health service. It is important though that confidential data is not inadvertently disclosed. Proper safeguards must be put in place to stop this from happening. “

From:  http://www.telegraph.co.uk/All-patients-to-be-given-online-access-to-medical-records

Dismantling Labour’s disastrous £12 billion NHS IT programme may cost taxpayers more than keeping it going.Ministers announced on Thursday that they will speed up the scrapping of the National Programme for IT (NPfIT)  after a review concluded “there can be no confidence that the programme has delivered or can be delivered as originally conceived”.

It confirmed earlier reports that the central part of the scheme, allowing NHS staff across England to access any patient’s details, was unworkable while costs had increases and deadlines were missed.

The governance board of the programme will now be scrapped, and local trusts will be given the freedom to develop their own versions of the electronic care record rather than having the rules dictated by Whitehall. A new Cabinet Office oversight committee will monitor future IT investment to ensure money is not wasted.

But many trusts across England have large contracts with private suppliers to supply their care record systems, and their cancellation could leave taxpayers even more out of pocket.

The Department of Health’s own chief information officer, Christine Connelly, told MPs on the Public Accounts Committee in May that a £3bn deal with CSC to deliver systems in the north, midlands and east of England would cost more to get out of than to keep going.

She said: “Potentially, if you ask me about the absolute maximum, we could be exposed to a higher cost than the cost to complete the contract as it stands today.”

A decision will be made on the future of the contract later in the autumn.

However the Cabinet Office’s Major Projects Authority said that some parts of the £12.7bn programme had worked and would be retained, including the NHSmail email system and the Choose and Book process of arranging hospital referrals.

Andrew Lansley, the Health Secretary, said: “Labour’s NHS IT Programme let down the NHS and wasted taxpayers’ money by imposing a top-down IT system on the local NHS, which didn’t fit their needs.

“We will be moving to an innovative new system driven by local decision-making. This is the only way to make sure we get value for money from IT systems that better meet the needs of a modernised NHS.”

Roger Goss, co-director of the pressure group Patient Concern said: “Thank goodness politicians have decided to stop money being poured into a huge bottomless pit. Now we must pray that they don’t sanction pouring it into endless incompatible regional pits.”

From: http://www.telegraph.co.uk/Dismantling-NHS-computer-scheme-could-cost-more-money

The Department of Health should consider abandoning the disastrous £12 billion NPfIT project to computerise all patients’ medical records according to a powerful group of MPs.The integrated electronic care records system was a central part of Labour’s £12 billion National Programme for IT (NPfIT).

The Public Accounts Committee says that although £2.7bn of taxpayers’ money has already gone on the scheme, it is unclear what the benefits have been and so ministers should think about whether the rest of the cash could be better spent elsewhere.

Although the intention was to create a single network that would allow NHS staff across England to access any patients’ details, the report says this will not happen now and the country has been left with a “patchwork” of costly and fragmented IT systems whose future is uncertain because of reforms to the health service.

The chief executive of the NHS, Sir David Nicholson, also comes in for criticism for failing to oversee the project properly while civil servants provided “late, inconsistent and contradictory” information to the MPs’ inquiry.

Margaret Hodge, the committee’s chairman, said: “The Department of Health is not going to achieve its original aim of a fully integrated care records system across the NHS. Trying to create a one-size-fits-all system in the NHS was a massive risk and has proven to be unworkable.

“The Department has been unable to demonstrate what benefits have been delivered from the £2.7 billion spent on the project so far.

“It should now urgently review whether it is worth continuing with the remaining elements of the care records system. 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.”

The integrated electronic care records system was a central part of Labour’s £11bn National Programme for IT in the NHS, which was set up in 2002 and faced repeated criticism since then over its cost and technical problems, most recently from the National Audit Office.

In the report the MPs say the intention to allow rapid sharing of patients’ records was “worthwhile” but the Department of Health has been unable to make it work.

They claim that creating a single system was always a “massive risk” especially as clinicians were not asked for suggestions on its operation.

In the north, midlands and east of England just 10 of 166 trusts have received only a basic system, while no mental health body has received one. Dozens of different interim and local schemes have been devised, at greater cost.

Whitehall officials are said to lack “basic management information” on the number of systems built and their cost, even though there is a body overseeing the whole project with 1,300 staff that has spent £820million.

Sir David Nicholson was accused by the committee of having “lacked the capacity to meet his responsibilities fully” as Senior Responsible Owner for the scheme, leading to “increasing costs and delays”.

The Department of Health is now trying to renegotiate some contracts and is working on a slimmed-down “menu of modules” that hospitals can choose for their patient records systems, but there is no guarantee the systems will work with each other.

In addition, the Strategic Health Authorities responsible for delivery of the programme are being scrapped and there is “considerable uncertainty” over how the new NHS bodies will adopt the IT systems and how much it will cost them.

Andrew Lansley, the Health Secretary, said: “This is yet more evidence that Labour’s botched approach to IT in the NHS failed taxpayers and failed patients. Their one-size-fits-all IT programme has once again been found unworkable.

“This Government is taking action where Labour failed. Already, we have reduced expenditure on Labour’s costly IT schemes by £1.3 billion. We are making sure that systems are not imposed on the NHS from the centre which organisations do not want. And we will shortly announce our plans for even stronger action to deliver value for money for taxpayers and the NHS.”

From: http://www.telegraph.co.uk/NHS-should-consider-abandoning-7bn-IT-project.html

NHS patients face a potential security breach after computer hackers gained access to health service passwords.
The group, which calls itself LulzSec, said that it had accessed a system that handles sensitive patient data. Last week it stole a million data records from a Sony website.

It published an email showing that it had informed the NHS of the security breach and saying “we mean you no harm and only want to help you fix your tech issues”.

It had taken master “admin” passwords from the system “months ago” while searching the internet for other materials, but had not exploited them.

On its Twitter account, which it uses to boast about its attacks, LulzSec claimed it had reported the security vulnerability after the dying wishes of Alice Pyne, a 15-year-old British terminal cancer sufferer whose online “bucket list” has become an internet phenomenon.

It said: “Greetings … we’re a somewhat known band of pirate-ninjas that go by LulzSec. Some time ago, we were traversing the internet for signs of enemy fleets. While you aren’t considered an enemy – your work is of course brilliant – we did stumble upon several of your admin passwords.”

The Department of Health admitted that the system had been breached, but said it was only on a local level. It has reported the incident to police.

“This is a local issue affecting a small number of website administrators,” a spokesman said. “No patient information has been compromised. No national NHS information systems have been affected.”

The incident is the latest in a string of computer security breaches, and has raised concerns about the security of patient data, which is being digitised en masse and uploaded to a national system as part of the much-delayed NHS national programme for IT.

LulzSec emerged in May when it published a database of more than 70,000 American X Factor contestants’ personal details, including their dates of birth and phone numbers. In a hacking spree, it has attacked Nintendo and Sony, and an FBI-linked security association. It says its attacks are for entertainment purposes.

From: http://www.telegraph.co.uk/Fears-for-patients-data-after-hackers-hit-NHS

Scrapping the controversial and delayed NHS electronic records project could cost more than seeing it through to completion, a parliamentary committee has heard.
The project to install electronic patient records systems at health trusts in the north and east of England and the Midlands is years behind schedule.

The programme has been described as not being “value for money” in a report from public spending watchdog the National Audit Office (NAO) and critics have called for the project to be abandoned.

But yesterday, Department of Health (DoH) CIO Christine Connelly told the parliamentary public accounts committee that cancelling the contract with supplier CSC could potentially leave the DoH “exposed to a higher cost than the cost to complete the contract as it stands today”.

She said if the contract were terminated, the resulting contractual costs could run up to “several hundred million pounds”, with the possibility that the supplier could seek damages.

Still further costs could be incurred during the process of moving health trusts over to new care records systems, she said.

But Connelly went on to say that the DoH is still considering all options for the contract with CSC, which the DoH has previously stated includes termination.

Sir David Nicholson, chief executive of the NHS, told the committee that the DoH is not currently minded to cancel its contract with CSC: “That’s not what we’re planning to do at the moment.”

Bizarrely he said the DoH could still get something “really good” out of its contract with CSC.

Care records systems are being installed across the whole of England, although progress has been slowest in the north, east and Midlands, the NAO report found.

CSC has repeatedly missed it’s required targets- known as milestones, for the rollout of the care records systems.

By March this year, CSC had missed 67 milestones set under its Local Service Provider (LSP) contract, and recently suffered a further setback when one of four trusts chosen to be early adopters of the care records system pulled out of the project.

The NAO report found that £2.7bn has been spent installing care records systems across the whole of England, and that there is a further £4.3bn still to be spent.

The care records system is being installed in the north, east and Midlands by CSC under the terms of its LSP contract, which is worth just over £3bn, but the DoH has said it expects negotiations will reduce the contract’s value by about £500m.

From: http://www.silicon.com/doh-cio-warns-on-cost-of-scrapping-e-records-project

NHS patients are getting “precious little” from the NHS electronic care records system in England, the National Audit Office (NAO) has found.
The £7bn system to replace paper files is falling further behind schedule and in places where it has been introduced it is not working as it should.

The National Audit Office also said some patients would not even get one as large chunks of the NHS had pulled out.

In conclusion, the NAO said the system was not providing value for money – something the government rejected.

The Electronic care records are the key part of the overall £12.4bn NHS IT project.

The scheme was launched in 2002 by Tony Bliar with the aim of revolutionising the way the health service uses technology and also includes developments such as digital x-rays and fast internet connections.

It is the third time the NAO has looked at electronic records – and each time the findings have been more damning.

The report from the NAO presents a depressing account of delays, contractual wrangling and technical glitches.

The original vision for the scheme was compelling – a national network connecting hospitals, GP practices, ambulance services and mental health trusts, and an end to the tortuous paper trails that have caused frustration and misery for doctors and patients alike.

But the complexity and cost of the scheme meant it was always seen by many as a high risk strategy. And when it ran into trouble the plans were scaled back, and the original vision set aside.

Many GPs and hospitals are now working with different systems, prompting the NAO to question whether further investment in the national programme would be pouring good money after bad.

The latest report details a range of problems that the programme is struggling with.

In London, all GP practices and more than half of hospital trusts have pulled out, while in the south three-quarters have. However, this has not been accompanied by a proportionate drop in cost.

Meanwhile, the contract covering the rest of country is currently being renegotiated. Even after such a scaling back, roll out in places that remain part of the system is still proving difficult.

The NAO said it doubted the final deadline of 2016 – which is already six years later than originally envisaged – would be met.

And even in those trusts that have electronic records, there are problems. For example, some hospitals have struggled to introduce electronic prescriptions.

The NAO said the difficulties were caused by a range of factors, including the government being too ambitious, difficulties with technology and the complexity of the NHS.

The problems have prompted some critics to call for the entire scheme to be scrapped – although this is something the NAO stopped short of suggesting.

The government has already announced there will be a review of the project. This is due to start next week.

Tory MP Richard Bacon, a member of the House of Commons’ Public Accounts Committee and long-standing critic of the plans, said: “It is perfectly clear that throwing more money at the problem will not work.

“This turkey will never fly and it is time the Department of Health faced reality and channelled the remaining funds into something useful that will actually benefit patients. The largest civilian IT project in the world has failed.”

But the Department of Health said while the original vision “was flawed”, the project still had the potential to deliver value for money.

Dr Chaand Nagpaul, of the British Medical Association, said: “We cannot turn the clock back, but this report provides useful lessons on how best to use resources in the future.”

From: http://www.bbc.co.uk/news/health-13430375

A new NHS computer system that will share the medical history of millions of patients with drug companies without proper consent is under attack from privacy experts, who say it is misleading, risky and potentially illegal.
The system, the Secondary Uses Service (SUS), is part of the NHS’s troubled National Programme for IT (NPfIT), and massively expands the amount of medical data that commercial and academic researchers can access.

In many cases, patients will not be asked for consent for their data to be shared, because it is claimed it will be “anonymised”, a process which deletes certain information with the aim of making individuals unidentifiable.

However, in a letter to the British Medical Journal, Dr Ian Brown of the Oxford Internet Institute said that NHS rules mean such unwitting participants in research can be “trivially” re-identified. They are also not to be told or given a choice about how their medical records will be used, he said, and misled about the risks to their privacy.

“This is something that is just getting going,” Dr Brown told The Telegraph.

The SUS replaces previous record sharing arrangements that were typically on much smaller scale and involved patient consent.

It will supply data where patients’ names and addresses have been replaced by their date of birth and postcode.

“As a postcode typically contains about 20 houses, almost all patients are easily identifiable by reference to these facts,” Dr Brown said in the letter, which is co-signed by Lindsey Brown, a researcher in public health ethics at Bristol University, and Professor Douwe Korff, a data protection law specialist at London Metropolitan University.

Some of the “anonymised” data also includes the unique NHS Number for each patient, making them even more easily identifiable. According to Dr Brown and his colleagues, such weak privacy policies could be illegal under European data protection laws.

“Patients are not currently being adequately informed about possible secondary uses of their medical data for medical research,” said Dr Brown and his colleagues.

“[Patients] are not asked to give clear, specific, free and informed consent; are not offered unambiguous and effective opt-outs; and are misled about the level of anonymisation of their data and the likelihood of re-identification,” they added.

The Department of Health had not responded to a request for comment.

The letter is a response to suggestions by scientists that the rules on accessing to patient data should be further relaxed. They have welcomed SUS and argued that easier access to sensitive data records will spur medical advances.

“It is irresponsible to insist that no regulation and governance should interfere with researchers’ access to health records or record linkage capabilities,” said Dr Brown and colleagues.

The National Programme for IT was conceived under the Labour government at a cost of around £12.7bn, making it the most expensive pulic technology programme in the world.

Since coming to power, the coalition has announced it will abandon the name and shave an £700m from the price tag, in addition to the £600m cut made by Alistair Darling in 2009.

Several suppliers have dropped out and doctors’ groups have questioned the clinical value of the scheme, which will digitise patient records and make them available throughout the NHS.

From: http://www.telegraph.co.uk/NHS-misleads-patients-over-sharing-medical-records-with-drug-firms

A service set up to enable millions of patients to email their GPs and access their Summary Care Records online has proved to be unwanted by the vast majority of potential users, according to a major new study.Academics from London found that instead of the 5-10% of the population that Connecting for Health predicted would sign up to the HealthSpace service, developed as part of the National Programme for IT, only 0.13% of those invited to take part got as far as activating the full functionality of their personal health record.

It was also predicted that patients would access use the HealthSpace service to access their Summary Care Records and notify their GP of errors, thereby driving up data quality in NHS medical records.

In fact, only 2,913 of 2.24 million patients invited to open an advanced HealthSpace account actually did so, and the research team did not find a single person who had accessed their Summary Care Record.

Research into trials of the service, published on BMJ.com, comes as the Government promises an ‘information revolution’ which will offer patients much more control over their records.

Professor Trisha Greenhalgh, from Barts and the London School of Medicine and Dentistry, who led the research covering uptake of HealthSpace from its release in 2007 until mid-2010, concludes in the report: ‘Unless personal electronic health records align closely with people’s attitudes, self-management practices, identified information needs and the wider care package, the risk that they will be abandoned or not adopted at all is substantial.’

She adds: ‘The findings raise questions about how eHealth programmes in England are developed and approved at policy level.’

Problems with HealthSpace uncovered by the researched included a complex registration process, a ‘clunky’ user interface and low levels of knowledge about, or interest in, the product from GPs and other healthcare staff.

HealthSpace’s future is already under review by the Treasury, with the Government increasingly looking for patients’ IT services to be developed by private providers.

Researchers said the recent emergence of rival products from commercial IT giants including Microsoft and Google raised serious questions about the place of a standard-issue personal health organiser from the NHS.

A Department of Health spokesman said: ‘Healthspace gives patients access to their Summary Care Record online and enables secure communication between clinicians and patients.

‘The UCL research has produced a historical snapshot, rather than insight into patients’ needs and expectations. Healthspace continues to be developed in response to those aspirations and the commitment to give patients, as well as clinicians, access to their Summary Care Record.’

From: http://www.pulsetoday.co.uk/story.asp?sectioncode=23&storycode=4127785

A new study to better understand what prevents people from using information technology to help them manage their health and care has found that few people have even heard of the three major NHS health information websites.
The study commissioned by Connecting for Health, looked at how social groups who may be excluded from electronic health information services used websites including health information website, NHS Choices, online health record, HealthSpace and health advice for those with learning disabilities, Easyhealth.

The report titled ‘Including Everyone in Electronic Health Information Services,’ states: “One of the most important findings of this study was that people had not heard of NHS Choices, HealthSpace and Easyhealth. This was even the case for people who had searched online for health information previously.”

The quantitative study by Raft, which interviewed 50 older people, people on low incomes and those with a learning disability from Bolton, Salford, Bury and Manchester, found that although few people had heard of NHS Choices and Easyhealth, participants were positive about the services when they were demonstrated to them.

However, some felt NHS Choices in particular was aimed at people that were newly diagnosed and could not help those who had had a condition for many years.

Others said that fear of health information, puts them off searching for health information “as a computer can’t reassure you if you’re frightened.”

In relation to HealthSpace, again, few participants had heard of the service including those in Bolton and Bury which are early adopters for the summary care record.

The reaction was mixed and found that it was “clear that most people would only wish to used certain functions of the website” such as the calendar function to help them remember hospitals appointments and the communicator.

Several added that they saw no advantage of seeing a record of medications or allergies when they already knew that they had them.

The report concludes that there is a high degree of trust in the information from the NHS websites which could usefully be used to promote the websites for effectively.

“Most people felt that leaflets and posters in GP surgeries and hospitals clinics would be suitable. Several people suggested the idea of TV advertising.”

The study also aimed to address those who had never accessed the internet, which amounts to 9.2 million people across England. It found that those who would consider learning wanted to do it as possible to home as possible in such as at home, community group they attended, GP surgery or hospital clinic.

Another finding was that although many people did not have access to computers or did not know how to use them, family members were able access the websites and provide the information.

The report recommends that “By promoting NHS websites to all computer uses, we can indirectly improve access to electronic health information for those people who do not use a computer.”

Marlene Winfield OBE, director for patient and public at CfH said: “This report is already helping CfH in the design and delivery of its products and services.

“It will we hope, contribute to the wider digital inclusion discussions taking place as a result of the current health whitepaper and the information strategy consultation that followed it.”

From: http://www.e-health-insider.com/major_nhs_public_websites_unheard_of