The NHS Connecting for Health (CFH) agency was part of the UK
Department of Health
A health department or health ministry is a part of government which focuses on issues related to the general health of the citizenry. Subnational entities, such as states, counties and cities, often also operate a health department of their ow ...
and was formed on 1 April 2005, having replaced the former
NHS Information Authority
The NHS Information Authority (NHSIA) was part of the United Kingdom, UK National Health Service (NHS). It was established as a NHS special health authority by an Act of Parliament in April 1999. With headquarters in Birmingham, UK, its aim was ...
. It was part of the Department of Health Informatics Directorate, with the role to maintain and develop the NHS national
IT infrastructure
Information technology infrastructure is defined broadly as a set of information technology (IT) components that are the foundation of an IT service; typically physical components (computer and networking hardware and facilities), but also variou ...
. It adopted the responsibility of delivering the NHS National Programme for IT (NPfIT), an initiative by the Department of Health to move the
National Health Service
The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
(NHS) in England towards a single, centrally-mandated electronic care record for patients and to connect 30,000
general practitioners to 300 hospitals, providing secure and audited access to these records by authorised health professionals.
On 31 March 2013, NHS Connecting for Health ceased to exist, and some projects and responsibilities were taken over by
Health and Social Care Information Centre
NHS Digital is the trading name of the Health and Social Care Information Centre, which is the national provider of information, data and IT systems for commissioners, analysts and clinicians in health and social care in England, particularly th ...
.
History
Contracts for the NPfIT spine and five clusters were awarded in December 2003 and January 2004.
It was planned that patients would also have access to their records online through a service called HealthSpace. NPfIT was said by NHS CFH to be "the world's biggest civil information technology programme".
The cost of the programme, together with its ongoing problems of management and the withdrawal or sacking of two of the four IT providers, placed it at the centre of controversy, and the Commons
Public Accounts Committee repeatedly expressed serious concerns over its scope, planning, budgeting, and practical value to patients.
As of January 2009, while some systems were being deployed across the NHS, other key components of the system were estimated to be four years behind schedule, and others had yet to be deployed outside individual
primary care trust
Primary care trusts (PCTs) were part of the National Health Service in England from 2001 to 2013. PCTs were largely administrative bodies, responsible for commissioning primary, community and secondary health services from providers. Until 31 May ...
s (PCTs).
''
The Guardian
''The Guardian'' is a British daily newspaper. It was founded in 1821 as ''The Manchester Guardian'', and changed its name in 1959. Along with its sister papers ''The Observer'' and ''The Guardian Weekly'', ''The Guardian'' is part of the Gu ...
'' noted that the announcement from the Department of Health on 9 September, had been "part of a process towards localising NHS IT that has been under way for several years". In 2011 remaining aspects of the National Programme for IT were cancelled, and most of the spending would proceed with the Department of Health seeking for local software solutions rather than a single nationally imposed system.
On 31 March 2013, NHS Connecting for Health ceased to exist, and some projects and responsibilities were taken over by
Health and Social Care Information Centre
NHS Digital is the trading name of the Health and Social Care Information Centre, which is the national provider of information, data and IT systems for commissioners, analysts and clinicians in health and social care in England, particularly th ...
.
In August 2018, NHS launched a healthcare finance innovation initiative to identify solutions which could streamline financial operations.
Structure and scope
The programme was established in October 2002 following several Department of Health reports on ''IT Strategies for the NHS'', and on 1 April 2005 a new agency called NHS Connecting for Health (CfH) was formed to deliver the programme. CfH absorbed both staff and workstreams from the abolished
NHS Information Authority
The NHS Information Authority (NHSIA) was part of the United Kingdom, UK National Health Service (NHS). It was established as a NHS special health authority by an Act of Parliament in April 1999. With headquarters in Birmingham, UK, its aim was ...
, the organisation it replaced. CfH was based in
Leeds
Leeds () is a city and the administrative centre of the City of Leeds district in West Yorkshire, England. It is built around the River Aire and is in the eastern foothills of the Pennines. It is also the third-largest settlement (by populati ...
, West Yorkshire. By 2009, it was still managed nationally by CfH, with responsibility for delivery shared with the chief executives of the ten
strategic health authorities
Strategic health authorities (SHA) were part of the structure of the National Health Service (England), National Health Service in England between 2002 and 2013. Each SHA was responsible for managing performance, enacting directives and implementin ...
.
The programme represented a significant shift to national priorities over local priorities.
Reviews
The refusal of the Department of Health to make "concrete, objective information about NPfIT's progress
..available to external observers", nor even to
MPs, attracted significant criticism, and was one of the issues which in April 2006 prompted 23 academics
[Signatories of the open letter to the Health Select Committee: Ross Anderson, Professor of Security Engineering, Cambridge University;
James Backhouse, director, Information System Integrity Group, London School of Economics;
David Bustard, Professor and Head of Computing and Information Engineering, University of Ulster;
Ewart Carson, Professor of Systems Science, Centre for Health Informatics, City University;
Patrik O'Brian Holt, professor, School of Computing, The Robert Gordon University;
Roland Ibbett, professor, School of Informatics, University of Edinburgh;
]Ray Ison
Raymond L. (Ray) Ison (born 3 July 1952, Bathurst, NSW, Australia) is an Australian-British cybernetician, systems scholar/scientist, and Professor of Systems at the Open University in the UK. He is currently President of the International Fede ...
, Professor of Systems, The Open University;
Achim Jung, professor, School of Computer Science, University of Birmingham;
Frank Land, Emeritus Professor, Information Systems Department, London School of Economics;
Bev Littlewood, Professor of Software Engineering, City University;
John A McDermid, Professor of Software Engineering, University of York;
Julian Newman, Professor of Computing, Glasgow Caledonian University;
Brian Randell
Brian Randell (born 1936) is a British computer scientist, and Emeritus Professor at the School of Computing, Newcastle University, United Kingdom. He specialises in research into software fault tolerance and dependability, and is a noted auth ...
, professor, School of Computing Science, University of Newcastle;
Uday Reddy, professor, School of Computer Science, University of Birmingham;
Peter Ryan, Professor of Computing Science, University of Newcastle;
Geoffrey Sampson, professor, Department of Informatics, University of Sussex;
Martin Shepperd, Professor of Software Technologies, Brunel University;
Michael Smith, Visiting Professor, Department of Computer Science, University College London;
Tony Solomonides, Reader in Computer Science and Medical Informatics, University of the West of England; Ian Sommerville, professor, Computing Department, Lancaster University;
Harold Thimbleby
Harold W. Thimbleby (born 19 July 1955) is a British professor of computer science at Swansea University, Wales. He is known for his works on user interface design within the realm of human computer interaction.
Overview
Harold Thimbleby he ...
, Professor of Computer Science, Swansea University;
Martyn Thomas, Visiting Professor of Software Engineering, Computing Laboratory, Oxford University;
Colin Tully, Professor of Software Practice, School of Computing Science, Middlesex University in computer-related fields to raise concerns about the programme in an open letter to the
Health Select Committee
The Health and Social Care Select Committee (abbreviated to HSC, HSCC and HSCSC) is a Departmental Select Committee of the British House of Commons, the lower house of the United Kingdom Parliament. Its remit is to examine the policy, administr ...
.
[
][
] On 6 October 2006 the same signatories wrote a second open letter
[
]
A report by the
King's Fund
The King's Fund is an independent think tank, which is involved with work relating to the health system in England. It organises conferences and other events.
Since 1997, they have jointly funded a yearly award system with GlaxoSmithKline. Th ...
in 2007 also criticised the government's "apparent reluctance to audit and evaluate the programme", questioning their failure to develop an ICT strategy whose benefits are likely to outweigh costs and the poor evidence base for key technologies.
A report by the Public Accounts Committee in 2009 called the risks to the successful deployment of the system "as serious as ever", adding that key deliverables at the heart of the project were "way off the pace", noting that "even the revised completion date of 2014–2015 for these systems now looks doubtful in the light of the termination last year of Fujitsu's contract covering the South", and concluding "essential systems are late, or, when deployed, do not meet expectations of clinical staff".
The initial reports into the feasibility of the scheme, known to have been conducted by
McKinsey
McKinsey & Company is a global management consulting firm founded in 1926 by University of Chicago professor James O. McKinsey, that offers professional services to corporations, governments, and other organizations. McKinsey is the oldest and ...
, and subsequent reports by IT industry analyst Ovum among others have never been published nor made available to MPs.
Costs
Originally expected to cost
£2.3 billion (bn) over three years, in June 2006 the total cost was estimated by the
National Audit Office to be £12.4bn over 10 years, and the NAO also noted that "...it was not demonstrated that the financial value of the benefits exceeds the cost of the Programme".
Similarly, the British Computer Society (2006) concluded that "...the central costs incurred by NHS are such that, so far, the value for money from services deployed is poor".
Officials involved in the programme have been quoted in the media estimating the final cost to be as high as £20bn, indicating a
cost overrun
A cost overrun, also known as a cost increase or budget overrun, involves unexpected incurred costs. When these costs are in excess of budgeted amounts due to a value engineering underestimation of the actual cost during budgeting, they are known ...
of 440% to 770%.
In April 2007, the
Public Accounts Committee of the
House of Commons
The House of Commons is the name for the elected lower house of the bicameral parliaments of the United Kingdom and Canada. In both of these countries, the Commons holds much more legislative power than the nominally upper house of parliament. ...
issued a damning 175-page report on the programme. The Committee chairman,
Edward Leigh
Sir Edward Julian Egerton Leigh (born 20 July 1950) is a British Conservative Party politician who has served as a Member of Parliament (MP) since 1983.
Leigh has represented Gainsborough, Lincolnshire in the House of Commons since 1983 (repr ...
, claimed "This is the biggest IT project in the world and it is turning into the biggest disaster." The report concluded that, despite a probable expenditure of 20 billion pounds "at the present rate of progress it is unlikely that significant clinical benefits will be delivered by the end of the contract period."
In September 2013, the Public Accounts Committee said that although the National Programme for IT had been effectively disbanded in 2011, some large regional contracts and other costs remained outstanding and were still costing the public dearly. It described the former National Programme for IT as one of the "worst and most expensive contracting fiascos" ever.
The costs of the venture should have been lessened by the contracts signed by the IT providers making them liable for huge sums of money if they withdrew from the project; however, when
Accenture
Accenture plc is an Irish-American professional services company based in Dublin, specializing in information technology (IT) services and consulting. A ''Fortune'' Global 500 company, it reported revenues of $61.6 billion in 2022. Accentur ...
withdrew in September 2006, then Director-General for NPfIT
Richard Granger
Richard Granger (born c.1965) is a British management consultant and former UK civil servant who was Director General for the NHS's information technology project, Connecting for Health.
Early career
Granger worked for Andersen Consulting (now ...
charged them not £1bn, as the contract permitted, but just £63m.
Granger's first job was with
Andersen Consulting
Accenture plc is an Irish-American professional services company based in Dublin, specializing in information technology (IT) services and consulting. A ''Fortune'' Global 500 company, it reported revenues of $61.6 billion in 2022. Accentur ...
,
which later became Accenture.
Deliverables
The programme was divided into a number of key deliverables.
*NHSmail was renamed to ''Contact'' in late 2004, before being reverted to NHSmail in April 2006.
The Spine (including PDS and PSIS)
The Spine is a set of national services used by the NHS Care Record Service. These include:
*The Personal Demographics Service (PDS), which stores demographic information about each patient and their
NHS number
NHS numbers are the unique numbers allocated in a shared numbering scheme to registered users of the three public health services in England, Wales and the Isle of Man. It is the key to the identification of patients, especially in delivering safe ...
. Patients cannot opt-out from this component of the spine, although they can mark their record as 'sensitive' to prevent their contact details being viewed by 831,000 staff.
*The Summary Care Record (SCR). The
Summary Care Record
A Summary Care Record (SCR) is an electronic patient record, a summary of National Health Service patient data held on a central database covering England, part of the NHS National Programme for IT. The purpose of the database is to make patient d ...
is a summary of patient's clinical information, such as allergies and adverse reactions to medicine.
*The Secondary Uses Service (SUS), which uses data from patient records to provide anonymised and pseudonymised business reports and statistics for research, planning and public health delivery.
The Spine also provides a set of security services, to ensure access to information stored on the Spine is appropriately controlled. These security measures were queried during the early stages of Spine development, with leaked internal memos seen by the ''
Sunday Times
''The Sunday Times'' is a British newspaper whose circulation makes it the largest in Britain's quality press market category. It was founded in 1821 as ''The New Observer''. It is published by Times Newspapers Ltd, a subsidiary of News UK, whi ...
'' mentioning "fundamental" design flaws. In addition, government spokeswoman Caroline Flint failed to dispel concerns regarding access to patients' data by persons not involved in their care when she commented in March 2007 that "''in general'' only those staff who are working as part of a team that is providing a patient with care, that is, those having a legitimate relationship with the patient, will be able to see a patient's health record."
The Spine was migrated to a new system in August 2014.
Exceptions
The NHS in
Wales
Wales ( cy, Cymru ) is a Countries of the United Kingdom, country that is part of the United Kingdom. It is bordered by England to the Wales–England border, east, the Irish Sea to the north and west, the Celtic Sea to the south west and the ...
was also running a national programme for service improvement and development via the use of information technology – this project was called
Informing Healthcare
Informing Healthcare was set up by the Welsh Assembly Government in December 2003, to improve healthcare services for people in Wales by introducing modern ways of sharing and using information.
It is one of the key enablers for 'Designed For L ...
. A challenge facing both NHS CFH and Informing Healthcare was that the use of national systems previously developed by the NHS Information Authority were shared by both of these organisations and the Isle of Man. Separate provision needed to be made for devolution, while maintaining links for patients travelling across national borders.
NPfIT was focussed on delivering the NHS Care Record Service to GPs, acute and primary hospitals, medical clinics and local hospitals and surgeries. While there were no immediate plans to include opticians or dentists in the electronic care record, services are delivered to these areas of the NHS.
Clusters and local service providers
The programme originally divided England into five areas known as "clusters": Southern, London, East & East Midlands, North West & West Midlands, and North East. For each cluster, a different ''Local Service Provider'' (LSP) was contracted to be responsible for delivering services at a local level. This structure was intended to avoid the risk of committing to one supplier which might not then deliver; by having a number of different suppliers implementing similar systems in parallel, a degree of competition would be present which would not be if a single national contract had been tendered. Four clusters were awarded in two tranches on 8 and 23 December 2003,
with the fifth on 26 January 2004.
However, in July 2007
Accenture
Accenture plc is an Irish-American professional services company based in Dublin, specializing in information technology (IT) services and consulting. A ''Fortune'' Global 500 company, it reported revenues of $61.6 billion in 2022. Accentur ...
withdrew from their 2 clusters, and in May 2008
Fujitsu
is a Japanese multinational information and communications technology equipment and services corporation, established in 1935 and headquartered in Tokyo. Fujitsu is the world's sixth-largest IT services provider by annual revenue, and the la ...
had their contract terminated, meaning that half the original contractors had dropped out of the project.
As of May 2008, two IT providers were LSPs for the main body of the programme:
*
Computer Sciences Corporation
Computer Sciences Corporation (CSC) was an American multinational corporation that provided information technology (IT) services and professional services. On April 3, 2017, it merged with the Enterprise Services line of business of HP Ente ...
(CSC) – North, Midlands & Eastern (NME) cluster
BT Health London(formerly BT Capital Care Alliance) – London cluster
*
Accenture
Accenture plc is an Irish-American professional services company based in Dublin, specializing in information technology (IT) services and consulting. A ''Fortune'' Global 500 company, it reported revenues of $61.6 billion in 2022. Accentur ...
had full responsibility for the North East and East/East Midlands clusters until January 2007, when it handed over the bulk of its responsibilities to the CSC, retaining responsibility for
Picture archiving and communication system
A picture archiving and communication system (PACS) is a medical imaging technology which provides economical storage and convenient access to images from multiple modalities (source machine types). Electronic images and reports are transmitted ...
(PACS) rollout only.
*
Fujitsu
is a Japanese multinational information and communications technology equipment and services corporation, established in 1935 and headquartered in Tokyo. Fujitsu is the world's sixth-largest IT services provider by annual revenue, and the la ...
– had responsibility for the Southern cluster until May 2008 when their contract was terminated.
Most of their responsibilities were subsequently transferred to BT Health except for PACS which was transferred to the CSC Alliance.
Local ownership
In the first half of 2007,
David Nicholson announced the "National Programme, Local Ownership programme" (known as "NLOP") which dissolved the 5 clusters and devolved responsibility for the delivery of the programme to the ten English
strategic health authorities
Strategic health authorities (SHA) were part of the structure of the National Health Service (England), National Health Service in England between 2002 and 2013. Each SHA was responsible for managing performance, enacting directives and implementin ...
(SHAs). Connecting for Health retains responsibility for the contracts with the LSPs.
Under NLOP, staff employed by CfH in the clusters had their employment transferred to the SHAs, with some being recruited to revised national CfH posts.
National Application Service Providers
In addition to these LSPs the programme appointed National Application Service Providers (NASPs) who were responsible for services that were common to all users, ''e.g.''
Choose and Book
Choose and Book was an E-Booking software application for the National Health Service (NHS) in England which enabled patients needing an outpatient appointment to choose which hospital they were referred to by their general practitioner (GP), an ...
and the national elements of the NHS Care Records Service that supported the summary patient record and ensure patient confidentiality and information security. As of October 2005, the NASPs were:
*
BT –
NHS Care Records Service
The NHS Care Records Service is a service provided by NHS Connecting for Health for the National Health Service in England
England is a country that is part of the United Kingdom. It shares land borders with Wales to its west and Scotland ...
and
N3
*
Atos Origin
Atos is a European multinational information technology (IT) service and consulting company headquartered in Bezons, France and offices worldwide. It specialises in hi-tech transactional services, unified communications, cloud, big data and ...
and
Cerner
Cerner Corporation is an American supplier of health information technology (HIT) services, devices, and hardware. As of February 2018, its products were in use at more than 27,000 facilities around the world. The company had more than 29,000 emp ...
– Choose & Book
*
Cable and Wireless – NHSmail
Changes to service providers
In March 2004,
EDS had their 10-year contract to supply the NHSMail service terminated. On 1 July 2004, Cable and Wireless were contracted to provide this service, which was initially renamed ''Contact''.
IDX Systems Corporation was removed from the Southern Cluster Fujitsu Alliance in August 2005 following repeated failure to meet deadlines.
They were replaced in September 2005 by
Cerner Corporation
Cerner Corporation is an American supplier of health information technology (HIT) services, devices, and hardware. As of February 2018, its products were in use at more than 27,000 facilities around the world. The company had more than 29,000 emp ...
.
In early 2006, ComMedica's contract for supply of
PACS to the North-West/West-Midlands cluster was terminated, and they were replaced by GE Healthcare.
In July 2006, the London region started the contractual replacement of IDX (which had been bought out by GE Healthcare in January 2006) as its supplier. Systems for secondary care, primary care and community and mental health services are proposed by BT to be provided by
Cerner
Cerner Corporation is an American supplier of health information technology (HIT) services, devices, and hardware. As of February 2018, its products were in use at more than 27,000 facilities around the world. The company had more than 29,000 emp ...
, INPS (formerly in Practice Systems) and CSE Healthcare Systems, part of the CSE-Global group of companies, respectively. This is subject to contractual negotiation known as 'CCN2'.
In September 2006, the CSC Alliance, Accenture and Connecting for Health signed a tripartite agreement that as of January 2007, the CSC Alliance would take over the responsibility for the majority of care systems the North East and Eastern clusters from Accenture, with the exception of
PACS. As part of the handover process, around 300 Accenture personnel transferred under a
TUPE
The Transfer of Undertakings (Protection of Employment) Regulations 2006 known colloquially as TUPE and pronounced , are the United Kingdom's implementation of the European Union Transfer of Undertakings Directive. It is an important part of UK la ...
process to CSC, and CSC took over the leases for some of Accenture's premises in
Leeds
Leeds () is a city and the administrative centre of the City of Leeds district in West Yorkshire, England. It is built around the River Aire and is in the eastern foothills of the Pennines. It is also the third-largest settlement (by populati ...
. Accenture now retains only a small presence in the city for the delivery of its PACS responsibilities.
In May 2008 it was announced that following the failure to conclude renegotiation of the contract for the Southern Cluster, CfH terminated the contract with Fujitsu. The majority of the Southern Cluster care systems were subsequently transferred to BT Health except for PACS which was transferred to the CSC Alliance, aligning with the technology deployed by each company.
Criticisms
Failure to deliver clinical benefits
The 2009 Public Accounts Committee (PAC) report noted, that the NPfIT had provided "little clinical functionality... to-date". The PAC report of 18 July 2011 said it failed to deliver clinical benefits.
Data security risks
NPfIT has been criticised for inadequate attention to security and patient privacy, with the Public Accounts Committee noting "patients and doctors have understandable concerns about data security", and that the Department of Health did not have a full picture of data security across the NHS.
In 2000, the NHS Executive won the "Most Heinous Government Organisation"
Big Brother Award
The Big Brother Awards (BBAs) recognize "the government and private sector organizations ... which have done the most to threaten personal privacy". They are named after the George Orwell character Big Brother from the novel ''Nineteen Eigh ...
from
Privacy International
Privacy International (PI) is a UK-based registered charity that defends and promotes the right to privacy across the world. First formed in 1990, registered as a non-profit company in 2002 and as a charity in 2012, PI is based in London. Its cu ...
for its plans to implement what would become the NPfIT. In 2004 the NPfIT won the "Most Appalling Project"
Big Brother Award
The Big Brother Awards (BBAs) recognize "the government and private sector organizations ... which have done the most to threaten personal privacy". They are named after the George Orwell character Big Brother from the novel ''Nineteen Eigh ...
''because of its plans to computerise patient records without putting in place adequate privacy safeguards''.
The balance between the right to privacy and the right to the best quality care is a sensitive one. Also there are sanctions against those who access data inappropriately, specifically instant dismissal and loss of professional registration.
A January 2005 survey among doctors indicated that support for the initiative as an 'important NHS priority' had dropped to 41%, from 70% the previous year. There have been concerns raised by clinicians that clinician engagement has not been addressed as much as might be expected for such a large project.
Concerns over confidentiality, and the security of medical data uploaded to the Spine have also led to opposition from civil liberties campaigners such as
NO2ID
NO2ID is a public campaign group, formed in 2004 to campaign against the United Kingdom government's plans to introduce UK ID Cards and the associated National Identity Register (NIR), which it believes has negative implications for privacy, civ ...
the anti-database state pressure group and The Big Opt Out who provide patients with a letter to send to their doctor so that their records are withheld from the database.
Reservations of medical staff
As of 5 August 2005, research carried out across the NHS in England suggested that clinical staff felt that the programme was failing to engage the clinicians fully, and was at risk of becoming a
white elephant
A white elephant is a possession that its owner cannot dispose of, and whose cost, particularly that of maintenance, is out of proportion to its usefulness. In modern usage, it is a metaphor used to describe an object, construction project, sch ...
. The Public Accounts Committee observed in 2009 that "the current levels of support reflect the fact that for many staff the benefits of the Programme are still theoretical".
Surveys in 2008 suggested that two-thirds of doctors would refuse to have their own medical records on the system.
Impact on IT providers
According to the Daily Telegraph, the head of NPfIT, Richard Granger, 'shifted a vast amount of the risk associated with the project to service providers, which have to demonstrate that their systems work before being paid.' The contracts meant that withdrawing from the project would leave the providers liable for 50% of the value of the contract; however, as previously mentioned, when Accenture withdrew in September 2006, Granger chose not to use these clauses, saving Accenture more than £930m.
The programme's largest software provider
iSOFT
iSOFT is an international supplier of software applications for the healthcare sector. Its products are used by an estimated 13,000 organisations in 40 countries for managing patient information and healthcare services. It was acquired by DXC Te ...
has been seriously affected by this process and is under investigation by the UK
Financial Services Authority
The Financial Services Authority (FSA) was a quasi-judicial body accountable for the financial regulation, regulation of the financial services industry in the United Kingdom between 2001 and 2013. It was founded as the Securities and Investmen ...
for irregular accounting. On 28 September 2006, the consultancy
Accenture
Accenture plc is an Irish-American professional services company based in Dublin, specializing in information technology (IT) services and consulting. A ''Fortune'' Global 500 company, it reported revenues of $61.6 billion in 2022. Accentur ...
announced its intention to withdraw from £2bn of 10-year contracts with NPfIT, which were taken over in January 2007 by the CSC Alliance – both Accenture and CSC laid blame with iSOFT, although CSC has said it will be retaining iSOFT as its software provider for all its clusters. Earlier in the year Accenture had written off $450m from its accounts because of 'significant delays' in the programme. iSOFT announced in March 2011 that trading in its shares would be suspended pending a corporate announcement. Subsequently, in April 2011, the company announced that it was recommending a cash offer from CSC. CSC acquired iSOFT in August 2011.
In September 2018 it was reported that
Fujitsu
is a Japanese multinational information and communications technology equipment and services corporation, established in 1935 and headquartered in Tokyo. Fujitsu is the world's sixth-largest IT services provider by annual revenue, and the la ...
was to be paid "hundreds of millions of pounds" in settlement of a legal dispute stretching back to the National Programme for IT when their £896 million contract was terminated. Substantial payments had also been made to CSC.
Implementation
The first trusts in the London and Southern clusters to implement the new
Cerner
Cerner Corporation is an American supplier of health information technology (HIT) services, devices, and hardware. As of February 2018, its products were in use at more than 27,000 facilities around the world. The company had more than 29,000 emp ...
system found it problematic, with
hospital trust
A hospital trust, also known as an acute trust, is an NHS trust that provides secondary health services within the English National Health Service and, until they were abolished, in NHS Wales. Hospital trusts were commissioned to provide these s ...
board minutes revealing a catalogue of errors. Difficulties with the system meant that:
*2007:
Enfield
Enfield may refer to:
Places Australia
* Enfield, New South Wales
* Enfield, South Australia
** Electoral district of Enfield, a state electoral district in South Australia, corresponding to the suburb
** Enfield High School (South Australia)
...
PCT were unable to obtain vital data on patients awaiting operations and were obliged to delay 63 patients of the
Barnet
Barnet may refer to:
People
*Barnet (surname)
* Barnet (given name)
Places United Kingdom
*Chipping Barnet or High Barnet, commonly known as Barnet, one of three focal towns of the borough below.
*East Barnet, a district of the borough below; an ...
and
Chase Farm hospitals. Further, 20 patients were not readmitted for treatment within 28 days towards the end of the year because the surveillance system for tracking them "was not operational in the new ... system".
Buckinghamshire Hospitals NHS Trust found that problems with the system had meant potentially infectious patients with
MRSA
Methicillin-resistant ''Staphylococcus aureus'' (MRSA) is a group of Gram-positive bacteria that are genetically distinct from other strains of ''Staphylococcus aureus''. MRSA is responsible for several difficult-to-treat infections in humans. ...
were not isolated for up to 17 days, requiring six weeks work by staff to update them manually.
*April 2008: Enfield PCT found that the system had failed to flag up possible child-abuse victims entering hospital to key staff, "leaving the responsibility to the receptionist"
*May 2008: Enfield PCT found that 272 elective operations were cancelled at the last minute for "non-clinical reasons"
*May 2008:
Barts and The London NHS Trust
Barts Health NHS Trust is an NHS trust based in London, England. Established in 2012, it runs five hospitals throughout the City of London and East London, and is one of the largest NHS trusts in England.
History
The trust was established on ...
blamed their failure over the preceding six months to meet targets for treating emergency patients within four hours on staff not being familiar with the new computer system. The same report cited "breaches of the two-week urgent cancer access guarantee" and delays in assessing 11 patients with possible cancer as being due to the computer system.
*July 2008: the
Royal Free Hampstead NHS Trust
The Royal Free London NHS Foundation Trust (formerly the Royal Free Hampstead NHS Trust) is an NHS foundation trust based in London, United Kingdom. It comprises Royal Free Hospital, Barnet Hospital, Chase Farm Hospital, as well as clinics run ...
said 12,000 patient records had to be manually amended over a three-week period due to the system, and noted that "The outpatient appointment centre has experienced a significant increase in the time taken to process individual patient appointment bookings. This has had a consequent and negative effect on call-answer performance."
Management team
The NHS appointed a management team, responsible for the delivery of the system:
In October 2002,
Richard Granger
Richard Granger (born c.1965) is a British management consultant and former UK civil servant who was Director General for the NHS's information technology project, Connecting for Health.
Early career
Granger worked for Andersen Consulting (now ...
the former Director General of IT for the NHS, took up his post before which he was a partner at
Deloitte Consulting
Deloitte Touche Tohmatsu Limited (), commonly referred to as Deloitte, is an international professional services network headquartered in London, England. Deloitte is the largest professional services network by revenue and number of profession ...
, responsible for procurement and delivery of a number of large scale IT programmes, including the
Congestion Charging Scheme for London. In October 2006, he was suggested by ''
The Sunday Times
''The Sunday Times'' is a British newspaper whose circulation makes it the largest in Britain's quality press market category. It was founded in 1821 as ''The New Observer''. It is published by Times Newspapers Ltd, a subsidiary of News UK, whi ...
'' to be the highest paid civil servant, on a basic of £280,000 per year, £100,000 per year more than then-Prime Minister Tony Blair. Granger announced on 16 June 2007 that he would leave the agency "during the latter part" of 2007. In February 2008 Granger left the programme .
His credentials were questioned by his own mother, a campaigner for the preservation of local health services in her area, who expressed her amazement at his appointment, criticising the whole scheme as "a gross waste of money".
In 2009, overall leadership of CfH was described by the Public Accounts Committee as having been "uncertain" since the announcement that Richard Granger would be leaving the project.
See also
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Megaproject
A megaproject is an extremely large-scale investment project.
According to the ''Oxford Handbook of Megaproject Management'', "Megaprojects are large-scale, complex ventures that typically cost $1 billion or more, take many years to develop and ...
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National Identity Register
The Identity Cards Act 2006 (c. 15) was an Act of the Parliament of the United Kingdom that was repealed in 2011. It created national identity cards, a personal identification document and European Economic Area travel document, linked to a ...
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Citizen Information Project
In the United Kingdom, the Citizen Information Project (CIP) was a plan by the Office for National Statistics to build a national population register.
On 18 April 2006 it was announced that instead of continuing as a separate project, it would be ...
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Cost overrun
A cost overrun, also known as a cost increase or budget overrun, involves unexpected incurred costs. When these costs are in excess of budgeted amounts due to a value engineering underestimation of the actual cost during budgeting, they are known ...
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Universal Child Database
ContactPoint was a government database in England that provided a way for those working with children and young people to find out who else is working with the same child or young person, making it easier to deliver more coordinated support. It ...
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Medical privacy
Medical privacy or health privacy is the practice of maintaining the security and confidentiality of patient records. It involves both the conversational discretion of health care providers and the security of medical records. The terms can also r ...
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Health Informatics
Health informatics is the field of science and engineering that aims at developing methods and technologies for the acquisition, processing, and study of patient data, which can come from different sources and modalities, such as electronic hea ...
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N3 (NHS)
The Health and Social Care Network (HSCN) is a standards-based network that replaced the N3 network in the National Health Service (NHS) in England. It went live in April 2017. Transition to the new network was completed by November 2020.
Histor ...
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NHS Care Records Service
The NHS Care Records Service is a service provided by NHS Connecting for Health for the National Health Service in England
England is a country that is part of the United Kingdom. It shares land borders with Wales to its west and Scotland ...
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NHS-wide Clearing Service
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Choose and Book
Choose and Book was an E-Booking software application for the National Health Service (NHS) in England which enabled patients needing an outpatient appointment to choose which hospital they were referred to by their general practitioner (GP), an ...
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OPCS-4
OPCS-4, or more formally OPCS Classification of Interventions and Procedures version 4, is the procedural classification used by clinical coders within National Health Service (NHS) hospitals of NHS England, NHS Scotland, NHS Wales and Health ...
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Picture archiving and communication system
A picture archiving and communication system (PACS) is a medical imaging technology which provides economical storage and convenient access to images from multiple modalities (source machine types). Electronic images and reports are transmitted ...
(PACS)
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NHS Electronic Prescription Service
The NHS Electronic Prescription Service is part of the NHS National Programme for IT of the National Health Service in England. It enables the electronic transfer of medical prescriptions from doctors (or other prescribers) to pharmacies and other ...
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Quality Management and Analysis System
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NHSmail
NHSmail is an email, diary and directory system for National Health Service (NHS) employees in England and Scotland. The system is not for patients of the NHS. Retired NHS staff do not have access.
NHSmail previously allowed faxes to be sent, ...
References
External links
"A guide to the National Programme for Information Technology" (PDF) NHS Connecting for Health, April 2005
NHS Connecting for Health History PageBT Health Delivering three major contracts to the NHS as part of the NPfIT
NHS IT upgrade success 'at risk'
{{DEFAULTSORT:Nhs National Programme For It
2005 establishments in the United Kingdom
2013 disestablishments in the United Kingdom
Government databases in the United Kingdom
National Health Service (England)
Science and technology in England
Political scandals in England
Databases in England
Discontinued custom software projects
Electronic health record software