£7bn NHS e-records plan faces failure, says watchdog

National Audit Office says patient records project will not hit its goals and represents poor value...

Hospitals and GP surgeries are still waiting for thousands of care records systems to be deployedPhoto: Shutterstock

A troubled £6.95bn NHS IT project will not achieve its aim of creating an electronic health record for every patient in England, according to the UK's public spending watchdog.

The goal of the project, part of the wider National Programme for IT, was for all 55 million patients to have a full electronic care record by 2010.

But a report by the National Audit Office (NAO) has found that GP surgeries and hospitals are still waiting for thousands of care records systems to be deployed.

Cuts to the project mean some health trusts will not get new systems, and those systems that will be delivered will not be in place until 2015-16. The revised timetable for delivery marks yet another delay to the project, which got underway in 2002.

None of the electronic patient records systems that have been delivered are providing the full electronic patient record that the Department of Health (DoH) expected, the report says, with systems mainly providing administrative and not clinical benefits in hospitals.

The report concludes that the project has not been value for money for the DoH.

"Although some care records systems are in place, progress against plans has fallen far below expectations and the department has not delivered care records systems across the NHS, or with anywhere near the completeness of functionality that will enable it to achieve the original aspirations of the programme," the report says.

"The department has also significantly reduced the scope of the programme without a proportionate reduction in costs, and is in negotiations to reduce it further still.

"So we are seeing a steady reduction in value delivered, not matched by a reduction in costs.

"On this basis, we conclude that the £2.7bn spent on care records systems so far does not represent value for money, and we do not find grounds for confidence that the remaining planned spend of £4.3bn will be different."

In a statement, head of the NAO Amyas Morse said the NHS is now getting far fewer systems than planned despite the department paying contractors almost the same amount of money.

"This is yet another example of a department fundamentally underestimating the scale and complexity of a major IT-enabled change programme," said Morse.

He expressed a hope that a forthcoming review of the project by the Cabinet Office and Treasury "will help to prevent further loss of public value from future expenditure on the programme".

The report says progress on delivering care records systems has been slowest in the north and east of England and the Midlands, where only...

The NAO report says care records systems are not expected to be in place until 2015-16Photo: Shutterstock

...four out of 97 systems have been delivered to hospital trusts by the supplier CSC in seven years.

It is unlikely, an NAO statement accompanying the report says, that the remaining 97 systems will be able to be delivered by the new 2016 deadline, as this would require CSC to implement two systems a month over the next five years.

Both David Cameron and the DoH have stated that CSC could be terminated as a supplier of the care records systems. The CSC-led project suffered a setback recently when one of four trusts chosen to be early adopters of the care records system pulled out of the project.

A number of records systems have been delivered in London. However, cuts to the project mean BT, the care records supplier to London health trusts, will deliver systems to only half the originally planned hospital sites. The NAO report points out that this significant reduction in scope represents only a £73m saving on the £1.021bn cost of the contract.

The report says DoH changes to the project appear to have increased the average cost of deploying each care records system by at least 18 per cent per hospital trust in London.

But the report also found that the same care records system is costing on average 22 per cent more at three BT sites in the south of England than in London.

The DoH's new approach of moving away from replacing systems at health trusts and instead enhancing and integrating trusts' existing systems will cost at least £220m, the report says.

The DoH issued a statement defending the programme: "We do think the investment made so far in the NPfIT will potentially deliver value for money now that we have a more flexible approach that allows the local NHS to be in charge of its own requirements."

The Care Records Service project is part of the wider £11.4bn National Programme for IT, which is made up of a range of projects at varying stages of completion - including building a service to send patient records between GP surgeries, providing a national broadband network for the health service and creating a system to share X-rays and other scans between hospitals.

How many care records systems have been delivered?

• Hospital trusts: 19 out of 122 - 16 per cent
• Community health services: 95 out of 131 - 73 per cent
• Mental health trusts: 21 out of 56 - 37 per cent
• GP practices: 1,377 out of 4,400 - 31 per cent