After months of speculation, the NHS and the director general of NHS IT, Richard Granger, have escaped censure from the National Audit Office (NAO) which published its report on the NHS National Programme for IT on Friday.
According to the NAO report, total expenditure on the programme — now called Connecting for Health — is now estimated at £12.6bn. This is twice as high as the original estimate of £6.2bn but includes many more elements.
In May, the Minister for Health, Lord Warner, warned that costs could reach £20bn provided everything was taken into account including issues of training, installation and the costs of transferring data into new systems.
In its report published on Friday, the NAO praised the programme for the "substantial progress with the programme" and for "established management systems and structures to match the scale of the challenge". In particular it praised the programme for "successfully placed contracts very quickly, after securing large reductions in prices from bidders, and including contract terms that include important safeguards to secure value for money for the taxpayer".
Many in the industry have credited Granger for keeping the programme's many suppliers tied down to very tightly controlled contracts which punish those that don't deliver to deadline or overshoot on cost estimates.
Earlier this month, one of the main suppliers to the contract, iSoft, said it was reducing staff numbers and would have to re-state its accounts in part becaise of difficulties it was facing with the NHS business.
But while the overall message was positive, the NAO was critical of the NHS in three areas, mostly in the areas of communications and timekeeping.
The NHS needs to ensure "that the IT suppliers continue to deliver systems that meet the needs of the NHS", the report said while, in the main, agreeing that the NHS was delivering on its promises. But, the report said it was not delivering to, "agreed timescales" and needed to avoid "further slippage".
According to the report, those behind the national programme need to ensure that "NHS organisations can and do fully play their part in implementing the programme systems".
Most of all it was vital, the report said, that more is done to win the support of staff and the public "in making the best use of the systems to improve services".
The report proposed a number of areas in which the latter might be achieved, suggesting that Department of Health and the NHS should "prepare an annual published statement quantifying the benefits delivered by the national programme" which explained that the "main justification of the programme is to improve services to patients" and make clear that the goal was not "merely to make economies in providing pre-existing standards of service".
The report also suggested that the Department of Health, NHS Connecting for Health and the NHS should "commission a study to measure the impact of the Programme on local NHS IT expenditure — both costs and savings — where systems are now being deployed".