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National Audit Office Press Notice

The 1992 and 1998 Information Management & Technology Strategies of the NHS Executive

HC 371 1998/99
28 April 1999
ISBN: 0102646996
Price: £11.10

Sir John Bourn, head of the National Audit Office, reported to Parliament today that the NHS Executive had spent £152 million on its 1992 Information Management & Technology Strategy, not including expenditure in the wider NHS. His report also covers the new IM&T Strategy launched in September 1998.

Sir John reports that the NHS Executive's 1992 Strategy successfully communicated a vision and a set of basic principles directed at the overall aim of providing information about patients to enable the NHS to deliver better health care. NHS organisations visited in the course of the study said that the Strategy had given direction to local IT developments. They also welcomed some projects designed to translate the vision of the Strategy in to practice. However, Sir John concludes that:

• a lack of overall objectives contributed to a lack of direction in implementation;
• while the Executive set objectives for individual projects, their business cases were not always complete in terms of specific, measurable and time related objectives, financial analysis and proposals for monitoring and evaluation;
• the Executive did not consider how all the projects related to each other, and overall, the Strategy lacked coherence;
• the impact of the strategy was limited because NHS bodies were not always clear about the purpose of projects and because of problems with their sequencing; and
• the Executive has not yet fully evaluated the impact of all the key projects.

Sir John finds that the 1998 Strategy represents an improvement in design in several important respects. The inclusion of overall objectives provides greater coherence, and the development of agreed local implementation plans should also help. The NHS Executive expects new liaison arrangements to provide better communication about the Strategy in the NHS, and it intends to achieve better co-ordination than with the 1992 Strategy through a Programme Management Framework. The new Strategy includes measures to increase the impact of specific projects, and the Executive also expects evaluation work to be done within the NHS.

However, Sir John:

• considers that the Strategy's objectives and targets should be made specific and measurable if they are to be useful in monitoring expenditure and achievements;
• is concerned that as with the 1992 Strategy, there is no overall business case, and he recommends that when business cases are produced for individual projects that they address interdependencies between them; and
• considers that there should be clearer plans for evaluation of the Strategy.

Notes for Editors

The Comptroller and Auditor General, Sir John Bourn, is the head of the National Audit Office employing some 750 staff. He and the NAO are totally independent of Government. He certifies the accounts of all Government departments and a wide range of other public sector bodies; and he has statutory authority to report to Parliament on the economy, efficiency and effectiveness with which departments and other bodies have used their resources.

Press Notice 33/99
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