The National Audit Office has today published the findings from its investigation into the General Practice Extraction Service (GPES), an IT system designed to allow NHS organizations to extract data from all GP practice computer systems in England. This data would be used to monitor quality, plan and pay for health services and help medical research.
The key findings of the investigation are as follows:
The project has been significantly delayed and many customers have yet to receive data. The original business case said the service would start in 2009-10, but it took until April 2014 for Health and Social Care Information Centre (HSCIC) to provide the first GPES data extract to a customer.
Mistakes in the original procurement and contract management contributed to losses of public funds, through asset write-offs and settlements with suppliers. The total expected cost of the GPES programme increased from £14 million to £40 million during the planning and procurement stage. Further cost increases have been smaller, but the project has had at least £5.5 million of write-offs and delay costs. The need for the service remains and further public expenditure is needed to improve GPES or replace it.
Only one customer, NHS England has so far received data from GPES. The time needed to design a new type of extract and restrictions in the contracts severely limits HSCIC’s ability to provide data to those who request it. It is unlikely that GPES in its current form can provide the NHS-wide service planned.
These issues were brought to the attention of the National Audit Office through its financial audit of the HSCIC. The NAO observed during its visit that the system was not working as expected and that additional costs had been incurred through a settlement with one of the main suppliers, Atos IT Services UK Ltd.
Notes for Editors
This report is a National Audit Office Investigation. The NAO conducts investigations to establish the underlying facts in circumstances where concerns have been raised with us, or in response to intelligence that we have gathered through our wider work.
Unlike in secondary care, data collection and analysis in primary care is fragmented, despite primary care being responsible for approximately 90% of patients’ interactions with the NHS.
Work on the GPES project began in 2007, first by the NHS Information Centre, and then by the HSCIC. GPES would be able to extract statistics about a group of people (such as the number in in a practice receiving a particular diagnosis) and individual ‘patient level’ data. The NAO has examined progress from then until the present. On 31 March 2013, the NHS Information Centre closed and responsibility transferred to the new Health and Social Care Information Centre (HSCIC). The HSCIC combines the Department of Health's informatics functions (previously known as NHS Connecting for Health or CFH) and the former NHS Information Centre.
The NAO investigation did not examine the methods or policy adopted by the HSCIC to govern the use of patient identifiable data that could be extracted via GPES, or the wider Care.Data project. The NAO has not sought to assess the value for money of the GPES project overall.
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The National Audit Office scrutinises public spending for Parliament and is independent of government. The Comptroller and Auditor General (C&AG), Sir Amyas Morse KCB, is an Officer of the House of Commons and leads the NAO, which employs some 810 people. The C&AG certifies the accounts of all government departments and many other public sector bodies. He has statutory authority to examine and report to Parliament on whether departments and the bodies they fund have used their resources efficiently, effectively, and with economy. Our studies evaluate the value for money of public spending, nationally and locally. Our recommendations and reports on good practice help government improve public services, and our work led to audited savings of £1.15 billion in 2014.