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Delivering the National Programme for IT in the NHS is proving to be an enormous challenge. All elements of the Programme are advancing and some are complete, but the original timescales for the electronic Care Records Service, one of the central elements of the Programme, turned out to be unachievable, raised unrealistic expectations and put confidence in the Programme at risk.

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Today’s progress report on the Programme by the National Audit Office concludes that the original vision remains intact and still appears feasible. However, it is likely to take until 2014-15 before every NHS Trust in England has fully deployed the care records systems, four years later than planned. In the North, Midlands and East area, the software has taken much longer to develop than planned, so some Trusts have had to take an interim system. Completing the development of the system and introducing it in this area are significant challenges still to be addressed.

The estimated cost of the Programme is £12.7 billion. The costs of the main contracts have remained broadly unchanged, aside from the purchase of increased functionality. Because of the delay in deployments, actual expenditure to date (£3.6 billion by 31 March 2008) has been much lower than expected. Planned ‘go live’ dates were missed for many of the first Trusts to take the new care records systems and the NHS and suppliers are now increasing their emphasis on establishing realistic timelines for deployments, reflecting the circumstances of each individual Trust.

According to today’s report, the success of the Programme will depend on the commitment of NHS staff. The Department’s latest survey, conducted in spring 2007, showed that 67 per cent of nurses and 62 per cent of doctors expected the new systems to improve patient care. Identifying and realising the benefits of the systems are essential to raising confidence further and convincing all staff of the value of the Programme. The Department reported on the benefits of the Programme for the first time in March 2008.

"The scale of the challenge involved in delivering the National Programme for IT has proved to be far greater than envisaged at the start, with serious delays in delivering the new care records systems. Progress is being made, however, and financial savings and other benefits are beginning to emerge. The priority now is to finish developing and deploying care records systems that will help NHS Trusts to achieve the Programme’s intended benefits of improved services and better patient care."

Tim Burr, head of the National Audit Office

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