NHS IT system is four years late

A central plank of the £12bn programme to computerise the National Health Service is running at least four years late and won't be fully live until as late as 2015.



In its second probe into the NHS IT scheme, the National Audit Office said the tentative timetable to give every patient a personal e-care record has not been met.



Unlike some parts of the IT programme, which are now advanced or complete, e-care records are unlikely to be in every trust in England before 2014, not 2010 as hoped.



Of the NHS trusts with the system, all of them had technical problems with e-care records and some reported "dissatisfaction," most noticeably immediately after deployment.



But most NHS staff preferred the new system to its predecessor, despite some being critical because technical holes they had identified were still being ignored, the NAO found.



Full roll out of electronic care records is expected between 2014 and 2015, and is dependent on the successful implementation of iSoft's Lorenzo software.



"Until Lorenzo is available and has started to be deployed, there remains a particular uncertainty over timing in the North, Midlands and East," the NAO said.



Pointing to the N3 network, the release of the Spine, and the full roll out of picture archiving, imaging and X ray systems, the NAO said parts of the programme were now complete or established. It said "good progress" had been achieved against time.



However the group said "added functionality" has forced the overall costs of the scheme, trumpeted as the world's largest civil IT project, to increase from £12.4bn in 2006 to £12.7bn today.



But the costs are yet to be meted out: the long delay and IT suppliers being paid only when their provided systems work, means that as of March 2008, just £3.6bn has been spent, £2bn less than planned.



"Since the start of the programme, there has been an increase of £678 million (11 per cent) in the value of the core contracts, due mainly to the purchase of increased functionality, though there have been no increases in the cost of individual elements purchased under the original contracts," the NAO said.



"The remaining increases on the core contracts have resulted from supplier and sub-contractor changes. There have also been reductions in some cost estimates as costs have become more certain."



Over the last 18 months until March, the programme's suppliers, primarily IT contractors BT, Fujitsu, CSC and Cerner, have achieved most of their targets for system service availability.



The NAO reflected: "Suppliers have largely met the targets for service availability and performance deductions have been applied where there have been service failures.



"Trusts have experienced some technical problems in using the new care records systems, especially in the period following a deployment."



The group added that some benefits from the programme, including financial savings, are starting to emerge, but work to identify and measure the actual and potential benefits is at a "very early stage."



"At trust level, the picture archiving and communications systems have yielded the most tangible benefits to date, for example in helping to reduce diagnostic waiting times," the watchdog said.



"The programme has also brought wider benefits, such as improved IT skills among NHS staff. There is a large amount of work now to be done on benefits realisation, in particular to drive benefits from the new care records systems at local level where the strategic health authorities and trusts have so far focused largely on the practicalities of getting the systems deployed."



Despite gloomy surveys in the past, and although some trusts still need to be convinced, the latest pulse for NHS IT is good, as two-thirds of clinicians expect the programme to improve patient care.