NHS e-records: Can DoH turn off the life support?

Why the Department of Health is locked into a failed project...

A damning report from public spending watchdog the NAO has again cast doubt on the future of the NHS patient records project. That's hardly surprising because it's a scheme with no apparent beneficiaries, says silicon.com's Nick Heath.

Spending almost £3bn on a project that pleases no one is an act of incompetence. But burning through another £4bn by persisting with that same doomed endeavour amounts to lunacy.

There appear to be no winners in the Department of Health's project to create electronic patient records.

Not the GP surgeries and hospitals that are waiting for thousands of new patient records systems to be delivered, stuck with interim systems while they bide their time for upgrades that are years overdue.

Not the Department of Health, which has spent £2.7bn on a project that has failed to deliver even a fraction of its vision of a detailed electronic record for all NHS patients in England.

Not the patients, who have seen minimal improvement to their care as a result of the new IT systems being fitted.

Medical records

Despite problems implementing care records systems, the government could find it difficult to extricate itself from its existing contracts with suppliersPhoto: Shutterstock

Not even the suppliers, which only get paid on delivery and so have seen their returns diminished by the project's frequent delays.

Yet the participants in this unhappy marriage seem to be locked together, condemned by contractual arrangements to march on grimly, hand in hand.

Speaking at a public accounts committee hearing this week, the government's chief operating officer Ian Watmore spelled out the legal reasons why it may be impossible to bail out on large IT projects early.

"You get into a dilemma on these things. They are never black and white when it comes to it, because one person's delay and overrun is another person's change of mind," he said.

"The lawyers have a field day in this territory... because it is really hard to pin down and say, 'You failed, and the reason why was nothing to do with something that we did differently', such as a minister changing their mind or a policy being changed.

"It is really hard to get the contractual penalties lined up."

The government is already locked in legal negotiations with Fujitsu as it tries to tie up the loose ends that arose from Fujitsu's early departure from the NHS National Programme for IT in 2008, and is unlikely to be keen to repeat the experience.

And while both Cameron and the DoH have said the care records project's largest supplier, CSC, could lose its £3bn contract following repeated delays in the delivery of care records systems, a Cabinet Office review of the programme in September 2010 said its existing contracts would be substantially honoured.

The government may be able to avoid a repeat of the care records project disaster through its pledge to favour IT projects weighing in at no more than £100m.

But in the meantime, Cameron and co have a sticky mess from which to extract themselves.

Failing to do so will cost the health service £4.3bn at a time when the service is being asked to save £20bn.

Given its chequered history, the care records project has more than earned its place on the chopping block.