£5bn NHS IT failure warning

The government's flagship £5bn NHS IT programme could be derailed by insufficient capacity and skills in the health service, poor evaluation of real health benefits and lack of consultation with doctors and nurses, according to a new report.

Public Value and e-Health by the influential Institute for Public Policy Research (IPPR) claims that while the potential benefits of better use of IT in the NHS are clear, there is still very little evidence to show that it is making a difference.

The IPPR examined over 40 different evaluation reports related to projects for the six key NHS IT services, including electronic patient records, electronic booking and electronic transfer of prescriptions.

"We were surprised by the disparity between the obvious potential benefits of using ICT more effectively in health and the paucity of evidence that these benefits are being delivered in practice," the report said.

This could be because there are no effective evaluation methods for these projects -- which in itself is worrying -- or because the benefits are not being realised.

Managing the change in business processes and working practices that will accompany the new IT systems is crucial to the success of the National Programme for IT in the NHS (NPfIT) and the IPPR report has highlighted two areas where barriers remain.

"There may simply be insufficient capacity within the NHS to cope with the magnitude of change that will be required. Inadequate funding, insufficient skilled staff and the competition of other priorities may mean that although ICT systems have been procured, the benefits delivered will not be as great as they might have been," the report said.

It also warns that control over NHS IT may have moved from being too devolved to being too centralised.

"This could potentially make systems insufficiently flexible to take account of useful variations in local working practices and might also lead to trailblazing NHS organisations being held back," the report said.

Jamie Bend, IPPR research fellow, said in the report: "Unless it's proven that things like electronic health records work, it will remain difficult to justify to doctors, nurses and patients existing and additional spending on ICT. Few of the problems with evaluation are new, yet they continue to occur and there is a perception that ICT projects have failed. This is not a reason to reject the use of ICT but to redouble efforts to use it effectively."

A spokeswoman for the NPfIT said in a statement in response to the IPPR report: "The National Programme has itself taken the lessons learnt from around the NHS including electronic patient record and electronic booking pilots to inform its work to ensure that the systems and services it is developing and implementing will bring benefits for clinicians and patients alike. The benefits realisation framework being developed by Aidan Halligan will enable individual trusts to assess, monitor and track benefits realisation throughout implementation."

The full report can be found here.