Connecting for Health computer system

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  • The biggest-ever government IT outsourcing project was plunged into chaos yesterday as Lockheed Martin dramatically pulled out of the race to supply up to £10 billion of computer systems to the National Health Service. Conal Walsh Sunday August 31, 2003 The Observer
  • The new computer system being installed by the NHS is set to cost taxpayers at least £15bn over the next 10 years - more than the total investment in the Channel tunnel. The eventual price tag may reach £30bn, five times the procurement costs announced two years ago by the former health secretary, Alan Milburn, the Department of Health said last night. John Carvel, social affairs editor Tuesday October 12, 2004 The Guardian
  • Few frontline NHS staff have any faith that the provision of IT will equip them to do their job more efficiently or effectively (NHS faces £15bn black hole, October 12). IT provision is being developed to serve the billing needs of service providers. Letters Wednesday October 13, 2004 The Guardian
  • As many as 3,000 babies and toddlers may have gone without crucial vaccinations because a privatised NHS computer system has failed to monitor which children are due for jabs and whether they have received them.  Jo Revill, health editor Sunday February 26, 2006 The Observer
  • Health chiefs have denied that problems with a new privately-run computer system would cause thousands of babies and young children to miss crucial vaccinations. Sunday February 26, 2006 8:18 AM
  • NHS's £6bn IT programme 'in need of significant changes'. Richard Jeavons, the man charged with implementing the NHS IT programme, has said it needs "a new operating model" and is being "refreshed" in the light of government policy changes since its launch in 2002. The government has moved to introduce a supplier market, bringing in private sector operators, competition, foundation trusts and patient choice and there are "significant changes arising from that". 'Choose and book' should have been in widespread use by last December but the target for full implementation has now moved well into next year. Patricia Hewitt has said that even by August only 1m of the 13m first outpatient appointments made annually will have gone through the system. Sir John Bourn, head of the National Audit Office, said the programme has become "a focus of dissension" within the NHS. Summary by Keep our NHS Public of  Financial Times 21 March 2006
  • Computer experts have written to MPs calling for an independent review of the NHS's £6.2 billion IT scheme. The National Programme for IT (NPfIT) will link more than 30,000 GPs in England to almost 300 hospitals by 2012. It involves an online booking system, a centralised medical records system for 50 million patients, e-prescriptions and fast computer network links between NHS organisations. Tuesday April 11, 2006 7:38 AM
  • MPs to probe IT fiasco at health service. The public accounts committee is to investigate the National Health Service's £6.2bn IT modernisation amid fears that the massive project is overbudget and behind schedule. Connecting for Health, launched by Tony Blair four years ago, involves centralised medical records for 50 million patients, prescriptions by email and online booking. Although much of the overhaul is funded by the government, hospitals are obliged to bear the cost of upgrading local networks, inputting patient data, and training staff to use the systems. Only a minority of hospitals are thought to have completed this so far. Summary by Keep our NHS Public of  Observer 7 May 2006
  • Plans for NHS files are late by two years. Plans to give all 50m NHS patients in England a full electronic medical record are running at least two to two-and-a-half years late, Lord Warner, the health minister who oversees the project, has confirmed. He also admitted that the full cost of the programme was likely to be nearer £20bn than the widely quoted figure of £6.2bn. The latter figure covered only the national contracts for the systems' basic infrastructure and software applications. The delays to the electronic care record, which mean it may not be in place until early 2008, come in part because of delays in providing the software, which is being developed by iSoft and other companies. Summary by Keep our NHS Public of  Financial Times 30 May 2006
  • NHS scheme 'risk to confidentiality'. The British Medical Association has raised concerns about the new multibillion-pound NHS computer system. The BMA has told the Government not to presume patient consent as planned, but attain consent before records are put on to the database; a move which would delay the system by a further two and a half years. The government has argued that the recommendation would add to doctors' already bulging workload with the Department of Health stating that "the NHS program is one of the largest IT projects in the world…As with any large, complex program there will be difficulties." Summary by Keep our NHS Public of  Times 31 May 2006
  • NHS to focus on getting IT project right. Officials in charge of an embattled multibillion pound health service IT project will ignore deadlines for its completion and concentrate on ensuring the new systems work correctly. Connecting for Health has admitted it is now running two and a half years late. The total costs of the project are now likely to be almost £20bn, compared with the official figure of £6.2bn. Summary by Keep our NHS Public of  Public Finance 2 June 2006
  • Electronic records and NHS reform. A Financial Times leader says that what threatens the NHS IT programme at least as much as the technical problems and delays is the fundamental disagreement within the medical profession over how patient data will be uploaded and what the summary record will contain. Summary by Keep our NHS Public of  Financial Times 2 June 2006
  • NHS trusts pay millions in fines to suppliers of delayed IT systems. NHS trusts are being made to pay multimillion-pound penalties to computer suppliers because of a clause in contracts for the health service's £20bn IT scheme. The government committed trusts to provide 200 staff to work with the computer companies to devise the best possible systems. In southern England the NHS was unable to meet an obligation to second 50 full-time employees to the Japanese-owned Fujitsu Corporation. The trusts will now have to pay Fujitsu £19m. Tory MP Richard Bacon, a member of the Commons public accounts committee, discovered the fines against NHS trusts. He found that trusts in north-west England and the West Midlands were committed to provide 50 IT staff to work with the US company CSC. They face potential penalties of up to £6.9m a year for 10 years. Summary by Keep our NHS Public of  Guardian 6 June 2006
  • Health service IT contracter in crisis. One of the software firms working on the NHS's £6.2bn IT upgrade yesterday said it had to change the way it accounts for its revenues, knocking a huge hole in its profits. The move has forced iSoft to cut 15% of staff, sell non-core assets, renegotiate its overdraft, and consider wiping £500m off the value of a business now valued at only £117.3m by the City, less than when it floated six years ago. Summary by Keep our NHS Public of  Guardian 9 June 2006
  • NHS risks £20bn white elephant, say auditors. The government's £20bn investment in new IT systems for the NHS in England could turn into a white elephant unless ministers work harder to involve doctors in developing it, according to the National Audit Office. The NAO says the scheme is two years behind schedule, but has not run over budget like other jumbo computer schemes. Summary by Keep our NHS Public of  Guardian 16 June 2006
  • Choose and book target postponed. The department of health has put off the deadline for its targets on using choose and book, but at the same time has doubled the requirements for when it is enacted. If GPs do not meet the new target of 50% of referrals using the system by the revised date of September 2007, then they will have to pay back 'aspiration' money at an average of £1,320 per practise. This news comes as the National Audit Office gave a more positive than expected report on the National IT programme, referring to "substantial progress." Summary by Keep our NHS Public of Health Service Journal 22 June 2006
  • The multi-billion pound computer system built to run NHS patient records is experiencing so many problems that there are concerns people could be put at 'clinical risk', with missed appointments and lost records meaning that some hospitals have pulled out of the scheme in despair. Jamie Doward, home affairs editor Sunday June 25, 2006 The Observer [The new system has been blamed for delays by some hospitals: the Nuffield Orthopaedic Centre in Oxford has already experienced problems printing letters which have led to delayed appointments.]
  • NHS computer officials accused. Senior officials in charge of the new multi-billion pound computer system for the NHS have been criticised by former advisors for ignoring the advice of medical staff, and in doing so choosing the wrong product. Professor Peter Hutton, former chief medical advisor to the project, described the contracting process as a "juggernaut". Ten days after voicing his concerns to then NHS chief executive, Hutton was asked to stand down from the advisory body he headed. Another advisor involved in the project, Anthony Nowlan, a Department of Health official at the time, said he felt "increasingly compromised" as he was asked to exaggerate the extent of consultation with clinical staff. The IT programme's director, Richard Granger, dismissed claims that clinical consultation had been inadequate and said that he had been determined to end the department's "pilot-itis". Summary by Keep our NHS Public of Financial Times 27 June 2006
  • The future of iSoft, one of the key software suppliers in the government's £6.2bn upgrade of NHS IT systems, was thrown into doubt today as the company delayed publishing its annual results because it was still locked in crucial financing talks with its banks.   Richard Wray Friday July 7, 2006 Guardian Unlimited
  • NHS loses track of children's jabs. A glitch in new NHS computer software has led to the possibility of thousands of children not being immunised against diseases such as measles, whooping cough or diphtheria. More than 50,000 children have not had their details entered onto the system to monitor their vaccination status, making it almost impossible to track anyone who may have missed out on jabs. The system, which covers 10 of the capital's 31 care trusts, is called "the child interim application" and is part of the multi-billion pound plans to over-haul the NHS computer system. The agency stressed that the children were "not necessarily unvaccinated". It did however report "worrying" figures of falling coverage in the two trusts affected, adding that many trusts had not been able to submit figures at all because of the computer problems. Summary by Keep our NHS Public of Telegraph 7 July 2006
  • BT plans to switch software supplier on NHS project. BT is to dump its current software supplier for the NHS's new multi-billion pound IT system. The company is in talks to replace GE Healthcare with its US rival Cerner in an attempt to speed up the already overdue project. Richard Bacon, a member of the Commons Public Accounts Select Committee, has already asked the Health Secretary to forbid BT from switching without more careful consideration. No formal contract has been signed between BT and Cerner but an announcement is expected as early as next week. Summary by Keep our NHS Public of Times 7 July 2006
  • Overhauling the National Health Service computer system so that it could store 50 million patient records electronically was never going to be an easy task. Now the £12.4bn project is mired in controversy following delays and cost overruns. The four companies charged with delivering the new system - BT, Accenture, Fujitsu and American firm CSC - risk financial pain and parliamentary scrutiny. Information obtained by shadow Health Secretary Andrew Lansley reveals that by 31 March this year the firms had between them received just £257m on contracts worth almost £5bn, or approximately 5 per cent of their value, while they are estimated to have spent at least £1bn so far. Richard Brooks and Richard Wachman Sunday July 16, 2006 The Observer
  • iSoft investigates possible accounting irregularities. Troubled healthcare software provider iSoft admitted last night that it had launched an investigation into "possible accounting irregularities", casting further gloom over the government's £6.2bn upgrade to the NHS's IT system. iSoft is supposed to supply electronic patient records and clinical software to three of five English regions. Summary by Keep our NHS Public of Guardian 21 July 2006
  • Hospitals resort to pen and paper after £1bn computer crashes. A £1bn administrative computer system used by eight major hospitals and 72 primary care trusts crashed on Sunday morning following problems with power supply. The system, which is used to log appointments, admissions, operating theatre booking and local clinics, is supplied be CSC Alliance based in Maidstone, Kent. The crash was caused by a power failure in the company's central data centre making it inaccessible. The incident has affected services to other CSC Alliance customers though they have now been restored; NHS systems are currently still being brought back up. Adrian McDermott, the deputy chief information officer for NHS North West said that staff were using manual back up systems and checking appointment lists by hand which "will cost time and money when we have to input the information". He added: "We have managed the impact as best we can." Summary by Keep our NHS Public of Telegraph 1 August 2006
  • Private sector to expand role in NHS tests. The private sector is to make further inroads into the National Health Service after the government signalled an expanded role for companies providing blood and other tissue tests.
    A faster pathology service is deemed essential if the government is to get the maximum wait between an appointment with the GP and a completed operation or treatment down to 18 weeks. NHS staff and Labour MPs are becoming increasingly vocal over their opposition to the creeping involvement of the private sector in the health service, with public sector unions and doctors' and nurses' bodies taking the rare step of joining forces in a campaign against the changes. The Royal College of Pathologists accused ministers of failing to take heed of the dangers of involving the private sector, particularly the risk of companies "cherry picking" routine tests and leaving NHS labs with more complex and expensive procedures. It has also been confirmed that the NHS's multi-billion pound programme to create an electronic patient record suffered a setback when the software company setting up the scheme in London was sacked by BT, the prime contractor. IDX Systems, part of GE Healthcare, will be replaced by Cerner.
    Summary by Keep our NHS Public of Financial Times 3 August 2006
  • Isoft faces formal probe as auditors find irregularities. Isoft faces the prospect of a formal investigation after a preliminary examination of its past accounts found evidence of irregularities. The struggling healthcare software group, which provides software for the government's £6.2bn National Programme for Information Technology, told the stock exchange yesterday that the initial investigation launched two weeks ago by Deloitte, its new auditor, had concluded that there were grounds for a further probe. Summary by Keep our NHS Public of Financial Times 9 August 2006
  • The NHS has admitted it made an upfront payment to healthcare software provider iSoft in the last days of its 2005 financial year. The firm's auditors found this week that revenues that year were recognised earlier than they should have been.  Simon Bowers Thursday August 10, 2006 The Guardian
  • NHS delivers fresh blow to sickly iSoft. Troubled software company iSoft has suffered another blow after an NHS trust abandoned the implementation of its patient management system, part of the national programme to digitise patient health records, after several delays. The Sheffield Teaching Hospitals NHS Foundation Trust said it took the decision because a number of requirements had not been met before the system was due to go live in June this year. The trust is now seeking an "alternative solution" but said it was still committed to the national programme. This is the latest in a series of problems for iSoft, which had to restate its accounts earlier this year and is undergoing an investigation into possible accounting irregularities. iSoft shares, which have tumbled 90pc since the start of the year, rose ½ to 49p. Summary by Keep our NHS Public of Telegraph 18 August 2006
  • A multi-billion pound plan by the government to link the computer systems of every hospital and GPs' surgery is unlikely to be delivered on time and may fall short of the NHS's requirements, according to a confidential review leaked to The Observer The revelations will prove acutely embarrassing for the government, coming at a time when up to 10 hospitals may be closed by cash-strapped NHS trusts. So far the project's total costs have spiralled from an estimated £2bn, at its launch in October 2002, to an estimated £15bn now. Tony Blair has set great personal store by the Connecting for Health system - holding the records of 30 million patients - arguing that an electronic database will create 'choice' within the NHS. Jamie Doward, home affairs editor Sunday August 20, 2006 The Observer
  • NHS computer chaos deepens. The multi-billion pound NHS computer system is unlikely to be on time and may fall short of the health service's requirements. The project's costs have spiralled from an initial £2bn to an estimated £15bn. Yet the government has consistently defended the plan, with Tony Blair insisting it will create 'choice' within the NHS. Now a review conducted by consultant firms Accenture and CSC a month ago has revealed that the software developed by IT company Isoft for the electronic database is unlikely to be ready by the government's date of 2008. Moreover the report has identified 13 out of 39 areas of the software project as in need of immediate work and 21 as posing a potential risk; only five areas have been given a green light. The report highlights the issue of clinical safety noting that, while a director of clinical safety had been appointed, financial problems were hampering efforts to set up a team to oversee the issue. The consultants also noted that Isoft's "programme planning…is based upon unrealistic assumptions that drive unachievable plans that ultimately fail to deliver on time." Summary by Keep our NHS Public of BBC Online 20 August 2006
  • NHS report 'criticisms deleted'. A report into the £6.8bn NHS IT upgrade had criticisms removed and toned down before publication. The BBC has obtained documents that show passages were removed from a National Audit Office report during consultation. The NAO defended the report saying that consultation with interested parties was normal and that its main conclusions had been left unaltered. However others have said the report was watered down. Changed phrases include the government being "slow in securing the engagement and commitment of the NHS to the programme" becoming a simple recommendation that more work was needed on engagement. "Insufficient trainers to train NHS staff" became staff considered the biggest barrier to implementation was a lack of knowledge and training. Tory MP Richard Bacon voiced his surprise at the report as "it did not reflect many of the concerns", and Sandra Gidley, Liberal Democrat health spokesperson, lamented the changes to what they were "expecting (to be) a hard hitting report". Summary by Keep our NHS Public of BBC Online 21 August 2006
  • 'No believable plan' for completion of iSoft work on NHS overhaul.  Review flags up 13 'red' areas of acute concern.  Software firm insists parts of system are being set up. Simon Bowers Monday August 21, 2006 The Guardian
  • Company at heart of NHS reform in serious trouble. Accounting questions and plunging profits put £6.2bn IT upgrade in doubt. Simon Bowers and Richard Wray Wednesday August 23, 2006 The Guardian
  • Yet another setback for Blair's vision of a hi-tech NHS. Inquiry casts shadow over £6.2bn computer scheme as doctors back change, but doubt it can be delivered.  Bobbie Johnson and Sarah Hall Thursday August 24, 2006 The Guardian
  • iSoft, the software firm at the heart of a much-delayed NHS computer upgrade, today reported a £343.8m loss and suspended its commercial director. Steve Graham, iSoft's commercial director, was suspended today after an initial review pending the outcome of a more formal investigation, amid the company's growing accounting problems. The company yesterday confirmed a Guardian newspaper report that it was under investigation by the Financial Services Authority for possible breaches of accounting standards. Mark Tran Friday August 25, 2006 Guardian Unlimited
  • Computer costs exceed benefits. Ministers approved the huge NHS computer system in spite of reports showing that its costs exceeded its likely benefits. They now concede that the planned £6.3 billion scheme will cost £12.4 billion by the time it is fully implemented. Now documents released to the Evening Standard in London under the Freedom of Information Act suggest that costs outweighed benefits in eight out of ten components of the scheme, called Connecting for Health. The project is divided into five regional "hubs", and the data released shows that for four of them, including London, the benefits of the scheme were calculated at £438 million, against costs of £604 million. Summary by Keep our NHS Public of Times 25 August 2006
  • Computer experts back calls for review of £6.2bn NHS project. The British Computer Society, the chartered institute for British IT professionals, has thrown its weight behind calls for a review of the over-budget and delayed NHS IT project. In a leaked letter to academics the Chairman of the BCS, Glyn Hayes, lists concerns over the project. He questions the suitability of the system's centralised "spine" for the complex NHS network and points to a lack of planning in some areas. BT, which has faced problems with its software partner for the scheme, is building the spine and is also responsible for delivering new IT to London. The 10-year contract for the capitol will total £996m, only £1.3m of which BT has received for the first two years work. Many have blamed iSoft, developer of the main plank of software for the programme, for the delays with the company's two partners saying that the software, named Lorenzo, has "no believable plan for release". Summary by Keep our NHS Public of Guardian 29 August 2006
  • MPs urge rethink of NHS records project. The controversial programme to upgrade the National Health Service's IT systems has suffered another blow after two MPs called for an overhaul of the project yesterday. Richard Bacon, the Conservative MP for South Norfolk, and John Pugh, the Liberal Democrat MP for Southport, argued that the programme should be reformed to allow hospital trusts to purchase systems locally that can then be linked into the national network. Both MPs are members of the Commons Public Accounts Committee that reviewed the programme in June. The pair said that the project's "fundamental error" was to centralise the procurement of single systems across the NHS. Summary by Keep our NHS Public of Independent 31 August 2006
  • New setback for NHS computer. Two thirds of hospital trusts will not meet the October deadline for installing the new electronic patient administration system. The delay has raised concerns that the project, already two years behind, is continuing to overrun with some questioning whether the predicted £12.4bn cost, already well over original estimates, could spiral further out of control to as much as £15bn. Of the 22 NHS trusts meant to be receiving the new system by October, only seven will meet the deadline, according to a survey by E-Health Insider, a specialist online magazine for health professionals. The further difficulties undermine the credibility of Connecting for Health, the body overseeing the project, after it assured the Commons Public Accounts Committee that 22 trusts would receive the system by the end of next month. Two of the committee's members, Liberal Democrat MP John Paugh and Conservative MP Richard Bacon, have taken the step of warning that the NHS is in danger of "sleepwalking to disaster" and wasting billions of pounds if the project is not scaled back. Summary by Keep our NHS Public of Observer 3 September 2006
  • Spending Watchdog to reopen inquiry into NHS computer overhaul delays. The National Audit Office is to re-examine the new NHS computer system only months after giving it a clean bill of health. The NAO refused to say why it was returning to the National Programme for IT (NPfIT) so soon after its report praising the scheme for "the notable progress and tight control of the central aspect of the program." The move comes after embarrassing revelations, and stringent denials, of how wording and emphasis were watered down for the report in June. The NPfIT has faced a string of crisis from continued delays in implementation to severe doubts from some of its biggest players. ISoft, the firm charged with supplying the main plank of software for the system has hit financial trouble and is under investigation by the Financial Services Authority. Many of the other companies involved, including BT and Accenture, have faced mounting problems and there are signs that NHS trusts are losing faith in the scheme. Many have already dropped any plans to use the system, favouring self-funded solutions over the government funded scheme despite financial problems. Patient Administration Systems, the only part of the plan to have yet been deployed to some hospitals, have proved problematic already. Last month, systems at eighty hospitals went down for four days due to a failure at a data centre. A data recovery system failed to provide backup. The Commons health select committee is to examine the programme in the autumn and could call for a full review. Summary by Keep our NHS Public of Guardian 5 September 2006
  • Thomlinson to run Accenture in UK. Accenture has appointed a new head of UK operations as part of a global shift in the consulting company's structure. David Thomlinson replaces Lis Astall as UK managing director. Accenture, with a large role in the £6.2bn upgrade to the NHS's information technology system, has become mired in controversy. The company has taken a $450m charge against potential losses from its work with the NHS and has a fractious relationship with Isoft, its software sub-contractor. Summary by Keep our NHS Public of Financial Times 7 September 2006
  • BT looks into connecting for health. BT is keen to take on any parts of the £6.2bn NHS IT programme abandoned by Accenture as the consultancy group negotiates a possible withdrawal. The programme to upgrade the NHS computer system has been dogged by delays and infighting between suppliers - Isoft is in a financially precarious position and Accenture is trying to renegotiate its participation amid fears it will make a huge loss. Patrick O'Connell, head of BT's health division, said BT had booked "hundreds of millions of pounds" in revenue and was confident of making a profit. Summary by Keep our NHS Public of Financial Times 14 September 2006
  • ISoft problems surfaced after NHS pulled plug in April.  Government refused to extend software contract.  Plea for another up-front payment was rejected. Simon Bowers Friday September 15, 2006 The Guardian
  • BT picks insider to salvage London NHS IT. Richard Wray Monday September 18, 2006 The Guardian
  • The government's £12.4bn programme to upgrade IT systems in the NHS experienced more than 110 technical breakdowns during the past four months, it emerged last night.  John Carvel, social affairs editor Tuesday September 19, 2006 The Guardian
  • Patients left on operating tables by computer failures. The new NHS computer system suffers almost one "major incident" failure every day, delaying operations and consultations across England. The scale of the problem has prompted calls for a rethink of the £12.4bn scheme amid fears for patient safety. Computer Weekly reports that over 110 major incidents of failure have occurred over the past four months. Problems have included the failure of systems providing surgeons with X-rays during surgery and a loss of access to the patient administration systems which hold records on appointments and planned treatments. However Connecting for Health, the body overseeing the project, claimed that the new system was more reliable than the one it was replacing. Nevertheless critics are worried about the potential harm to patients as the system is expanded to cover more of the NHS and processes such as proscribing drugs and ordering tests. Richard Bacon, Conservative member of the Public Accounts Committee said: "In many respects the NHS IT programme is making things worse, not better." A Connecting for Health spokesperson said the term 'major incident' was open to interpretation and that reports were often made when the system was merely running slowly, adding that "we expect performance to compare favourably with any large-scale organisation that uses IT." Summary by Keep our NHS Public of Times 19 September 2006
  • IT providers left in the debris of NHS's big bang. The National Programme for IT, which aims to create electronic patient records and link all the NHS IT systems across the country, attempts to drag the National Health Service into the 21st century. However, the 10-year £6.2bn project has been beset with controversy and delays. The project is run by Connecting for Health, headed by Richard Granger. The procurement process was completed in less than a year amid fierce competition. And Granger shifted a vast amount of the risk associated with the project to the service providers, which have to demonstrate that their systems work before being paid. Increased competition forced prices so low that some observers say the final bids were unworkable. Critics also say procurement was rushed and ignored the complexity of the programme and the need for consultation. Summary by Keep our NHS Public of Telegraph 28 September 2006
  • US consultancy firm Computer Sciences Corporation has taken over as the largest regional contractor on the NHS's troubled £6.2bn IT overhaul after rival group Accenture yesterday exited two 10-year contracts with the health service worth £2bn. CSC, already the lead contractor on a £973m contract in the north-west of England, is now charged with computerising largely paper-based systems in GP surgeries, hospitals and other NHS trusts in the east and north-east of England. Accenture yesterday remained circumspect about its reasons for leaving the NHS's National Programme for IT (NPfIT) after almost three years' work. Under the terms of its exit agreement, Accenture must repay £63m of the £173m it has been paid for work delivered on its two contracts. The settlement is a fraction of damages the NHS promised to extract in the event of a major contractor leaving the project. Accenture faced a maximum liability on the two contracts of close to £1bn. Earlier this year, Accenture made a £240m provision against future losses on its work on the NPfIT. This came on top of a £75m loss on the two contracts last year. Simon Bowers Friday September 29, 2006 Guardian
  • The company charged with rescuing the NHS's troubled IT system has consistently failed to meet its deadlines for introducing the project across the health service, The Observer can reveal. Last week Computer Sciences Corporation (CSC) was awarded a £2bn contract to take on a bigger role in overseeing the implementation of the Connecting for Health system, the biggest civilian computer project in history which is supposed to electronically link all doctors' surgeries and hospitals. But government hopes that CSC will prove the £12.4bn project's salvation have been hit by news that the company has itself experienced huge problems in implementing even the most basic parts of the project. According to its original business plan, obtained by The Observer, CSC was contracted to install new computer systems to 32 acute hospitals by April 2006. However, according to the NHS, only eight of the hospitals had received the basic 'administrative' systems by that date and the company had failed to deliver any working clinical systems - the key part of the project which is supposed to record a person's medical data electronically. Nearly three years into the project CSC continues to miss targets, due in part to problems with the software provided by iSoft, the troubled IT company currently being investigated for accounting irregularities.Jamie Doward, home affairs editor Sunday October 1, 2006 The Observer
  • Fat cats of the public sector take top pay. The civil servant in charge of the Health Service's disaster-prone £20 billion computer system is being paid £280,000 a year. Richard Granger's salary is £100,000 more than Tony Blair's - yet his 'Connecting for Health ' system has so far cost double its initial projection of £6 billion and is more than two years behind schedule. Granger was brought in from the consultancy Deloitte in 2002. Summary by Keep our NHS Public of Times 8 October 2006
  • Query over £12bn NHS IT upgrade. Scientists have sent an open letter to the Commons health select committee calling for a probe into the National Programme for IT in which they express their doubt that the system will "work adequately". IT experts from Oxford and Cambridge universities are though to be the leading signatories of the letter that stresses the urgency of a review. NHS Connecting for Health, which oversees the project, said it recognised that a range of parties could offer "helpful perspectives" though suggested that not just those from computer science should be involved. The organisation said it was "currently exploring the possibility of a reference panel made up of a mix of academic and non-academic disciplines". Last month it emerged that there had already been 110 major glitches in the last four months for those organisations already using the programme. Summary by Keep our NHS Public of BBC Online 10 October 2006
  • Serious problems with one of iSoft's most complex hospital computer system installations are threatening to wipe more than £16m off the expected income for University Hospital of North Staffordshire.  Simon Bowers Monday October 16, 2006 The Guardian
  • A key delivery target on the NHS's £6.2bn IT upgrade will be missed in two weeks time as the troubled project fails to meet a promise to have iSoft patient-administration systems installed at 20 acute trusts by the end of October. The latest NHS figures show 11 of the iSoft systems were operational at the end of September - just one more than when the promise was made to MPs in June. Simon Bowers and Jill Treanor Tuesday October 17, 2006 The Guardian
  • Congratulations to the NHS for facing down Accenture. The refusal at the end of last month to renegotiate contracts worth £2bn that were less than three years into their 10-year life led to the consultancy giant's decision to resign as a prime contractor from the NHS National Programme for IT. Although presented as an amicable parting of the ways, it is the most spectacular bust-up between IT contractor and government in 20 years of systems outsourcing. Comment has been surprisingly kind to Accenture, with apparent agreement that if a firm that canny sees no future in the NHS, the world's biggest civil IT programme must be in deep trouble. But I think that's wrong, and now that spin has passed, it's time to point out that any sympathy for Accenture is misplaced. Although the programme has flaws, nothing that has happened in the past three years was unforeseen at the outset. Michael Cross Thursday October 19, 2006 The Guardian
  • Fujitsu, one of the lead contractors on the NHS's troubled £6.2bn IT upgrade, has installed only three patient-administration systems in two-and-a-half years on the project. It has recently all but frozen further installations while it struggles to fix problems at these sites. Fujitsu's problems are the latest blow for the health service's ambitious IT upgrade, the biggest non-military project of its kind in the world, which has been dogged by delays and contract disputes. Simon Bowers Tuesday October 24, 2006 The Guardian
  • Warning over privacy of 50m patient files. Call for boycott of medical database accessible by up to 250,000 NHS staff. What you can do. David Leigh and Rob Evans Wednesday November 1, 2006 The Guardian
  • 'A national database is not essential.' What health professionals say about the new NHS database. David Leigh Wednesday November 1, 2006 The Guardian
  • Spine-chilling. The most closely guarded of secrets are often medical. A history of depression, a sexually transmitted disease or a long-ago abortion may well be deeply personal matters which many people would wish to remain private. Likewise, anyone who has recovered from a drug problem or from a suicide attempt may dread nothing more than these facts about their past getting into the wrong hands. Sometimes the desire for privacy reflects disposition, sometimes the potential impact on work or on family. Whatever the grounds, there is a right to expect that the confidentiality of one's medical history should be respected.Which is why there are good causes for alarm in our reports today about the way in which such data is being transferred to electronic records. There is a cause for real doubt about whether medical privacy can continue to be guaranteed. Leader Wednesday November 1, 2006 The Guardian
  • In the second of our series on the NHS's new database we talk to Helen Wilkinson, named as having a drink problem after a computer error. Rob Evans Thursday November 2, 2006 The Guardian
  • How Icelanders gave computer scheme cold shoulder. In the last part of our series on the planned NHS database, we look at a rebellion that succeeded. David Leigh in Reykjavik Friday November 3, 2006 The Guardian
  • A database that could be good for our health. Letters Friday November 3, 2006 The Guardian

  • GPs revolt over patient files privacy Poll shows doctors fear national database will be at risk from hackers. About 50% of family doctors are threatening to defy government instructions to automatically put patient records on a new national database because of fears that they will not be safe, a Guardian poll reveals today. It shows that GPs are expressing grave doubts about access to the "Spine" - an electronic warehouse being built to store information on about 50 million patients - and how information on it could be vulnerable to hackers, bribery and blackmail. The survey reveals that four out of five doctors think the confidentiality of their patients' medical records will be at risk if the government proceeds with plans to load them on to the new database. More than 60% of family doctors in England also said they feared records would be vulnerable to hackers and unauthorised access by public officials from outside the NHS and social care. Ministers have committed a large slice of the NHS's £12bn IT upgrade to developing the Spine. They acted on the assumption that doctors would provide the information without asking their patients' permission first. The new system has been constructed to upload information from GPs' computer systems automatically, without giving patients a say. But the poll found 51% of GPs are unwilling to allow this uploading without getting each patient's specific consent. Only 13% say they are willing to proceed without consent and the rest are unsure or lack enough information to comment. John Carvel, social affairs editor Tuesday November 21, 2006 Guardian
  • NHS plan for central patient database alarms doctors.  Poll shows dwindling support for IT project. GPs say system destroys medical confidentiality. A poll of doctors about the new £12bn computer system for the NHS shows growing unease about a potential threat to patients' rights. After answering questions by the medical pollsters Medix, the GPs and hospital doctors were invited to volunteer comments. John Carvel, social affairs editor Tuesday November 21, 2006 The Guardian
  • Scots NHS 'gets poor value for £100m IT spend'. The NHS in Scotland lacks a joined-up strategy for information technology and does not know exactly how much it spends overall on the service. A report by Audit Scotland warned yesterday a "major cultural shift" is required, revealing that the service gets poor value for the estimated £100m it spends. The Scottish Executive must do more to improve the way it funds spending, according to the public sector efficiency watchdog. Funding should be based on a system which clearly sets out the justification for the investment over the whole lifetime of the project and the benefits which will be delivered. This happens at present only when spending exceeds £2m, it said. The recommendations came in an independent report on how IT is managed by the NHS in Scotland. In the past, the health service has had a range of locally developed IT systems, and the report says the executive must continue to improve the way it manages IT. The report is published two days after Health Minister Andy Kerr signed a £300m contract to provide the NHS with a new computer network. The contract will provide the NHS with most of its national computer services for 11 years, in areas ranging from patient records to nurse roster systems and the payroll.  Summary by Keep our NHS Public of Herald 23 November 2006
  • Switch threatens health service IT suppliers. The Government has signalled a change of tack in the disastrous IT programme for the NHS as it shifts "ownership" of the project from central management to local NHS trusts. The news comes shortly after a minister admitted that the programme's managing body, Connecting for Health, could be scrapped. Bridgewell analyst Kevin Ashton said: "There would be massive implications for the local service providers [such as BT, Fujitsu and CSC] if we're talking about decentralisation of the ability to procure services. That would effectively be the end of the National Programme." The new boss of the NHS, David Nicholson, ordered the local ownership programme as one of his first jobs since taking the helm in September. However, critics say he has not gone far enough. Richard Bacon, Conservative MP and member of the Public Accounts Committee, said: "What it is not saying is a shift in control. What it boils down to is … a way of decentralising blame." Connecting for Health is under increasing pressure as the programme falls behind schedule and costs look likely to spiral to £20bn, or £7.6bn over budget. The agency's future was put in the balance when the government said its status would be reviewed after five years. Previously industry experts thought Connecting for Health would remain permanently to administer the IT programme. The Department of Health has now said: "Connecting for Health is preparing for executive agency status and its management is therefore undertaking a review to ensure that it is correctly structured and staffed to deliver the projected programme [to] schedule." The National Programme aims to digitise patient care records, provide an electronic appointment booking and prescription service, and link up all the NHS's IT systems. But support for the project has waned. A recent Medix survey showed that around two thirds of doctors do not consider it a good use of NHS resources.  Summary by Keep our NHS Public of Telegraph 24 November 2006
  • Technology programme delay grows at NHS. The £12.4bn NHS IT programme is to undergo an overhaul that is likely to further delay the project. The chief executive of the NHS, David Nicholson, has ordered a review of both the scope and operation of the project, looking at whether it is "too prescriptive" in what it offers GPs and hospitals. Connecting for Health which runs the project is to be slimmed down and turned into an executive agency with some staff being transferred to local NHS control. It is hoped the review will resolve key ambiguities about the plan as Richard Granger, the programmes head, said that NHS financial problems and a need for more useful software meant that the new patient administration systems would be further delayed. He said that other aspects of the programme, such as digital imaging systems, software for the new NHS payment system and electronic proscribing, would receive greater focus. Mr Granger has continually blamed policy and operational difficulties for the project's problems rather than IT issues. He will remain in charge of the roll-out but, as chief executive, Mr Nicholson has now become the programme's senior overseer, seeking to reassure himself that it will provide what the NHS needs, while making sure the service finally comes to "own" it. Mr Granger has indicated that he will support such changes. "Sorting out consent [whether patients should be asked before their medical records are uploaded on to the system] is a policy question that is being pinned on me [that] I would say belongs elsewhere [in the department]," he said.  Summary by Keep our NHS Public of Financial Times 27 November 2006
  • Most patients reject NHS database in poll.  ICM finding released at campaign launch. Leaked report reveals safeguard problems. A national campaign was launched last night to persuade people to refuse on privacy grounds to have their medical records uploaded to a national database.  David Leigh and Rob Evans Thursday November 30, 2006 The Guardian
  • GPs angered by call to reveal names of NHS database rebels. The Department of Health provoked uproar among doctors yesterday by asking GPs in England to send in correspondence from objectors who do not want their confidential medical records placed on the Spine, a national NHS database. Sir Liam Donaldson, the chief medical officer, said letters from patients who want to keep their private medical details out of the government's reach should be sent to Patricia Hewitt, the health secretary, for "full consideration". Campaigners who fear the national database will infringe patients' civil liberties said the exercise would give Ms Hewitt access to the names and addresses of patients most likely to be offended by government intrusion. GPs wrote to the General Medical Council asking for a ruling on whether Sir Liam had broken the doctors' code of good practice by using his authority to encourage GPs to breach patient confidentiality without clinical justification. John Carvel, social affairs editor Saturday December 2, 2006 The Guardian
  • Health officials reject requests to opt out of patient database.  Department's letter says fears are not valid.  Many 'harmed by unavailability of records'. Patients who have complained about the idea of having their confidential medical records uploaded on a new centralised NHS database were sent letters over the weekend flatly rejecting their concerns. In an uncompromising statement, the Department of Health said nobody could have genuine grounds for claiming "substantial and unwarranted distress" as a result of having their intimate medical details included on a national computer system, known as the Spine. John Carvel, social affairs editor Monday December 4, 2006 The Guardian
  • Hospital reforms, air ambulances and 'super' A&Es. Professor Martin McKee and Dr Ellen Nolte of the London School of Hygiene and Tropical Medicine write in a letter to the Times: "The Private Finance Initiative, which has funded virtually all hospital developments for the past decade, requires hospitals to make fixed payments for 30 years or more. Any change to existing facilities during this time will incur even greater costs. Yet the new system for paying hospitals is likely to make income streams extremely volatile. Fixed outgoings and unpredictable income, both largely outside the control of hospital management, are simply incompatible. The health authorities are still reeling from the most recent reorganisation, which led to the loss of many highly skilled staff. The implementation of a complex health information system is consuming enormous resources and management time, while new independent treatment centres are destabilising the system by creaming off non-urgent care. Finally, those managing the training of health professionals must adapt to the changing pattern of hospitals while themselves being reorganised. Hospitals do need to adapt to changing circumstances but they will need time to do so, a crucial element that seem to have been ignored consistently in the stream of recent reforms." Summary by Keep our NHS Public of Times 8 December 2006
  • Ailing iSoft's future in doubt after plunging into the red. ISoft, the beleaguered software company with a key role in the multi-billion pound IT programme for the NHS, has warned it may be unable to continue operating after plunging into the red in the first half following a costly restructuring. Summary by Keep our NHS Public of Telegraph 12 December 2006
  • NHS IT system offers poor value for money says British Computer Society. The British Computer Society (BCS) has criticised the NHS IT programme for being bad value for money and slowing down existing IT projects in hospitals. In a report based on the opinions of IT workers, both within and outside the NHS, the BSC says: "The National Programme for IT has been successful in limiting payment for non-delivery, but having underspent because of not delivering is hardly a success and the central costs incurred by NHS Connecting for Health are such that, so far, the value for money from services deployed is poor. The deployment of departmental systems in hospital has been slowed down by the unsuccessful attempts of the National Programme for IT to meet this demand with fully integrated enterprise systems that have yet to be implemented (or in some cases produced)." The BSC said that it had initially started the report to defend the project from being axed after it received "heavy attack". The report recommends focusing on local implementation of the plan, building on "what presently works and encouraging convergence to standards over time". The report goes on to say that "until confidentiality issues are resolved, we believe it is better to push information from one professional to another via the messaging system," and that doctors should only be able to access records from the system in an emergency. Summary by Keep our NHS Public of Telegraph 15 December 2006
  • Patients win right to keep records off NHS computer. The government has bowed to privacy concerns about a new NHS computer system and conceded that patients should be allowed a veto on information about their medical history being passed from their GP to a national database. Following a Guardian campaign against the compulsory uploading of personal details to the system known as The Spine, Lord Warner, the health minister, will announce a plan that would allow individuals to review and correct their records and withhold them from the database. Critics fear that details about mental illness, abortions, pregnancy, HIV status, drug-taking or alcoholism could become vulnerable to prying by the police, insurance companies and hackers working for the press. This month the Department of Health sent more than 1,300 curt letters rejecting requests from patients for their medical details to be kept off the national database. But ministers have changed their minds after advice from a taskforce on patient records headed by Harry Cayton, the department's "patient tsar". John Carvel, social affairs editor Saturday December 16, 2006 The Guardian
  • How patients' protests forced a rethink on NHS computer records.  The question no one asked: what do you think?  Taskforce seeks to find a form of compromise.  The government's change of policy on patient records, disclosed in the Guardian today, is the first departure from a roadmap drawn by Tony Blair in 2002 when he approved a scheme to spend billions on a new IT system for the NHS. The prime minister was captivated by the vision of a national database containing the medical records of 50 million patients throughout England. Heads of the corporations developing cutting edge technology convinced him that lives could be saved if doctors, nurses and paramedics could gain instant access to key information about patients that might cause conventional treatments to cause life-threatening reactions. Instead of consultants waiting for hours to locate the patient's GP and ask for relevant information, a paramedic on the scene would be able to access data from a palmtop computer. Who could object? John Carvel, social affairs editor Saturday December 16, 2006 The Guardian
  • Patients veto for e-care records. Ministers have backed down over plans to place every person's medical records on the NHS "spine" by offering a right to veto them being uploaded. The move comes after doctors and patients expressed fears that the electronic record system could damage the relationship between patients and doctors and compromise confidentiality. Further problems were raised when polls showed many doctors were prepared to defy the government plans to upload all records without patient consent. Pilots of the project are due to start in the spring and the government is now to set up an advisory board to see how the veto can be implemented. It is envisaged that patients will be able to view their records online before they are uploaded to the database, and amend information or restrict access to the document. If patients do not do so then they will be assumed to have consented to their records being uploaded. The U-turn was prompted by a report by patient's tsar, Harry Cayton, which said that the project needed "public support and clinical confidence". Some issues on sensitive data, such as HIV status, are yet to be decided. Health Minister Lord Warner said: "We are going forward cautiously. We believe that despite the noise it has generated patient care records will be of huge benefit to patients' care. We believe there are some myths about how effective the current arrangements are in regards to safety." The move was welcomed by the British Medical Association which has remained sceptical of the plans. James Johnson, the association's chairman, said: "The recommendations provide a good first step and we look forward to building on this work." Summary by Keep our NHS Public of BBC Online 18 December 2006
  • Minister admits U-turn on NHS database amid privacy fears. The government gave a categorical assurance yesterday that NHS patients would have an absolute right of veto on any part of their medical records being uploaded to a national database. The health minister Lord Warner confirmed a report in the Guardian on Saturday that the government was abandoning an attempt to oblige GPs to provide a medical summary on every patient for a centralised electronic record. John Carvel, social affairs editor Tuesday December 19, 2006 The Guardian
  • Headed for the rocks. In a comment piece Ross Anderson, chair of the Foundation for Information Policy Research, writes: "The NHS's ill-starred computer project is in the news again. After polls showed that most doctors and patients oppose a compulsory national database of medical records, health minister Lord Warner promised an opt-out. But don't break out the champagne yet. The report was cleverly spun; hidden in an appendix is confirmation that you can opt out of the Summary Care Record, but not the Detailed Care Record. The first is merely a synopsis for emergency care. But ministers are not offering an easy opt-out from the second - the database replacing your current GP and hospital records. They plan to "upload" your GP data over the next year or two to a regional hosting centre run by a government contractor. The data will initially remain under your GP's nominal control but, after hospital records have been uploaded too, the chief medical officer will be the custodian of the whole lot. Your "electronic health record" will be used for many purposes, from cost control through audit to research. So the Home Office plans to use health data to help predict which children are likely to offend (despite a recent report to the information commissioner that collecting large amounts of data on children without their parents' consent will probably break human rights law) yet confidentiality is often vital for care. Ministers say that the rules for police access to data will not change, but this masks a practical shift. At present the law allows the police access to health records that contain evidence of a crime. Once the records of millions of people are on one system, to which a court will give access without GPs' knowledge, the police will be sorely tempted… Gordon Brown will have to decide soon whether to scrap the central database and build safe systems that will work. If he calls it wrong then it may well be the decision for which he is remembered." Summary by Keep our NHS Public of Guardian 21 December 2006
  • NHS £6bn IT system poor value, say experts.  Schemes 'costing four times going rate'.  Health officials reject claims of overpayments. Leading healthcare IT experts have warned that the NHS's troubled £6.2bn system upgrade is costing taxpayers substantially more than it should. They claim the same functions could be delivered for considerably less outsid e of the national programme for IT, dogged by delays and software setbacks. Simon Bowers Monday January 22, 2007 The Guardian
  • £20bn NHS computer system "doomed to fail". A senior insider has given a damning warning over the government's NHS computer system. Andrew Rollerson, the health-care consultancy practice lead at the computer giant Fujitsu, said that the project "isn't working and isn't going to work", and that firms involved were in danger of delivering "a camel and not the racehorse that we might try to produce". In a speech on the project delivered to a conference of computer experts last week, he went on to criticise a lack of visionary leadership and implied that the project had lost its way. Summing up the situation, Mr Rollerson painted a bleak picture: "There is a belief that the national programme is somehow going to propel transformation in the NHS simply by delivering an IT system. Nothing could be further from the truth. A vacuum, a chasm, is opening up." Stephen O'Brien, the shadow health minister, said: "Even those from inside the programme are now telling the Government that it is coming apart at the seams." Summary by Keep our NHS Public of Telegraph 13 February 2007
  • Faulty software puts child health at risk. The health of children is at risk because an NHS computer system wrecked 20 years of accurate immunisation records. Faulty software introduced in 2005 has left some primary care trusts (PCTs) unable to track whether children have been vaccinated and screened for genetic conditions, raising fears that many are unprotected against diseases. Parents are not being reminded when their children are due for jabs and check-ups. The Health Protection Agency cannot publish full statistics on the uptake of vaccines because the five worst-affected London trusts cannot provide accurate data. When the shortcomings of the Child Health Interim Application (CHIA) software were disclosed by The Times a year ago, the Department of Health stated that the problems were being addressed. But staff are said to be "in despair" at continuing difficulties with the system supplied by BT. Summary by Keep our NHS Public of Times 13 February 2007
  • Potential buyer emerges for iSoft.  The Australian health information company IBA Health has emerged as a possible rescue-bidder for iSoft, the struggling NHS software supplier. Fiona Walsh, business editor Friday February 16, 2007 Guardian Unlimited
  • NHS seeks rival IT firms as trusts lose faith in iSoft. The NHS will start recruiting alternative software suppliers to its troubled £6.2bn IT upgrade project this month, in a move which could see the government's vision for a single IT system for the health service in England unravelling. The move is a tacit admission that a fully integrated IT system may never be completed. NHS bosses had until recently discouraged hospital trusts from deserting the scheme. But disaffection is now so widespread and delays so long that officials are working on a list of accredited alternative suppliers, which is widely seen as a move to appease hospital trusts. Simon Bowers Monday March 5, 2007 The Guardian
  • New man at NHS supplier CSC will keep health service job too - BMA warns he must 'declare conflict of interest'. CSC, a key supplier to the NHS's £12.4bn National Programme for IT (NPfIT), has appointed two NHS managers to beef up its UK healthcare business - one of whom will continue to work for the NHS as well. CSC is the lead contractor for three of NPfIT's five regions, following the pull-out of Accenture last year. The IT contractor named Pearse Butler, formerly chief executive of the Cumbria and Lancashire strategic health authority, as director of clinical engagement, while Rajan Madhok, medical director at Manchester primary care trust, has been appointed clinical director, in a move CSC said would support its approach to engaging with health professionals. But Madhok will retain his NHS post, and will "divide his time between his new position at CSC and his duties as medical director of the Manchester PCT", the company said. Dr Richard Vautrey, IT lead on the British Medical Association's GP negotiating committee, warned that Madhok should "declares his conflict of interest in any settings where it may be necessary for him to do so". Pearse Butler was a senior representative for NPfIT's North West and West Midlands region - one of three where CSC is lead contractor. The Cumbria and Lancashire SHA was abolished in an NHS reorganisation last year. Butler has also been chief executive at an acute hospital trust. Summary by Keep our NHS Public of Computer World UK 12 March 2007
  • Divisive choice. An IT scheme for booking hospital appointments is well behind its take-up target, but it does have its supporters, reports SA Mathieson. Choose & Book, the IT programme that allows GPs to book hospital appointments electronically at a time convenient to their patients, is set to miss a key target. The government wanted 90% of referrals by GPs to run through the system by March, but usage is well below that. However the figures hide a more complex picture, with some GPs enthusiastic about the system and others critical. Tuesday March 13, 2007 SocietyGuardian.co.uk
  • First test launched of NHS's controversial 'Spine' database. The government's plan to put the medical records of every NHS patient in England on a central electronic database will begin first trials tomorrow at two carefully selected GP practices in the north-west. About 14,500 patients in Bolton will be told their confidential medical details will be uploaded to a national data warehouse known as the Spine, unless they object. Their reaction will be the first test of whether patients accept the government's argument that a national electronic record can save lives - or agree with campaigners for personal privacy who see the scheme as a lurch towards a Big Brother state. After a Guardian campaign last year, ministers conceded that patients should have the right to stop their medical files being passed from the GP to the national database. But they postponed giving an explanation of how this would be done until the first trial. Patients at the two practices will receive individual letters from their GPs tomorrow, posted to their home addresses, saying they have eight weeks to decide if they want to opt out. If they do, they will be invited to write to the GP or lodge their objection on a helpline at NHS Direct. At the same time, Connecting for Health, the NHS's IT agency, will tell 50 million patients across England about a procedure to notify their GP if they do not want their records uploaded. John Carvel, social affairs editor Thursday March 15, 2007 The Guardian
  • NHS funding. In a letter to the Independent Jo Selwood writes: "It is disgraceful that MPs on the Public Accounts Committee should seek to put the blame for the current NHS funding crisis on the shoulders of doctors. What about the millions of pounds the Government is forcing the NHS to pay to private companies to do operations that could be done better and more cheaply in-house ? What about the money being poured into the multi-million pound fiasco that is the "Connecting for Health" IT project that very few health professionals actually want ? What about the ever-increasing number of "management consultants" being brought in to service the ever-expanding numbers of "targets" and "initiatives' pouring out from the Government ? Doctors determine treatment based solely on what is best for the patient. These decisions are based on clinical need and based on the years of training and experience of doctors. To try and tell them that the decision should be based instead on cost can only be detrimental to patients." Summary by Keep our NHS Public of Independent 21 March 2007
  • NHS pours £100m into finding additional software suppliers. NHS bosses charged with delivering the much-delayed £6.2bn IT upgrade to health trusts throughout England have launched a £100m-plus drive for "additional" IT suppliers to meet "immediate business needs". Separately, the Guardian has learned that the Australian group IBA Health is close to abandoning talks over a potential all-share takeover of cash-strapped software supplier iSoft, which is contracted to provide systems for 60% of the NHS's troubled National Programme for IT (NPfIT). The decision by NHS bosses to seek new suppliers is a significant move away from the troubled NPfIT, which has been running for four years, mired in delays and software setbacks. Concern has been mounting among clinicians and trust executives that the NPfIT has become over-reliant on software sub-contractors iSoft and Cerner and the suitability of their systems. The two firms have been blamed in some quarters for delays. Simon Bowers Thursday March 29, 2007 The Guardian
  • Passing the reins. On April 1, much of the responsibility for the £6.2bn NHS National Programme for IT, parts of which are two years late, will pass from NHS Connecting for Health (CfH) to strategic health authorities (SHAs). The National Programme for IT local ownership programme will include the transfer of staff to SHAs from five super-regional "clusters" run by CfH as local delivery arms. According to a document released by the North-East SHA, this might include redundancies. The SHAs have formed two groups to deal with the dominant "local service provider" suppliers, according to documents placed online by SHAs, based on the areas covered by these companies. BT supplies London SHA only, but the southern CfH cluster supplied by Fujitsu - covering the South Central, South-East Coast and South-West SHAs - has established a south NHS management board. A similar structure has been created for a new "NME" (North, Midlands and East) group for the six SHAs covering the rest of England, which are all served by CSC following Accenture's withdrawal from the national programme. In what might be an indicator of future problems with these groups, Dr Singleton, the North-East SHA's medical director wrote that his SHA wanted a decentralised approach to CfH staff, whereas other authorities want to centralise. A spokesperson for North-East SHA said it prefers to place staff working across the region within individual trusts, to keep them in touch with frontline work. The localisation work was mentioned, but not detailed, by health minister Lord Hunt. He told the Healthcare Computing conference: "Greater involvement from NHS staff is vital if we are to offer a product that meets their needs, and supports their day-to-day working." He added: "It is now time for the local NHS to take ownership of the programme and its delivery on the ground." CfH said: "The SHAs, in partnership with trusts and PCTs, will from April 1 have responsibility for the local delivery and implementation of the national programme, with authority commensurate with current contractual and commercial constraints." Murray Bywater, managing director of health IT consultancy Silicon Bridge Research, said the localisation work could run into problems if SHAs and trusts disagree, or if they want to alter the terms of the local service providers' secret contracts. "There will need to be some readjustment of those contracts for [the suppliers] to operate effectively in the new environment," he said. The change comes as CfH launches a £100m tender to find additional software suppliers. Bywater said decisions including this and the localisation work show power shifting from CfH back to the Department of Health, following the national programme's numerous difficulties. "The Department of Health is beginning to reassert itself," he said. "Politically, you can interpret this as CfH having its wings clipped." Summary by Keep our NHS Public of Guardian 30 March 2007
  • Hospital's computers 'a failure'. Medical and secretarial staff at a hospital have declared a new computer system as "not fit for purpose". The Patient Administration System introduced to Milton Keynes General Hospital five weeks ago as part of the Government's £12.4bn IT scheme for the NHS, is not working, say 79 members of staff in a letter to the hospital's management. The setback is the latest to hit the National Programme for IT, run by Connecting for Health, a government agency. The rebellion at Milton Keynes emerged as Computer Weekly reported that Connecting for Health had sought to suppress a critical report into the system by the British Computer Society. In their letter, the staff at Milton Keynes say the software is "awkward and clunky". "In our opinion, the system should not be installed in any further hospitals." Summary by Keep our NHS Public of Times 3 April 2007
  • 79 Milton Keynes staff say Millennium "not fit for purpose". Seventy-nine clinicians and admin staff at Milton Keynes General Hospital have written an open letter to the management stating that the new Cerner Millennium system installed by Fujitsu in February is "not fit purpose". In their open letter, the staff describe the software as "awkward and clunky" and state: "In our opinion the system should not be installed in any further hospitals." Reported problems include clinics not being available, patient notes being lost or unavailable, staff being trained on a different system to the one implemented and problems with reporting around key areas such as 18-week waits. One senior clinician from the trust described the situation in outpatients as "a nightmare". NHS Connecting for Health said that there had been "some unacceptable problems" with the new system installed at Milton Keynes which "require immediate attention". The patient administration system introduced to Milton Keynes General Hospital five weeks ago as part of the Government's £12.4 billion IT scheme for the NHS, was installed after repeated delays. The Cerner system is meant to provide the foundations for developing a Care Records Service (CRS) of electronic medical records. Summary by Keep our NHS Public of E-Health Insider 9 April 2007
  • Lib Dems demand rethink on NHS IT project. The Liberal Democrats today called for an immediate moratorium on all further spending on the NHS's £12.4bn IT programme in England pending an independent inquiry into a mounting catalogue of errors and delays. Norman Lamb, the party's health spokesman, said the government was in a state of denial about the technical, financial and political deficiencies of Connecting for Health, the agency responsible for the scheme, which is the world's biggest ever non-military IT project. John Carvel, social affairs editor Monday April 16, 2007 SocietyGuardian.co.uk
  • Fresh blow to faith in care records. Confidence in Connecting for Health's development of care records has fallen to a new low with hospital staff claiming that a patient administration system that will form part of the service is 'not fit for purpose'. This comes on top of existing concerns about patient confidentiality and the robustness of the national spine. Management at Milton Keynes General Hospital, one of the five trusts at which the Millennium system has been rolled out, were sent a letter from 79 hospital doctors and administrative staff reporting major problems. The Millennium system is a patient administration system that includes a module allowing clinicians to record medical problems and procedures directly onto the electronic patient record. Staff reported that the system was 'clunky', and that patient notes were lost or impossible to access. 'We cannot foresee the system working adequately in a clinical context,' the letter said. 'It should not be installed in any further hospitals. If it is not already too late, there is a strong argument for withdrawing the care records service system from this hospital.' Dr Paul Cundy, GPC IT subcommittee chair, said the faults reported in Milton Keynes raised serious questions about the NHS care records service project as a whole. A spokesperson for Connecting for Health denied that the problems with Millennium would have a larger impact on the care records service, but admitted there had been 'unacceptable problems' that required 'immediate attention'. The other trusts at which Millennium has been rolled out are Nuffield Orthopaedic, Winchester, Buckinghamshire and Weston. Staff at the Nuffield Orthopaedic Centre filed a serious untoward incident after the system went live in December 2005, amid reports of delayed treatments and lost patient records. Summary by Keep our NHS Public of Pulse 20 April 2007
  • GPs set for mass care record opt-out. GPs are gearing up for a confrontation over electronic care records amid serious concerns over patient confidentiality. Only a third of GPs plan to advise patients to allow their information to be shared, an analysis of the first 250 responses to Pulse's medical ethics survey reveals. GPs are similarly cautious with their own records - just a third will allow full sharing, and four in 10 will opt out completely and allow no data to be uploaded. The refusal to co-operate with the NHS Care Records Service will pitch GPs into fresh conflict with ministers, who stand accused of failing to take into account doctors' concerns over their ambitious NHS IT programme. Pulse's survey found that despite a Government PR drive, more than 80% of GPs still believe electronic care records threaten patient confidentiality. Just 31% plan to advise patients to share information when Summary Care Records are rolled out across England next year, and one in four will advise against uploading any information at all. The findings will come as a blow to Connecting for Health, which has stressed the need to win GPs over. Summary by Keep our NHS Public of Pulse 20 April 2007
  • NHS investment achieves 'limited' success. Retired health minister Lord Warner has said that the government's massive investment in the NHS hasn't delivered all the improvements hoped for. He blamed a smaller than expected benefit from the increased work force on "productivity" issues. He also attacked staff for resisting change. "If you say 'have [staff] delivered all that you would have liked them to deliver for that extra investment' then the frank answer for me is 'not as much as I would like to have seen'," he told Parliamentary Monitor magazine. "They have done a lot of good things, but some of the productivity issues which have been around in the NHS for such a long time need more work." He also highlighted a lack of enthusiasm for the £12bn NHS computer upgrade. "The idea that we could carry on with a paper-based NHS forever is nonsense, but a lot of the staff have been very slow to embrace the idea that you could have an electronic patient record and that you could move information about people faster," he said. He insisted that the government's reforms were necessary and would continue. "I can't tell you how many meetings I have been to with NHS staff when they say 'why can't you ministers just stop this change and let us get on with this perfect path ?' Well, the truth is there has never been one of these perfect paths because health has always continued to change and evolve as new treatments arrive and new demands are made," he said. "One of the great frustrations has been trying to explain to people the inevitability of change." Summary by Keep our NHS Public of Guardian 24 April 2007
  • Smartcard loophole fears. Administrative staff in a Midlands PCT are logging on to Choose and Book using GP practice access rights, in a loophole that practices have warned could have implications for the NHS Care Records Service. Five employees of Warwickshire PCT have a smartcard enabling them to access the referral system, which is registered in the name of a local GP practice. Staff accessing the system are able to view patient information, including why a GP has referred a patient. Dr Paul Cundy, chair of the GPC IT subcommittee, warned PCTs could use a similar workaround when Summary Care Records are rolled out across England next year. 'It makes a nonsense of the so-called access controls and audit trail,' he said. 'Choose and Book is a system that is supposed to be secure and free of interference, but it's being worked around in a variety of places and I dare say the same thing will happen to the Summary Care Record.' Dr Paul Thornton, a GP in Warwickshire, said PCT staff using GP practice access rights would lead to a loss of accountability. A Connecting for Health spokesperson said the matter was 'an information governance and business process matter for the PCT' and was 'not a system security issue'. Summary by Keep our NHS Public of Pulse 27 April 2007
  • Stormy waters ahead as GPs rail at IT disasters. GP anger over IT issues looks set to provoke debate at this year's LMCs' conference, which is destined to be one of the stormiest in years. LMCs from across the country have submitted motions outlining a catalogue of IT problems. Delegates will discuss a range of controversial issues surrounding the National Programme for IT, including problems with Choose and Book, patient confidentiality and the NHS Care Records Service. Devon LMC alone has submitted three separate motions on the topic. One states 'conference is disgusted at the billions of pounds of NHS funds being poured into the current muddled IT program', while a second demands an immediate end to Choose and Book referrals. The third calls for patients to opt in rather than opt out from having a Summary Care Record, and warns 'the public are sleepwalking into a medical confidentiality disaster because the Government has downplayed real concerns'. Summary by Keep our NHS Public of Pulse 27 April 2007
  • Hospitals suffer in computer fiasco. Hospitals have been hit by 200 "major incidents" in four months because of breakdowns in the NHS's £12bn computer system, a report claims. The problems, affecting dozens of hospitals between last October and January, led to doctors being unable to call up X-rays on computer screens in wards and operating theatres, creating delays in treatment. Some hospitals also lost access to records on appointments and planned treatments. The report in Computer Weekly magazine is another blow to the Government's scheme to centralise the records of 50m patients and link 30,000 GPs to 300 hospitals by 2012. MPs have warned that it is turning into the "biggest disaster" in the world. Another glitch, in Manchester, led to hundreds of inaccurate patient records being created every day last month after a software upgrade. Summary by Keep our NHS Public of Telegraph 8 May 2007
  • IT delays 'endangering patients'. Patient safety across the NHS in England is being put at risk by long delays in a £12bn programme to modernise IT systems, according to a study of opinion among senior managers reported today by the British Medical Journal. The study found that hospitals were left relying on outdated patient information systems and some were considering buying interim programmes while they wait for the agency responsible for IT procurement, Connecting for Health, to deliver on its promises. John Carvel, social affairs editor Thursday May 17, 2007 The Guardian
  • Main customer could thwart iSoft merger. An audacious all-paper takeover of cash-strapped NHS software group iSoft by much smaller Australian rival IBA Health could yet be blocked by the British firm's largest customer. US firm Computer Sciences Corporation (CSC), contracted to use iSoft's Lorenzo software package across 60% of hospitals in England, has refused to back the deal. The British firm nevertheless recommended the £132m all-share offer late on Tuesday night. A change of control clause in CSC's contract with iSoft gives the US firm the right to ditch the software provider from its NHS work. IBA executive chairman, Gary Cohen, yesterday insisted he was "confident" of winning CSC's backing. The US firm has made clear it must be convinced that the deal will enhance iSoft's ability to deliver Lorenzo before sanctioning the deal. Simon Bowers Thursday May 17, 2007 The Guardian
  • NHS upgrade at risk after IT firm's rescue bid is blocked. The future of NHS software supplier iSoft was thrown into doubt yesterday after a rescue takeover offer for the business was blocked. iSoft now has until November to secure an urgent cash injection or go bust - a move that could be calamitous for the government's £6.2bn NHS IT upgrade. iSoft last month told investors it was recommending an all-share rescue offer from IBA Health, a much smaller Australian rival. The proposed deal was to come with new equity and debt to fund iSoft's urgent need for working capital. The deal was effectively blocked yesterday by consultancy firm Computer Sciences Corporation, which deploys iSoft's software under the government's troubled National Programme for IT (NPfIT). CSC's contract with iSoft contains a "change of control" clause which gives the US firm the right to ditch iSoft if the business is sold. Simon Bowers Wednesday May 30, 2007 The Guardian
  • iSoft bemused by rescue claim. The IT consultancy group blocking a rescue takeover of NHS software supplier iSoft yesterday claimed it was in exploratory talks with the cash-strapped firm and its lending banks over ways to "underpin its long-term financial stability". Simon Bowers Thursday May 31, 2007 The Guardian
  • IT delays putting patient safety at risk and the NHS is wasting 12% of IT funds. Senior NHS staff support IT modernisation but say that continuing delays are putting patient safety at risk, according to a study published on bmj.com.  Care and Health 31 May 2007
  • 'Scandal' over shredded reports. Civil servants have been ordered to destroy reports on controversial, multi-billion-pound NHS and ID card computer projects in an attempt to keep details of mismanagement from the public, it has been claimed. The order, given to officials at the Office of Government Commerce (OGC), was condemned by the Tories and Liberal Democrats, who accused the Government of trying to hide details of bungled computer schemes. An official tribunal upheld a decision that the documents should be disclosed after a Freedom of Information Act request, but the OGC is appealing against the decision at the High Court. Its paper tells civil servants to shred gateway review reports, which are internal assessments of the projects. The reports are carried out by independent specialists to monitor progress and assess the chances of success. As well as the ID card report, another has been carried out on the NHS's £12.4bn National Programme for IT. Vince Cable, the Liberal Democrats' shadow chancellor, has tabled a Commons question demanding that a Treasury minister explain why the order to shred documents was given. He said: "This is an absolute scandal. The Information Commissioner has ruled that the Government must divulge gateway reviews, which often identify major shortcomings and incompetence in IT projects. For government departments now to be destroying records, apparently under orders from the Treasury, is an absolute disgrace." Summary by Keep our NHS Public of Telegraph 4 June 2007
  • Ministers lose grip on £14bn IT. Ministers are failing to keep a grip on Government computer projects that cost the taxpayer up to £14bn a year, a report by MPs warns. Senior officials running many of Whitehall's most "mission critical" IT schemes have not even held a meeting with the minister responsible, the report discloses. The high turnover of civil servants running such projects, and their lack of experience, has led to damaging "discontinuity" and increased the risk of cost over runs and delays. The report from the Commons public accounts select committee follows a catalogue of costly problems with Government IT projects, including new computer systems for the NHS and tax credit systems. Many have gone billions of pounds over budget and are years behind schedule. The MPs said that in one in five "mission critical and high-risk" computer schemes, senior officials had not met the minister responsible. It found that 70% of senior officials were concerned about the lack of "programme and project management skills" within their departments. There was also a disturbing turnover of staff involved in such schemes. More than half of the senior officials in charge of IT projects were carrying out the role for the first time. Summary by Keep our NHS Public of Telegraph 5 June 2007
  • ISoft takes legal action after takeover blocked. ISoft has begun legal action against its largest customer after it refused to give its consent to a takeover bid from the Australian software firm IBA Health. The Manchester-based software company claimed that Computer Sciences Corporation (CSC) had been working on its own offer for months. ISoft claims that CSC is acting unreasonably by blocking the deal. By initiating legal action, it hopes to force CSC to change its position. In August, a leaked report conducted by CSC and Accenture found there was "no believable plan" for the rollout of Lorenzo. Accenture pulled out of the project, and its contracts were handed to CSC. The Financial Service Authority began investigating "accounting irregularities" at iSoft after its auditors found evidence that revenues from some contracts may have been booked too early. There are concerns that the wider NHS IT upgrade could be harmed by this series of problems, which culminated in iSoft putting itself up for sale last October. Summary by Keep our NHS Public of Guardian 5 June 2007
  • Health service's IT surgeons. Paid £290,000, Richard Granger has had to withstand a relentless tide of attacks on his 'National Programme for IT' to provide the NHS with a range of computer systems. The value of the contracts he manages is more than £7bn. He admits he has been fire-fighting crises for the past three days. His chief concern is the future of software firm Isoft. This key sub-contractor is being investigated for possible accounting irregularities and is in the middle of a bitter takeover battle that threatens delivery timetables. He wants the future of Isoft secure, to ensure that software provider Cerner delivers glitch-free products and to see that the project sails through a parliamentary health committee probe. The critics won't ease off. Sources have suggested that the programme could be the biggest disaster ever seen in a public IT project. Some believe that perhaps one of the three main contractors, Fujitsu, CSC and BT, may be booking profits on work not yet paid for, allegations that are unflinchingly rejected by Granger. He says that BT, which has been chiefly responsible for building the spine of a system that will allow patient records to be shared between GPs and hospitals, will reap commercial dividends. Granger says that the firm's salesmen are jetting around the world to persuade other governments to adopt it. Critics have seized on the fact that Accenture had to pull out of the project last year, writing off hundreds of millions of pounds. It has been claimed that Accenture wanted to change its software provider, ISoft, but that Granger overruled that as it would have led to ISoft's bankruptcy. Utterly untrue, says Granger. 'Accenture found the job very difficult. It was futile persisting with them.' Maybe this was no bad thing given Accenture's bungling of the outsourcing of Sainsbury's IT systems. Asked about claims that IT firms are being rewarded for failure, Granger counters that it's 'actually quite difficult to get paid on these contracts', adding that contractors do not get their money until 45 days after doctors and nurses are happy with the product. Granger believes the main contractors aren't in it to make money but are genuinely interested in improving the NHS. Time will tell whether he is right. Summary by Keep our NHS Public of Observer 10 June 2007
  • GPs blast online patient records scheme. Four family doctors in the area have slammed moves to extend an online patient records scheme which is being piloted in the borough. They raised serious concerns about the security of the system, which allows access by dozens of health professionals, as well as the cost of the scheme which is part of the £12bn NHS computer upgrade. They are also worried that it may put patients off visiting their doctor for fear of their records being made public. One of the four, Dr John Tabor from the Kilodnan House medical Practice in Horwich, said: "There will be 250,000 people who will have access to these records and even though they have been criminally checked, I just don't believe there won't be the odd bad apple." Only 11 surgeries in Bolton have so far signed up to the scheme - bringing 66,000 patients - but letters have been sent to all other Bolton patients and it is expected they will be signed up by the end of next summer. Summary by Keep o