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Experts call for review of NHS IT upgrade

Inadequately designed infrastructure will struggle to cope with demands of health system, say critics

The planned £6.2bn upgrade of the NHS IT system, National Programme for IT (NPfIT) must be independently investigated, say 23 of the UK's top academics in computer-related sciences.

In an open letter to MPs, the group of academics cast doubts on the robustness of the IT system, questioning the wisdom behind upgrades to an infrastructure that critics say is inadequate for dealing with the huge demands of the NHS.

According to reports in Computer Weekly, the unprecedented step of an open letter was forced upon those involved. They reported that, "suppliers say they have been warned off speaking about the NPfIT, and IT directors in the NHS fear being victimised if they openly express critical views. Academics, who are independent of the NHS, can express their concerns without fear of repercussions".

The senior academics have questioned whether the NPfIT has been designed properly or reviewed adequately. They suggest that systems are not robust enough to handle huge volumes of data, and also fear that the shared database threatens patient confidentiality - many GPs have already expressed their fears that there aren't enough safeguards in place.

The letter to MPs said: ìConcrete, objective information about NPfIT's progress is not available to external observers. Reliable sources within NPfIT have raised concerns about the technology itself. We propose that the Health Select Committee help resolve uncertainty about NPfIT by asking the government to commission an independent technical assessment with all possible speed.î

Tom Brooks, a long-standing member of the Parliamentary IT Committee, told Computer Weekly that a thorough independent review of the NPfIT was overdue.

He said: ìA number of informed parliamentarians and many senior managers in NHS trusts have lost confidence in the implementation plansÖand in its management.

The Department of Health has rejected the claims. A spokeswoman said: ìThe National Programme for IT is under constant review, scrutiny and audit by parliament and government bodies. It is a robust and resilient programmeÖ We remain confident that the technical architecture of the national programme is appropriate.

The IT system, including its upgrades, has been dogged by controversy. According to the BBC, Oxford's Nuffield Orthopaedic Centre experienced major upgrade difficulties. And GPs in Nottinghamshire found the 'choose and book' system, already a year behind schedule, to be insecure.

Connecting for Health, which is managing the NPfIT, claims that thousands of deployments have gone smoothly. However, critics say the national plan has turned into temporary systems and local initiatives similar to schemes that pre-dated NPfIT's conception.

Suppliers are also facing difficulties - Accenture, the main supplier to two of the five NHS clusters in England, announced a predicted write-off of £260m on its contract; a senior subcontractor, iSoft, has had share prices halved since January; BT has been fined more than once for poor performance; and CSC have announced significant job losses before putting itself up for sale.

30th September 2008

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