NHS underspends on NPfIT after late care record rollouts

The NHS is estimated to have spent £331 million (US$486.2 million) less than it planned last year on the £12.7 billion National Programme for IT.

Spending is tied to how much suppliers have delivered, and the NHS is four years behind on the summary care record rollout, having temporarily stopped the rollout after some early adopters experienced serious problems.

In the 2008 to 2009 financial year, the NHS is estimated to have spent £586 million, as opposed to a budget of £917 million, health minister Ben Bradshaw told MPs.

In all five years since the start of the programme, the NHS has consistently under-spent. In 2007 to 2008, the NHS under-spent by £229 million, in 2006 to 2007 by £466 million, and in 2005 to 2006 by £769 million. Total underspend since 2005 has been £1.8 billion.

Planned expenditure on the programme this year is £800 million, but this figure is "subject to revision in light of the evolving IT needs of the NHS", Bradshaw said. It has spent £3.5 billion so far.

A spokesperson at Connecting for Health, which runs the national programme, said payments are not made "until we are fully satisfied safe and workable systems have been delivered". Underspends mean "the taxpayer's money is being protected", the spokesperson said.

Martin Bellamy, head of NHS Connecting for Health (NHS CFH) and director of programme and systems delivery at the Department of Health last week said the NHS will be deploying new systems to NHS trusts "as a matter of routine" within 12 months.

Negotiations with suppliers have at times been prolonged and exhaustive. Following months of talks over a contract "reset", Fujitsu left the programme in May last year. It failed to agree with the NHS on tailoring systems for local needs and on payment for those changes. Bradshaw maintained that Fujitsu's contract was terminated "because of failure to meet key contractual milestones and to provide an acceptable remediation plan". The dispute continues.

In 2006, Accenture left the programme after it said it had lost large amounts of money on the work.

Two suppliers are left on the NPfIT, BT and CSC. The first is delivering the Cerner Millennium patient records system in London and in the early adopter trusts previously handled by Fujitsu in the south of England. The latter is delivering the iSoft Lorenzo system in the northern and central clusters of England. Both are expected to compete to win contracts with the remaining southern ex-Fujitsu trusts that have not yet installed a system.

BT in March confirmed a £336 million on its IT services contracts, in which the NPfIT is widely expected to have played a part after early BT rollouts in London experienced severe difficulties.

As of 13 March, some 249,000 summary care records had been created across five of the six early adopter areas: Bolton, Bury, Dorset, South Birmingham and Bradford.

Stoke-on-Trent, Medway and Somerset have begun public information programmes to inform local residents before their GP records are made available on the new systems.