PAC Hearing

From Nhs It Info


Uncorrected Transcript of Oral Evidence - PAC Hearing, 26 Jun 2006

CfH accused of 'sham' on clinical consultation (27 Jun 2006)

e-Health Insider Primary Care

"Perhaps the most unexpected part of the Commons Public Accounts Committee hearing on the National Programme for IT this week was the appearance of two senior figures from the programme's early days – Dr Anthony Nowlan and Professor Peter Hutton – who came back to haunt the proceedings with accusations about lack of clinical engagement. Professor Hutton, a distinguished anaesthetist who resigned as chair of the National Clinical Advisory Board in April 2004, said: “A senior person said he felt the consultation was a sham. We used to meet in Starbucks in Leeds station to talk about it.” He told the committee that he wrote setting out his concerns about the lack of meaningful clinical engagement ahead of systems actually being procured and within 10 days was asked to resign. Dr Nowlan, a former director of the NHS Information Authority, said: “I was approached to provide hundreds of names of people who supported it [the NPfIT] and I declined.” He said that he spoke to 10 people on the list of those who were shown to have been consulted and “none had any memory of any meaningful input into the programme.""

NPfIT scrutinised by Public Accounts Committee (27 Jun 2006)

E-Health Insider Primary Care

The Public Accounts Committee hearing into the NHS National Programme for IT yesterday heard that the £12.4bn programme is largely on track, other than its central component: the NHS Care Records Service intended to deliver rich local clinical systems and a national database of summary records. So far just 12 acute trusts have so far received the patient administration systems that are meant to provide the first building blocks of detailed local care record systems. No trusts have yet received more complex integrated clinical systems – the local component of CRS. Committee chairman Edward Leigh, said: “There are 170 acute trusts and the system has just been deployed into 12, CRS is not in yet.” . . . Leigh said that he had been told that CfH had fought the NAO over its report “street by street and block by block”. “I don’t see it as a battle,” said Sir John Bourn, head of the NAO. He added that robust debate with CfH, the examined body, was a natural part of the process. “Of course one side argued with the other.” Greg Clarke, committee member and Conservative MP, said of the NAO report. “I’ve read 62 NAO reports over the past year and this is easily the most gushing.”

Officials blame suppliers for NHS's NPfIT delays (27 Jun 2006)

Computer Weekly's+NPfIT+delays.htm

"Lack of capacity among suppliers has led to things “going wrong” with the £12.4bn NHS National Programme for IT and is still a risk, senior officials have admitted to MPs. NHS chief executive Sir Ian Carruthers, director of IT implementation Richard Jeavons and Richard Granger, chief executive of Connecting for Health, which runs NPfIT, received a grilling at a Commons Public Accounts Committee hearing on Monday to examine the National Audit Office’s report on NPfIT on Monday. The MPs were sceptical of the “almost universally positive tone” of the NAO report, described by Greg Clark MP as “easily the most gushing” he had seen, and turned the heat on the officials. Pressed by committee chair Edward Leigh, Caruthers admitted the two year delay in introducing a national clinical record service – a core part of NPfIT – was a decision taken because “some suppliers were having difficulties meeting the timetable” and clinicians wanted to pilot the scheme. Granger was forced to agree with Leigh that suppliers were showing “signs of strain”. In a heated exchange, Austin Mitchell MP challenged Granger, “You’ve got Accenture with an estimated half a billion dollar losses, you’ve got iSoft going belly up fairly soon, IDX which is blamed by BT and Fujitsu, from which BT wants to walk away and you’ve got Cerner brought in which I’m told is able only to support one hospital in one region using its standard software yet its been stretched to two regions.”"

MPs slam NHS IT delays - Lack of early clinical consultation attacked... (27 Jun 2006),3800010403,39159935,00.htm

"Delays with the £6.2bn NHS IT programme have been blamed on a lack of proper clinical consultation during the procurement of the systems. NHS CEO Sir Ian Carruthers and NHS director general of IT Richard Granger were grilled on the Connecting for Health programme by MPs during a heated Public Accounts Committee (PAC) meeting at the House of Commons this week. The National Audit Office (NAO) also came under attack for the "gushing" and "universally positive tone" of its long-delayed report into the NHS IT programme, despite the fact the cost of the scheme has risen to £12.4bn and the rollout of key systems is running years behind schedule, and was accused of being "ground down" by officials at the Department of Health."

Risk fears on NHS computer scheme (27 Jun 2007)

BBC News

"England's NHS IT upgrade does pose clinical risks, but the system will "dramatically" cut the dangers of wrong prescriptions, MPs have been told. . . The questions session also saw the project's former senior clinical advisor claim that doctors were not consulted enough in its early stages. Peter Hutton, who was later asked to resign from his post, said people had not been sure what was needed. . . But Richard Granger, director general of IT for the NHS, said hundreds of doctors were already using the part of the system which had already been delivered. . . NAO chief Sir John Bourn told the MPs he thought the system was likely to be value for money, unlike many government IT projects. And he thought it would be delivered on time if the NHS accepted his recommendations. Sir John denied he had been "ground down by a war of attrition" with the Department of Health into producing a "gushing" report. He said there had been arguments and "proper debate" over his report - but such discussions were not "illegitimate". But Public Accounts Committee chairman Edward Leigh said the project managers had fought "street by street, block by block" with the NAO."

Leader: No to any NHS IT whitewash - Why are officials refusing to admit there are problems? (27 Jun 2006),3800010403,39159939,00.htm

"Public spending watchdog the National Audit Office (NAO) may have been able to ignore many of the problems with the £6.2bn NHS IT programme in its surprisingly upbeat progress report last week but MPs have not been as accepting. Indeed, at a packed and at times extremely heated Public Accounts Committee meeting at the House of Commons yesterday evening, MPs accused the NAO of giving in to bullying by Department of Health officials and producing a "gushing" and "universally positive" report into the Connecting for Health programme. More interesting were the barbed exchanges between MPs, NHS IT director general Richard Granger and two of his now highly critical ex-colleagues, Professor Peter Hutton. . . Granger has rightly been praised for drawing up IT contracts that avoid the mistakes of past government IT failures, only rewarding suppliers for delivery - and penalising them, rather than taxpayers, for failure to deliver. But at what cost has this come? Has the rush to procure and fit the timetable set by the Prime Minister led to a fundamental failure to engage the very people who will have to use the new NHS IT systems? Just this month we can see evidence of that in the £19m that some healthcare trusts in the south of England have had to pay to get out of a contract that could have seen them paying more than £50m per year in penalties to lead contractor Fujitsu Services for failing to provide IT resources to support implementation of new systems. And the PAC meeting heard that NHS Trusts in the northwest of England may now also have to fork out £37m to CSC to get out of a similar contractual obligation. The NHS IT programme is indeed a highly ambitious project and, understandably, with that will come risks and setbacks along the way. Yet while it is already delivering some tangible successes there are also serious causes for concern and simply trying to ignore that is a recipe for disaster. The question has to be asked: is now the time for the government to admit there should be a fully independent review of the NHS IT programme?"

NHS IT charade re-played - But does not stand up to PAC scrutiny (28 Jun 2006)

The Register

"The £12.4bn National Programme for IT might not have been good value for money, said the National Audit Office on the publication of its report on the scheme only 10 days ago. This story had changed when the report's findings were quizzed by the House of Commons Public Accounts Committee earlier this week. Sir John Bourne, auditor general, said he thought the controversial NPfIT contracts would deliver value for money because they refused payment to suppliers until they had delivered results. This appeared to contradict Chris Shapcott, director of health value for money studies at the NAO, who said it would not be possible to assess whether NPfIT had been value for money until a proper cost benefit analysis had been done and the project was finished in 2010. Bourne went further, however, saying it was well thought out, and well managed considering the challenge of such an ambitious scheme. The PAC hearing then unveiled a string of queries and revelations that appeared to support Shapcott's reserved view of the programme and less so what Greg Clark, conservative MP for Tunbridge Wells called the "most gushing" of 62 NAO reports he had read on he PAC. The committee heard how the management of the programme was haphazard. The wisdom accumulated from other bodged government IT projects holds that there should be one Senior Responsible Owner, or grand overseer. NPfIT had six SROs since 2004. NPfIT's vision had already implicitly criticised by the NAO in the one significant criticism levelled at the programme in its report, which was the lack of consultation undertaken with the system's users (clinicians) before the specification was drawn up, the contracts let and development commenced. . . Taking all the flack for this was Granger, the man brought in to do just the job he did: crack skulls and perform the miracle of pulling off the largest and most complex project of its kind ever attempted anywhere in the world, in record time. The fact that he hasn't pulled it off, that serious questions have been raised and must be taken further, should be answered by the senior responsible owner, if there had been one, or the chief executive of the NHS, had he not just resigned."

NHS IT faces fresh scrutiny: Claim that programme suffers a lack of clinical involvement is denied (29 Jun 2006)


"The National Programme for NHS IT (NPfIT) is continuing to attract criticism for a lack of clinical involvement.

Professor Peter Hutton, NPfIT chief medical adviser until 2004, told the Commons Public Accounts Committee (PAC) this week that the contracts signed in 2003 did not buy what doctors wanted. ‘It was like being in a juggernaut on the M1 – it didn’t matter where we went as long as we arrived on time,’ said Hutton. But representatives from the NHS and Connecting for Health (CfH), the organisation responsible for implementing the programme, denied Hutton’s claim. . . PAC chairman Edward Leigh emphasised the two-year delay to the national electronic patient record system at the heart of the programme. Of 170 acute hospitals, none is yet able to access national electronic records, he said. . . MPs questioned the report’s broadly positive tone, in the light of its release a year later than expected and rumours of struggles between the NAO and the Department of Health over its contents. Bourn said the report took time be cause of the complexity of the subject. Summing up, Leigh said the programme is ambitious, with some positive elements but with systems not yet fully working on the ground. He requested further NAO investigation, to be discussed again by the committee."

NHS leader ‘asked to resign’ after voicing fears over lack of user input (4 Jul 2006)

Computer Weekly

"He revealed the circumstances around his resignation at a meeting of the Public Accounts Committee last week into the NPfIT. The hearing was told that core software for the Care Records Service – a system designed to provide an online medical record for 50 million patients in England – has been delayed for at least two years. Hutton told the committee, “I think the situation we are in was entirely predictable in the early part of 2004.” Hutton said he had written to Nigel Crisp, then chief executive of the NHS. His letter in March 2004 was written months after Whitehall had awarded £6.2bn worth of IT contracts as part of the NPfIT. The letter said, “I remain concerned that the current arrangements within the programme are unsafe from a variety of angles and, in particular, that the constraints of the contracting process, with its absence of clinical input, may have resulted in the purchase of a product that will potentially not fulfil our goals.” Hutton told the committee, “Within 10 days of writing that, I was asked to resign.” . . . Many statistics were given to MPs during their one-off hearing on the National Programme for IT. But they did not learn exactly why the core software is at least two years late. When an IT programme is in trouble, truth can become a precious jewel buried so deep it can be extracted only with tireless determination. That is why we continue to campaign for an independent review of the scheme. Not until last week did it emerge that a disastrous IT-related reform programme at the Child Support Agency had been the subject of 40 audit reviews, 70% of which had sounded alarm bells. None had been published, so there was no parliamentary pressure to act on them. Ministers say there have been many independent reviews of the NHS scheme. But none has been published. We do not want to wait for years, perhaps until it is too late, to discover the real challenges and difficulties the NHS programme has faced."

Officials blame suppliers for delays to IT scheme (4 Jul 2006)

Computer Weekly

"Lack of capacity among suppliers has led to things “going wrong” with the £12.4bn NHS National Programme for IT, and it is still a risk, senior officials told MPs last week. NHS acting chief executive Ian Carruthers, director of IT implementation Richard Jeavons and Richard Granger, chief executive of Connecting for Health, which runs the IT programme, were questioned at the Commons Public Accounts Committee hearing to examine the National Audit Office’s report on the NPfIT. The MPs were sceptical of the “almost universally positive tone” of the NAO report, described by MP Greg Clark as “easily the most gushing” he had seen. Pressed by committee chairman Edward Leigh, Carruthers said the two-year delay in introducing a national clinical record service was a decision taken because “some suppliers were having difficulties meeting the timetable” and clinicians wanted to pilot the scheme."

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