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From Nhs It Info

This dossier has been put together by the group of twenty-three academics who, in April 2006, became concerned by what they had learned of the plans, progress, reported difficulties and controversies surrounding the UK National Health Service’s National Programme for Information Technology (NPfIT). It brings together a host of evidence, covering a very wide range of issues that in combination suggest the project is in serious trouble.

Given the scale of the project, one of the largest ever attempted, the past track record of large public sector IT projects, and the mounting evidence of serious concerns from health and IT professionals and from the media, the risk to the NHS and the public of significant failures reinforces the need for a careful, open, honest and independent examination of the situation.

The first main section of the dossier documents interactions with the Health Committee and the NHS. The single biggest section (Section 4) consists of quotations from published reports and articles reporting on problems or expressing various types of concern over the National Programme for Information Technology (NPfIT), whenever possible accompanied by the Internet address at which an on-line version of the full text of the original article or report can be found. However this is preceded by a section containing the full texts of a number of unpublished expressions of concern.

Other sections include ones that are to devoted to material emanating from or about various organisations, such as the Public Accounts Committee, Parliament, the Department of Heath, the British Computer Society, etc., together with two that attempt to document all the Parliamentary Questions and contributions to Parliamentary Debates relating to NPfIT and concerns about its progress during the early years of the Programme. (These questions and contributions are from forty-eight Members of Parliament and from seven Members of the House of Lords.)

Updating of this dossier continued until September 2010, when a Department of Health review "concluded that a centralised, national approach is no longer required, and that a more locally-led plural system of procurement should operate".

Some noteworthy late additions
Health Select Committee Inquiry
Supplier sets out risks facing NHS IT plan
Summary: Private Eye Special Report on the NHS IT Programme
Public Accounts Committee: Department of Health: The National Programme for IT in the NHS

Our Supplementary Evidence to the EPR Inquiry on Independent Reviews

Bad Health Informatics Can Kill
Secret papers reveal Blair's rushed NPfIT plans
Summary Care Record Early Adopter Programme: An independent evaluation by University College London
Newcastle NHS trust quits the NPfIT ship
NHS records project grinds to halt
Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method
Printable (4.3MB PDF file) 489-page report based on the contents of the final version of this on-line dossier, as of 9 Sep 2010.
(Here for the record is the 212-page 3.5MB PDF version, printed copies of which were distributed to a large
number of MPs and officials on 18 Jan 2007.)


Health Select Committee

The Open Letter to the Health Select Committee

This letter, signed by twenty-three academics, was sent on 10 April 2006. One of the immediate consequences was that we all received invitations from the Director-General of NPfIT, to discuss the concerns expressed. In addition the House Select Committee requested from us, and were provided with, a memorandum containing a more detailed proposal and with suggestions for the terms of reference for an independent technical assessment of NPfIT, together with an initial version of a Bibliography of Published Concerns.

Agreed Statement

This agreed statement was issued, and placed on the NHS Connecting for Health web-site, following the meeting at NHS attended by representatives of the signatories on 20 April 2006.

    Initial Incorrect Version of the Agreed statement

    This was placed on the Connecting for Health web-site shortly after meeting, but replaced by a corrected version once we had pointed out the small but significant error.

    Current Replacement Text on the CfH Web-Site

    The text (in place of the agreed text) provided on the CfH web-site as of 12 Oct 2006 - it is not known when the original agreed statement - which made it clear that both sides accepted that a "constructive and pragmatic independent review of the programme could be valuable" - was replaced by this text.

Media Commentary on the Open Letter and the Agreed Statement

(Quotations from, and links to the full text of, 7 articles.)

====Memorandum for Health Committee==== (Sent on request 14 May 2006)

====Technical Review ToR==== (Attachment to the memorandum sent on 14 May 2006)

Second Open Letter to the Health Select Committee

(This further letter, by the same signatories, was sent to the Health Select Committee on October 6, 2006.)

Media Commentary on the Second Open Letter

(Quotations from, and links to the full text of, 7 articles.)

Media Commentary on our NHS IT Info Dossier

(Quotations from, and links to the full text of, 7 articles.)

Health Select Committee Inquiry

(Documents and media commentary following the Health Select Committee's reversal of their earlier decisions, and announcement that they would hold an inquiry into NPfIT.)

Unpublished Concerns Regarding NPfIT

This section of the dossier contains previously-unpublished informative and constructive contributions that we have received from people who have extensive direct knowledge of NPfIT and the challenges of developing large IT systems.

Bibliography of Published Concerns Regarding NPfIT

This ever-growing set of quotations (now greatly expanded from the original version provided to the Health Select Committee in May 2006) gives just one side of the case, so to speak - no doubt a number of alternative quotations relating to NPfIT could be selected that would paint a somewhat rosier picture - this however is a task for CfH.

National Audit Office

(Reports and commentary)

Public Accounts Committee

(Hearings, submissions and commentary)


(Official records, reports, etc.)

Individual Members of Parliament

Written parliamentary questions (since Jan 2004), and papers, speeches, etc., relating to concerns about NPfIT, by current MPs. (The answers to the written questions can be found via the links provided.)

Individual Members of the House of Lords

Written parliamentary questions (since Jan 2004), and papers, speeches, etc., relating to concerns about NPfIT. (The answers to the written questions can be found via the links provided.)

Department of Health

(Documents and commentary.)

British Computer Society

(On the BCS's statements about NPfIT; the actual statements are referenced in appropriate sections of the Bibliography of Published Concerns, above.)

NPfIT Specifications and Policies

(Reports and commentary.)

Refereed Studies

(Quotations from, and links to the full text of, papers providing detailed field studies of deployed healthcare systems, in particular NHS EPR systems.)

Other Documents

(Quotations from, and links to the full text of, other relevant documents.)

Other Websites

(Relevant websites and other online resources.)

The End of NPfIT

(The Department of Health announcement, and some press commentary.)

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