When the Office of Government Commerce Gateway reviews were made available last month they revealed that NPfIT had been given 'red' status, indicating that emergency remedial action was needed, nine times out of 31. A further 19 areas received 'amber' status, indicating that the project should proceed but take serious notice of OGC recommendations, while only three were given 'green', showing they were on track.
The areas given 'red' status included Choose and Book, the Care Record Service (CRS) in London and the North West and the procurement of electronic transmission of prescriptions (ETP), some of the most important elements of the NPfIT
One of the reviews found that Choose and Book was "well behind schedule" and did not have "the robustness and resilience that is required to support the acceleration of deployment".
The CRS in London was described as "a major disappointment so far, due in the main to poor supplier performance". The reviews were slightly more positive about the North East region, which received 'amber', "although there have been some painful teething problems, the roll out process has been proven and lessons are being learned".
Regarding the ETP, the reviews stated: "The programme is perceived to have gone slower than other programmes over the past 12 months. This arises from several factors, amongst them the pharmacists' contract renegotiation, a referral of pharmacy competition to the Office of Fair Trading, and the major procurements taking place for the national and local service provider contracts."
The OGC was very reluctant to publish the material in response to a freedom of information request by the shadow minister for health Stephen O'Brien. The information was only made available once the Information Commissioner's Office stepped in and ordered its publication.
It is important to note that the reviews cover the period between 2002-07, and that while they provide an accurate picture for the time, many achievements have been made since then. This is not to say that there are no concerns about the CRS, which could be subject of a major overhaul later in 2009 if there are no major improvements by November.
It is also important to note that 'red' denotes neither a complete failure nor a recommendation that the programme should stop. It just means that these areas "need to be acted upon with immediate effect." In addition, the recommendations provided by the reviews are now largely out of date and out of context.
So much has changed in the NPfIT in past two years and so much more could happen in the next few months – as suppliers endeavour to achieve significant progress in the CRS area before Christine Connelly's November deadline – that many aspects of the programme are hardly comparable to 2007.
Two important points need to be made. The first is that the reviews' findings should be read with caution. It is essential to distinguish between useful, up to date information which could help to improve the programme and shallow and selective government bashing.
Secondly, the information should have been made available for public consumption without reluctance in 2007, when it was truly relevant. The OGC asked for four extensions before responding to the request, and has withheld six reports undertaken since 2006, the most recent of which was completed in February this year. We remain oblivious to the content of these documents, but such information is of public interest and should not be confined to a highly exclusive audience.
Health trusts would also benefit from these findings. This information could help them to understand the achievements of the NPfIT and assess which systems they should implement and which they should avoid, allowing them to make more robust strategic and procurement decisions.
The NPfIT should not be focused on OGC grades from two years ago. Instead, it's time to prepare for a sterner test.
Victor Almeida is a senior analyst at Kable
