Health IT Spending Is Not Working in Britain

The National Programme for IT in the National Health Service was launched in 2002 with a 2010 goal of providing every NHS patient with his very own electronic medical record. Yet in its most recent report, the British National Audit Office states that the Department of Health there has been a:

steady reduction in value delivered not matched by a reduction in costs. On this basis we conclude that the £2.7 billion spent on care records systems so far does not represent value for money, and we do not find grounds for confidence that the remaining planned spend of £4.3 billion will be different.

As in the U.S., the system was sold with claims that it would improve services and the quality of care. In fact, many of the proposed applications, like internet appointment scheduling, electronic prescribing, computerized order entry in hospitals, and a secure organizational broadband communications network are already in use, without government subsidy, in the U.S.

The project consisted of three parts: (1) the development of a Summary Care Record containing key medical information that could be accessed across England for each patient; (2) the development of a Detailed Care Record containing complete medical history with access limited to one’s physicians, hospital, or local caregivers for each patient; and (3) the development of a national broadband architecture allowing all of this information to be shared between sites that deliver NHS care.

The development of the Detailed Care Record has been far more difficult than expected. The Audit Office reports that the aim of creating an electronic record for every NHS patient will not be achieved. Of the 4,715 NHS organizations in England that were expected to receive new IT systems, 3,197 are still waiting. About half of hospital trusts will not have systems delivered. Care records for 1,243 GP practices and the London Ambulance Service have been canceled. This will save just £73 million out of the original £1,021 million because the original systems did not work.

The attempt to impose centrally managed systems on local hospitals has failed, and the Department has announced that it has shifted from its original intent of replacing entire data systems wholesale to building on existing systems and letting local groups make smaller changes in line with their local business requirements and capacity.