NPfIT to cost £10 billion

The final cost of the National Programme for IT in the NHS is expected to be more than £10 billion.

Around £2.6 billion of actual benefits had been identified as of March 2011, but the Department of Health is predicting a final benefit figure of £10.1 billion.

An NPfIT benefits statement, released to EHI under the Freedom of Information Act, reveals that as of 2012, the total cost of the programme in 2004-05 prices was forecast as £10 billion with around £7.3 billion spent already.

The programme was set up in 2002 and originally slated to cost £12.7 billion, however it was officially axed in September 2010 and again in 2011, without delivering its original vision of electronic patient records across the health service.

The benefits report was released by the National Audit Office, which used it for a recent note for the Commons’ Public Accounts Committee on the DH’s analysis of the costs and benefits of the national programme, which has still to be published.

The NAO is sceptical of the DH’s benefits predictions, saying there is “very considerable uncertainty about whether the forecast benefits will be realised.”

Another report released by the NAO comparing the costs and benefits provided by the DH in previous years confirms that in 2008, the total forecast spend until the end of national contracts was £12.7 billion.

By 2011, this had reduced to £11.4 billion and by 2012 this had reduced again to £9.6 billion. The headline figure of £10 billion relates to the cost until the ‘end of life’ of the programme, although it does not specify when this is.

The NPfIT benefits statement says the forecast cost until the end of life of the London Programme for IT – where BT has rolled-out Cerner Millennium to acute trusts and CSE’s RiO to community and mental health trusts – is £1.25 billion.

The cost as of March 2012 was £764m, but a number of Cerner deployments are yet to go ahead including Croydon Health Services NHS Trust, which was due to go live this Sunday, but is now aiming for the end of September.

The actual benefits realised from the London programme were £18m by March 2011, but estimated at £784m by the programme’s end.

In the South, where Millennium has been deployed at 10 trusts and 19 trusts have 25 instances of RiO, the forecast is £960m in ‘core’ costs and another £300m in ‘local clinical systems’, however what comes under ‘local clinical systems’ is not explained.

While just £15m benefits had been realised by March 2011, more than £1.3 billion was forecast by the end of SPfIT.

The North Midlands and East forecast cost is £2.9 billion. Actual benefits as of March 2011 were £114m, but forecast benefits are nearly £3.3 billion.

These figures are excluding the costs and benefits of the Lorenzo elements of the CSC contract.

When questioned by the PAC, Tim Donohoe, the senior responsible owner for the local service provider programmes at the DH, said the government’s total predicted spend on the Lorenzo system is nearly £600m.

The National PACS Programme cost to install picture archiving and communications and radiology information systems at trusts that needed them is expected to be nearly £1.1 billion.

The documents identify £711m in actual savings by March 2011, with £1 billion in total savings forecast.

The combined cost of national applications such as Choose and Book, GP2GP, the Electronic Prescription Service and Summary Care Record programme is forecast as £950m.

The predicted benefit of these applications is nearly £2 billion by the end of the programme, but just £650m in benefits had been identified by March 2011.

National infrastructure including N3, NHSmail and the Spine is estimated to cost £2.4 billion and to reap £1.8 billion in benefits.

EHI has received detailed reports on the costs and benefits of NPfIT from the National Audit Office. We will be running a series analysing the released information called ‘The NAO Files’ over coming weeks.