There is no single national start or completion date for the national programme for information technology as a whole, or for its individual systems and services. The aim is to achieve substantial integration of health and social care information systems in England under the national programme by 2010. The approach, in line with best practice, is to implement new services incrementally, avoiding a big bang approach, and to provide increasingly richer functionality over time.
Of the key centrally-funded programme projects, the first elements of the national health service care records service, to provide a transaction messaging service, a personal demographics service, a spine directory service and secure access controls via smartcards, went live on time and to budget in July 2004. The software to support choose and book is complete and went live on time and to budget, also in July 2004. The software to introduce the quality management and analysis system (QMAS) in support of the general medical services contract went live on time and to budget in August 2004 and was fully rolled out within three months, supporting payments to 100 per cent. of general practitioners (GPs) under the quality outcomes framework (QOF) every month since then. The software to allow electronic prescriptions to be issued went live on time and to budget in February 2005. The rate of connections to the new national broadband network (N3) has always been, and remains, ahead of schedule, and 98 per cent. of GPs now have a broadband connection.
The first Picture Archiving and Communication System (PACS) under the programme was implemented in April 2005 and 57 systems have been implemented to date with over 86 million digital images stored. NHSmail was implemented on time in October 2004 and currently has over 210,000 registered users sending 800,000 e-mails per day.
Further details of progress towards delivery across the NHS of the centrally funded national infrastructure and services within the programme are contained in the National Audit Office (NAO)'s report published on 16 June 2006 which is available in the Library and via the NAO website at
However, some local service deployments are late, as some suppliers and their subcontractors have taken longer than anticipated to deliver software. Local service provider (LSP) systems are between one and two years behind original plans. Delays are due in part to the great complexity of developing computer software but also other factors—the need to reach a consensus with stakeholders, including doctors and patients, about the detail of both the software and the operational framework of electronic health records. Significant levels of data corruption and concomitant problems in existing local systems have also impeded the take-up of the new systems. The cost of delays is met by suppliers, not the taxpayer.
Though there have been delays, the programme is also delivering additional projects which were not part of the original scope of the programme. These include PACS, QMAS, the NHSmail email system, an IT system that will be used to invite people to take part in the bowel cancer-screening programme, andspecial enterprise-wide agreements by which NHS organisations can buy additional products and services at significantly discounted prices. In its first two years of implementation activity the programme has made more progress towards the objective of information being available throughout the NHS than had been achieved in the previous decade.
As the NAO made clear in their report, the value of contracts let for the core components of the national programme over 10 years has not increased since the contracts were let in 2003 and 2004. None of the relevant project budgets managed by the Department's NHS Connecting for Health agency have been exceeded. Anticipated expenditure under these contracts remains at planned levels.