The National Programme for IT - the multi-billion pound contract to update NHS technology use - continues to show an absence of basic management, and even though the scope of the project is shrinking costs are not.
Today's report from the National Audit Office is damning even for the NAO and questions whether there is any point in continuing the £11.4bn scheme.
It starts with the good(ish) news - £2bn spent on a broadband network and X-ray exchange is mostly now working.
But on patient records the picture is less good.
The NAO said:
The rate at which electronic care records systems are being put in place across the NHS under the National Programme for IT is falling far below expectations and the core aim that every patient should have an electronic care record under the Programme will not now be achieved.
Auditors noted that even where programmes have been delivered they're not fulfilling all the functions promised. And even though the number of systems has been significantly reduced there has not been a similar cut in costs.
They state simply:
The £2.7 billion spent so far on care records systems does not represent value for money. And, based on performance so far, the NAO has no grounds for confidence that the remaining planned spending of £4.3 billion on care records systems will be any different.
Much of this criticism of course has been heard before during the life of the much-delayed project.
More damning is the NAO accusation that unclear information about the success or failure of key objectives.
In Whitehall-mannered words the auditors said:
Our findings are presented in the context of a lack of clarity between the Department and its suppliers about basic management information. In some cases we have been unable to reconcile the discrepancies we have identified. For example, information we received from the suppliers on Friday 13 May does not reconcile with information provided by the Department the previous day. The Department was unable to provide clarification to reconcile the discrepancies by the time this report was submitted by the Comptroller and Auditor General for publication on Monday 16 May.
Looking forward the NAO is also concerned that much of the management structure supposedly running the project will have been closed by the coalition government before the contracts end.
It asks: "Who will manage the existing contracts up to July 2016, who will measure and report on the benefits of the Programme?"
Connecting for Health, the quango which was meant to be managing the project, sent us the following:
Improving information technology is a fundamental part of delivering a modern, world-class health service. This report from the NAO highlights major concerns with the pace and scale of delivery of information systems under the National Programme for IT. We agree change is needed and that the original vision was flawed. This is why last year we announced a move away from a centralised, national approach to IT to localised responsibility and decision making. However we do think the investment made so far in the NPfIT will potentially deliver value for money now that we have a more flexible approach that allows the local NHS to be in charge of its own requirements.
The NAO report on the National Programme for IT in the NHS is here. ®