An IT system designed to extract data from all GP computer systems in England is late, over budget and not fully working, according to the Public Accounts Committee.
In a report, the committee has highlighted severe failures in the creation of the General Practice Extraction Service (GPES), which would be used to monitor quality, plan and pay for health services and help medical research.
It also said that Atos, contracted supplier for a key part of the system, “did not show an appropriate duty of care to the taxpayer” and accused it of acting “solely with its own short term best interests in mind”.
The committee concluded the service, started five years later than planned, was over-budget and still did not provide the full service required.
During the planning and procurement stage, the expected cost of the project increased from £14 million to £40 million. Only two of the eight organisations identified as users of the service have received data from GPES so far.
The committee concluded the Department of Health did not have effective governance in place for the project, and that mistakes from previous failed IT projects were still being made. These included adopting the wrong contracting approach, failing to ensure continuity of key staff, and failing to undertake proper testing before accepting the system. It also urged the Cabinet Office to review Atos’s relationships as a supplier to the Crown.
“It’s incredible that basic mistakes on contract and project management are still being made, from inadequate testing to woeful governance,” said Meg Hillier, Labour MP and chairman of the committee.
“We keep calling for ‘lessons to be learned’ and keep receiving reassurances from senior accounting officers that they are. Yet the same issues occur time after time. It’s simply not good enough.”
The committee report said that the Department had admitted that it was not getting value for money from the project, that it was only delivering about half of what was specified and paid for, and that the fixed-price contract approach which was used had been inappropriate.
The committee has made a series of recommendations including that the Department of Health and the Health and Social Care Information Centre (HSCIC) develop a clear plan for the future of GPES within the next six months.
The department must also ensure IT projects are managed by people with the appropriate skills and experience and appoint a named individual responsible for signing off each stage of the system. There must be clear lines of accountability between the department and the bodies delivering IT projects, with proper oversight mechanisms to monitor projects and take timely remedial action when necessary. Systems must be tested properly before they are accepted.
The committee was also very critical of Atos, claiming it had failed to show an appropriate duty of care to the taxpayer. The report said: “Atos, supplier for a key part of the system, may have met the letter of its contractual obligations but took advantage of a weak client by taking the client’s money while knowing full well that the whole system had not been properly tested.”
Later it continued: “We are not satisfied Atos provided proper professional support to an inexpert client and are very concerned that it appears to have acted solely with its own short term best interests in mind,” the report said.
In response, Atos said that the GPES had been running as it was designed to since March 2014, delivering around 40 extractions per year from 8,000 general practices in England. It said it was responsible for a single part of the GPES system and was not responsible for the increase in budget to £40 million. A spokesperson said: “At the hearing [PAC hearing] we made clear that given we were one of eight suppliers and not acting as the system integrator we did not have visibility of the end-to-end programme in order to advise the NHS IC on the overall programme.
“On the part of the system we built, we collaborated fully with NHS IC adding additional functionality as requested and where issues were found we fixed them quickly at our own cost.”
The committee also highlighted its recent report on strategic financial management in the Ministry of Defence and military flying training, where it recommended that consideration be given to adding clauses to contracts placing a duty on contractors to give early warnings of problems with contracts even if this could be financially disadvantageous to the contractor. The GPES project is the latest government IT project to come under fire for various failures, including the National Programme for IT in the NHS, the Single Payment Scheme and Tax Credits.
The committee recommended that the Cabinet Office widely disseminate the failings in the GPES project to avoid the same mistakes being repeated.
Hillier said: “The government needs to get its house in order, properly address these very serious failings and ensure public money is not squandered in such an irresponsible manner.”
Info: What is GPES?
GPES was designed to extract data from the four major clinical IT systems used by GPs for use by NHS organisations, including Public Health England, NHS England, the Clinical Commissioning Groups, UK Biobank, the Healthcare Quality Improvement Partnership, the National Institute for Health and Care Excellence, the Medicines and Healthcare Products Regulatory Agency and the Care Quality Commission.
Work on the project began in 2007 when it was the responsibility of the NHS Information Centre (NHS IC), which designed and ran the project. NHS IC contracted with the four major suppliers of the clinical IT systems used by GPs to produce software to extract data from their systems.
NHS IC awarded a contract to Atos in December 2011 to produce the central software required to interact with each of these systems.
The Department of Health approved the business cases and provided the required funding as well as contributing technical expertise around the design and how it would integrate with other NHS systems.
In March 2013 NHS IC closed and responsibility for GPES transferred to the new Health and Social Care Information Centre, which found that the system had fundamental designs flaws and did not fully work.