The Open Letter to the Health Select Committee

From Nhs It Info


The Select Committee may be aware of the concerns of health professionals, technologists and professional organisations about the £6bn NHS National Programme for Information Technology (NPfIT):

- The NHS Confederation has said "The IT changes being proposed are individually technically feasible but they have not been integrated, so as to provide comprehensive solutions, anywhere else in the world".

- Two of NPfIT’s largest suppliers have issued warnings about profits in relation to their work and a third has been fined for inadequate performance.

- The British Computer Society has expressed concern that NPfIT may show a shortfall of billions of pounds.

- Various independent surveys show that support from healthcare staff is not assured.

- There have been delays in the delivery of core software for NPfIT.

Concrete, objective information about NPfIT’s progress is not available to external observers. Reliable sources within NPfIT have raised concerns about the technology itself. The National Audit Office report about NPfIT is delayed until this summer, at earliest; the report is not expected to address major technical issues. As computer scientists, engineers and informaticians, we question the wisdom of continuing NPfIT without an independent assessment of its basic technical viability. We suggest an assessment should ask challenging questions and issue concrete recommendations where appropriate, e.g.:

- Does NPfIT have a comprehensive, robust:

    - Technical architecture?

    - Project plan?

    - Detailed design?

Have these documents been reviewed by experts of calibre appropriate to the scope of NPfIT?

- Are the architecture and components of NPfIT likely to:

    - Meet the current and future needs of stakeholders?

    - Support the need for continuous (i.e., 24/7) healthcare IT support and fully address patient safety and organisational continuity issues?

    - Conform to guidance from the Information Commissioner in respect to patient confidentiality and the Data Protection Act?

- Have realistic assessments been carried out about the:

    - Volumes of data and traffic that a fully functioning NPfIT will have to support across the 1000s of healthcare organisations in England?

    - Need for responsiveness, reliability, resilience and recovery under routine and full system load?

We propose that the Health Select Committee help resolve uncertainty about NPfIT by asking the Government to commission an independent technical assessment with all possible speed. The assessment would cost a tiny proportion of the proposed minimum £6bn spend on NPfIT and could save many times its cost.


Ross Anderson
Professor of Security Engineering
Cambridge University

James Backhouse
Director, Information System Integrity Group
London School of Economics

David Bustard
Professor and Head of Computing and Information Engineering
University of Ulster

Ewart Carson
Professor of Systems Science
Centre for Health Informatics
City University

Patrik O’Brian Holt
School of Computing
The Robert Gordon University

Roland Ibbett
School of Informatics
University of Edinburgh

Ray Ison
Professor of Systems
The Open University

Achim Jung
School of Computer Science
University of Birmingham

Frank Land
Emeritus Professor
Information Systems Department
London School of Economics

Bev Littlewood
Professor of Software Engineering
City University

John A McDermid
Professor of Software Engineering
University of York

Julian Newman
Professor of Computing
Glasgow Caledonian University

Brian Randell
School of Computing Science
University of Newcastle

Uday Reddy
School of Computer Science
University of Birmingham

Peter Ryan
Professor of Computing Science
University of Newcastle

Geoffrey Sampson
Department of Informatics
University of Sussex

Martin Shepperd
Professor of Software Technologies
Brunel University

Michael Smith
Visiting Professor
Department of Computer Science
University College London

Tony Solomonides
Reader in Computer Science and Medical Informatics
University of the West of England

Ian Sommerville
Computing Department
Lancaster University

Harold Thimbleby
Professor of Computer Science
Swansea University

Martyn Thomas
Visiting Professor of Software Engineering
Computing Laboratory
Oxford University

Colin Tully
Professor of Software Practice
School of Computing Science
Middlesex University

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