NAO damning report on NHS NPfIT

A snappy title?  I doubt I could have fitted the full names into the title box, so:

National Audit Office - home

NAO: The UK’s National Audit Office scrutinises public spending on behalf of Parliament.  More here.


NHS: The National Health Service – still, despite political rhetoric, one of the very best health services in the world and still free at the point of need. More here.


NPfIT: The National Programme for IT (information Technology).  Sometimes called “Connecting for Health” it is an £11billion+ programme to create unified broadband network to share patient records across the whole NHS. More here.

How Damning?

Very: their report “concludes that 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 [one part of NPfIT] will be any different.”  Ouch!  (from the press release)

Some of my former colleagues have worked on this project, so I need to tread a little carefully, especially as some I like and respect greatly.

But the NAO’s conclusions speak for themselves:

“This is yet another example of a department fundamentally underestimating the scale and complexity of a major IT-enabled change programme” said Amyas Morse, head of the NAO.

Change – Projects – Risk

The subtitle of this blog: “Change-Projects-Risk” is there because the three are intimately linked.  At Deloitte, at the time I was leaving, several partners made it clear to me that “Change Management and Project Management are different disciplines: you are a Project Manager, Mike”

I saw this – and still see this – as nonsense.  Change management and project management are labels for two ends of a spectrum and whilst I understand the business need to create artificial divides to make a service offering clear, the real world is messier.  And the management of project and change risk is vital – all the more so as the scale and complexity rises.

And when this attitude contaminates the thinking of practitioners on the ground, as I suspect it did with some of the leaders of NPfIT, then the lack of sophistication has consequences.

Many Many Reasons

The NAO report does not go into the reasons for the failings in great depth.  But it is clear that there are many many reasons for the NPfIT’s failings – as you would expect – a complex set of issues in a complex world.

The “so what?”

I wrote Risk Happens! for this very reason – too few project managers give sufficient time and effort to identifying potential points of failure, dealing with them and managing risk.  Planning is often over-confident by a BIG margin.

I’d love to write “Change Happens!” about managing the change that runs alongside major projects, but two publishers have told me “books on change management don’t sell.”  Unless, that is, they feature loveable mice or penguins.

But I have plans… watch this space.

For fuller details of the NAO reports:


One thought on “NAO damning report on NHS NPfIT

  1. Pingback: Risk! £4.3 Billion of our cash is under threat |

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