The National Programme for IT in the NHS, the world’s biggest civilian IT project, is four years behind schedule, according to government auditors.

“Delivering the National Programme for IT in the NHS is proving to be an enormous challenge,” said the National Audit Office.

"The original timescales for the electronic Care Records Service, one of the central elements of the Programme, turned out to be unachievable, raised unrealistic expectations and put confidence in the Programme at risk,” the public spending watchdog continued.

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Although all elements of the Programme are advancing and some are complete, the public spending watchdog said original plans to deliver an electronic care record by 2010 have proved "over-ambitious". The NAO warned “it is likely to take until 2014-15 before every NHS Trust in England has fully deployed the care records systems”.

But this estimate depends on the delayed Lorenzo system, which is slated to launch in June and is being supplied by CSC, working properly from its first scheduled delivery this summer.

"There remains considerable uncertainty over the delivery schedule for Lorenzo," said NAO.

The initial vision of the NPfIT “remains intact and still appears feasible” and that the “costs of the main contracts have remained broadly unchanged, aside from the purchase of increased functionality”.

Delays in deployments have meant that spending on the project to date is £2 billion less than planned at £3.6 billion up to 31 March 2008. This is because vendors and suppliers will only be paid when systems are delivered and are working acceptably.

The report says that: “the success of the Programme will depend on the commitment of NHS staff,” but then cites “latest” survey from the Department of Health, which is a year old, saying that 67 per cent of nurses and 62 per cent of doctors expected the new systems to improve patient care.

Repeated surveys for the Department of Health and others independent organisations have also shown that NHS staff have been significantly alienated from the NPfIT because of the nature of the consultation processes they have been put through and the poor performance of systems installed so far.

The NAO itself has highlighted the fact that almost all hospitals that have installed interim care records systems have faced significant technical difficulties.

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