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DH admits it ‘misspent’ public money on vital GPES after costs quadrupled

The Department of Health has admitted it “definitely” misspent cash on the General Practice Extraction Service (GPES) – on which it still relies – after it emerged that costs ballooned to four times the original price tag during a Public Accounts Committee (PAC) inquiry. Luana Salles reports.

The HSCIC-run service, originally intended to start in 2009-10, is an IT system designed to let NHS organisations extract data from all GP practice computer systems in England to monitor quality, plans and payments for health services and research.

It was intended to provide data to all national health bodies to identify key health trends nationally – but, so far, the seven-year-old service has only delivered data to NHS England.

The project was branded a catastrophe and a failure by MPs on the PAC. Committee chair Meg Hillier MP questioned the security of personal data stored in the patchy system.

Significant mistakes in the original procurement and contract management at very early stages caused the GPES programme price to soar from £14m to £60m. This is even higher than the £40m calculated by the National Audit Office in July of this year, when the service’s drain on the public purse was first investigated.

The service was transferred from the defunct NHS Information Centre to the current HSCIC in 2013, at which point it was already known that the project had “fundamental design flaws” and “did not work”.

But it was signed off, accepted and delivered regardless and, in the HSCIC 2012-13 annual report, GPES was included as part of its list of achievements.

Richard Bacon MP, a member of the PAC, also revealed during the inquiry – which questioned two HSCIC representatives, Atos UK’s chief executive and the Department of Health’s director general of innovation, Will Cavendish – that the service had highly rotating governance. It had seen 10 project managers responsible for GPES in five years – a record high of one manager every six months. The chair of the board also changed three times in three years.

Cavendish accepted that the frequent rotation of directors “should have been picked up”.

Bacon also reminded them of a 2010 statement claiming that delays to the project’s procurement could delay it to the point where it was no longer viable – indicating that concerns about its contracting method not being suitable were already clear three years before it was absorbed by HSCIC.

And the accounting officer at the time, Tim Straughan, responsible for the programme when doubts over its effectiveness were already prevalent, left the organisation with a redundancy pay-out worth £330,000.

Bacon asked the HSCIC witnesses at the inquiry: “Why is that not misconduct? His organisation attested and signed for a piece of IT equipment and you and the auditors found out it was being written down because it didn’t work.

“But he signed it off as being okay, and indeed, there were then public statements that it was okay. And as we now know, it was fundamentally flawed.”

He went on to criticise the NHS “revolving door” culture where leaders are fired with fat redundancy cheques just to walk right back in, reminding the committee that Straughan now works as a programme director in telehealth at a CCG.

Atos participation

Atos UK’s boss, Adrian Gregory, told the inquiry that their side of the contract – covering one of eight parts of the GPES system – was initially priced at £8m when it was signed in late 2011. This was broken down between £5m for the project and £3m for ongoing support.

But he admitted that this will grow to £11.4m until July 2018, when the contract terminates – £4m for the support and £7.4m for the project.

Gregory said: “The query tool that we delivered, one of eight component parts, was only able to be tested at a component level, because the end-to-end test for QOF, which was what we were supposed to be tested against, was not available.

“We fixed the issues related to that system that were Atos issues, at our cost.”

An Atos spokeswoman told NHE that these issues surfaced after testing the service with all suppliers in the full live environment, at which point there were clear faults with the system that needed to be fixed.

But she added: “GPET-Q [GP Extraction Tool – Query, the part Atos is responsible for] has been running since March 2014 and delivers around 40 extractions per year.”

‘It’s a necessary system’

Although Cavendish and the HSCIC representatives present – Andy Williams, chief executive and accounting officer, and James Hawkins, director of programmes – justified the mistakes by saying “we don’t do technology and data projects now in the way they were done then”, Bacon said the DH has a “track record of severe IT difficulties”. He suggested they had not learned enough from a previous debacle to prevent this one from happening.

But Cavendish said: “It was in the wrong organisation with the wrong capabilities. There was just a lack of suitable oversight assurance. There weren’t the proper mechanisms for ensuring this project was on track, that it had the suitable procedures underway, the right testing, that didn’t happen systematically and properly.

“We are putting in place proper processes for sign-off scrutiny assurance to ensure technology and data spend is properly and robustly checked in advance and scrutinised as it goes through its timetable.”

He admitted that there was “definitely money misspent” and write-offs that represented the wrong use of public cash.

But despite the mistakes embedded in the programme, it’s a necessary system for now.

HSCIC is now looking again at reforming and improving the system, with a board that oversees technology and data projects expected to report in February 2016. Williams hopes the project will be delivered within £5m of its current price tag.

And Cavendish added: “There is a range of things that can be done to make GPES work better – the query times can be reduced, the extraction volumes can be increased. It may not be the medium-term future: that probably lies in the standardisation through the GP suppliers at a different and much more seamless approach to collection of data.

“But here and now, this is the only system we have. The commercial systems don’t provide the scale of data that we need. They are cheaper, but they provide a subset of the data that don’t underpin the payment systems that we need to have in place. It’s a necessary system for now, but it’s not yet good enough.

“Although late and delayed and not done perfectly at all, things are coming together.”