• CQC criticises major central IT project over delays, governance failures, and complications from NHSE/I merger 
  • Regulator says extension with current provider Atos likely despite not being possible under procurement rules
  • Comes after CQC withdraws from project, and plans to cut internal budgets to divert money to its own alternative IT programme
  • NHS England said earlier this year that it had made improvements to the programme

The Care Quality Commission has heavily criticised a major NHS England-led IT project after a review found it to be dysfunctional and at risk of breaking procurement rules.

The programme to create a new service to run IT services including more than 12,000 desktop computers across five central health bodies has already prompted intervention from the health and social care secretary and withdrawal from one participant – the CQC.

Other organisations involved include the Department of Health and Social Care, NHS Improvement, and the Health Research Authority.

The CQC pulled out of the “future services programme” in November last year because, it told HSJ in February, of the “diverse and different needs of CQC’s user groups”.

But CQC papers, provided to HSJ in response to a Freedom of Information Act request, show the withdrawal was prompted by concerns that the programme may be beyond saving.

A letter sent in late November by the CQC to other parties involved (see attached) said:

  • There was a lack of clear and agreed commercial exit strategy from the current Atos contract, despite more than two years of preparation;
  • A host organisation needed to be set up to run the new IT service, but no such organisation existed or could be agreed by partners;
  • The merger between NHS England and NHS Improvement had further complicated and delayed the programme; and 
  • Recommendations to improve the programme had not been acted upon, governance was “problematic” and “decision making remains slow and accountability insufficiently clear”.
  • That “the programme as it is currently conceived is now overengineered for the problem it is trying to solve; it is more complex than required technically and lacks sufficient focus on non-technical areas”.

The papers also show the CQC believed a new central IT service was unlikely to be ready by the time the contract for the current IT service, run by Atos, expired in April next year, potentially breaching procurement rules and increasing costs.

In a letter to other partners on 28 November, the CQC said: “It [is] imperative that the commission exits the Atos contract at the end of its term… given the poor quality of the service experienced by CQC. In any event, the contract has already been extended to the fullest extent possible in compliance with procurement rules.

“CQC is not confident that the programme will be able to meet its objectives in sufficient time to enable this to happen.”

The programme had also changed so much since planning started in 2017 that it was “questionable whether its continuation remains in the interests of all the programme members”, the letter said.

A Capgemini review in October last year, commissioned by the CQC, found the programme had faced severe delays and warned big decisions about its future were needed within weeks.

In its letter three weeks later, the CQC said its withdrawal was prompted partly by a lack of urgent action from other partners in response to the review. The letter also set out the failings listed above.

Since the CQC withdrew from the project, NHS England has signed a multimillion-pound contract with IT recruitment agency LA International to hire more people and get the programme back on track.

Meanwhile, HSJ reported this week that the CQC plans to cut 10 per cent of the budgets of all its five directorates for 2019-20, including reducing its hospital inspection team, to free up £12m for its own separate IT programme.

An NHS England spokesman said: “The Department of Health’s Atos contract and Future Services Programme (FSP) remains on track to transition away from the existing Atos arrangement by April 2020.”

HRA, and DHSC were all contacted for comment for this story.

HSJ asked Atos whether the company has been approached to extend the IMS3 IT contract with the NHS, and the terms of any such extension. A spokesman said the company did not comment on “commercial matters”.