To compound its errors the NHS IC spurned specific warnings and advice from the Department of Health's National Integration Centre and Assurance unit to carry out more tests, specifically testing whether GPES could extract data from more than one system at once and whether it could handle a number of different queries at once.
Commenting on the problems with the system that was intially handed over by Atos and accepted by the NHS, Atos said: "We delivered the GP Extraction Service in line with requirements set out by NHS IC. When the service did not work as planned, we worked with them to improve functionality and have worked with the HSCIC since its inception to ensure the system was up and running to meet the deadline of the Quality and Outcomes Framework 13/14 year end."
The resultant failure has left the NHS IC putting more money into the project though the NAO notes, "it is still not certain that all aspects of GPES work". What is clear is that the NHS IC estimate that the health service will achieve less than two more years of use from the GPES in its current form, in contrast to the five-year minimum lifetime assumed for new IT systems.
The NHS's Health and Social Care Information Centre says that many of the problems were historic - before this latest incarnation of a centralised NHS IT body came into existence, and it argues that it will get vlaue from the system.
"The NAO report states that significant issues occurred with GPES in the years before the inception of the HSCIC, which was created two years ago with a new mandate, structure and senior leadership team. It is clear the GPES procurement and design stage was not good enough, regardless of the intent of predecessor bodies," the HSCIC notes.
"The HSCIC is equally clear that upon our creation we took full responsibility for delivering a data extraction service that is operationally and financially efficient. We are maximising the working aspects of GPES and replacing those parts that do not work. Our focus is on developing a suitable service that meets the needs of the NHS and patients."
Negotiations are currently underway with NHS bodies, other than NHS England on "their current requirements" with a promise of being "realistic on what can be achieved".
If the ability to extract and analyse health data from a number of health sources is a key requirement of the NHS today, there are significant issues around that data, beyond this troubled project. The NAO makes plain that it did not examine the methods or policy to govern using patient identifiable data that could be extracted via GPES, or the wider Care Data project, itself dubbed "unachievable" by the government's Major Projects Authority. These broader issues are far from resolved.
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