IT powering NHS screenings ‘unfit for purpose’ for a decade

Clinician's computer meltdown

Failures in 11 health screening programmes across the UK are fundamentally connected to a "hopeless" IT system that will have been deemed inadequate for the best part of a decade when it is due to be replaced in 2020.

All health screening programmes, such as tests for breast cancer and cervical cancer, have relied on a single IT system that was deemed "not fit for purpose" for health screening by the Department for Health and Social Care (DHSC) in 2011.

And dependency on the National Health Application and Infrastructure Services (NHAIS) is the reason why health screening programmes are failing to test enough people with potentially life-threatening conditions, according to the Public Accounts Committee (PAC).

"The benefits of screening cannot be under-estimated: if found at an early stage, treatment can be significantly more effective," said PAC chair Meg Hillier MP.

"Yet millions of people are not being screened for serious illnesses like bowel, breast and cervical cancer.

"Our inquiry has exposed a health service that is losing its grip on health screening programmes. Many individuals waiting for delayed results will suffer avoidable anxiety, stress and uncertainty. Those delays also stretch far beyond the Department's target waiting periods."

The PAC examined statistics relating to four of the 11 programmes during 2017/18 as a measure for how screening is performing generally. They found the number of individuals being screened fell well sort of national targets, and that a swathe of eligible people had not even been invited to begin with.

NHS England told the committee during inquiry stages that reliance on NHAIS, which itself comprises 83 separate databases, was a key weakness, while Public Health England said the "IT was hopeless" when questioned.

The DHSC also admitted in 2011 that NHAIS was "not fit for purpose" to function in screening programmes because it was difficult to track a person's history if they moved across geographical boundaries.

NHS England, which has been tasked with overseeing these screening programmes and in some cases the supporting IT system, is not expected to replace NHAIS until at least 2020. This is three years later than initially planned and will cost 14 million.

The delay is attributable to the fact NHS England was working on the replacement project with outsourcing giant Capita. But after the organisation declared it could no longer work with the firm, NHS Digital has taken on the responsibility for replacing NHAIS.

The state of the cervical cancer screening programme, in particular, is alarming given its reliance on 360 IT systems in total including the 83 databases comprising NHAIS and a further 270 that deal with invites, reminders, analysis and results. Some of these systems are more than 30 years old.

The PAC has recommended that NHS England sets out a clear pathway for how it plans to deliver the new IT system, deemed a "risky" project, on time without making the screening service even worse.

The influential committee of MPs also suggested that Public Health England and NHS England develop a more integrated approach to its IT to ensure these disparate systems talk to each and deliver the best service for patients.

IT Pro approached NHS England, NHS Digital and DHSC for comment.

Keumars Afifi-Sabet

Keumars Afifi-Sabet is a writer and editor that specialises in public sector, cyber security, and cloud computing. He first joined ITPro as a staff writer in April 2018 and eventually became its Features Editor. Although a regular contributor to other tech sites in the past, these days you will find Keumars on LiveScience, where he runs its Technology section.