NHS National Programme for IT: audits and final outcome

What the audit found

The NAO's first report on 16 June 2006 examined progress, procurement, cost control and NHS preparation. It found major contracts had been awarded quickly and prices were held through the procurement, but it said the main implementation work and benefits still lay ahead ¹.

The NAO returned in 2008. It found the original timescale for the electronic Care Records Service was not achievable and had damaged confidence. Full deployment across NHS trusts was then expected in 2014 to 2015, four years later than planned. The estimated programme cost was £12.7 billion, with £3.6 billion spent by 31 March 2008 ².

The 2008 report recorded completed or advancing parts of the programme, including network, imaging, booking, prescription and email services. It said success depended on supplier delivery, NHS readiness and staff support ².

The official response

The Department of Health announced accelerated dismantling on 22 September 2011 after a Major Projects Authority review. It said the central programme could not deliver its original intent, but the Spine, N3 network, NHSmail, Choose and Book, Secondary Uses Service and imaging systems would remain ⁴.

The same statement said those established services accounted for about two-thirds of the £6.4 billion spent by that point. The department moved decision-making for local systems toward NHS organisations ⁴.

In June 2013 the department published a final benefits statement at Parliament's request. It set out programme costs, realised benefits, forecast benefits and new governance for the work that continued after the national programme ended ⁵.

Parliament

The Committee of Public Accounts reported on detailed care records in August 2011. It asked the department to test whether the remaining £4.3 billion would produce working systems and value. The government accepted the recommendation ³.

A later Treasury Minute recorded the recommendation as implemented. It said the national programme had been dismantled in September 2011, a full informatics review ended in January 2012 and named senior responsible owners were accountable for the programmes that continued ³.

Parliament's scrutiny covered evidence from the department and the suppliers BT and Computer Sciences Corporation. The committee said late and inconsistent information had made scrutiny harder ³.

Follow-up audits and recommendations

The NAO reviewed the final benefits statement in 2013. The department forecast lifetime benefits of £10.7 billion and costs of £9.8 billion for programmes formerly managed under the national programme ⁶.

The NAO found the department used a structured method, but it warned that benefit delivery was uncertain. About £6.6 billion, close to two-thirds of forecast benefits, was expected after March 2012. For three programmes, 98% of forecast benefits had not yet been realised ⁶.

No later NAO report giving a single final realised-benefit total for every former programme was found as of 19 October 2026.

Courts, tribunals and investigations

No court judgment determining the NAO findings or a criminal investigation tied to the audit recommendations was found as of 19 October 2026. The public record reviewed for this page concerns performance, contracts, programme closure and benefits ^1,36.

Where it stands now

The national programme no longer exists. Central services judged useful continued under later NHS bodies, and local NHS organisations took greater responsibility for care record systems ^4,5.

The final audit record is mixed. The programme delivered national infrastructure and applications ^2,4. It did not deliver the central care-record vision to its original timetable, and the NAO could not confirm that all forecast benefits would be realised ^2,6.

Timeline