Report points to continued challenges for the IT system behind Scotland’s telehealth service
NHS 24 has made progress in repairing the big failures in Scotland’s telehealth service, but is still a long way from meeting the financial targets and delivering efficiency savings, according to the country’s chief public sector auditor.
Audit Scotland has published a report on the programme that acknowledges the NHS 24 health board has been dealing with the problems that caused delays in the launch, then swift withdrawals, of the new IT system. But it also points to remaining challenges that are still holding up the plan for a new system to support telephone and online health advice and information.
Work began under the Future Programme in 2011, but a series of problems pushed back the launch from June 2013 to October 2015, when it went live but was quickly withdrawn twice in a matter of weeks.
NHS 24 has since been looking at the fundamental problems and, with the support of an external contact centre specialist, identified weaknesses in matching resources to the workforce plan. It has also identified concerns about the integrity of the IT infrastructure and applications.
In June of this year a revised, three-stage implementation plan was agreed, which should involve the planned care services element going live in the autumn. This will be followed by unscheduled care services for a single health board in March 2017, and a national roll out by the end of next year.
The report says that NHS 24 has invested significantly in implementing the IT system over the past six years, but the failure to launch it successfully and additional double running costs have caused a big increase in the projected cost of the programme – by 73% from the original business case to £131.2 million.
An earlier report by Audit Scotland to the Public Audit Committee attributed cost increases to the changes in the contract specification.
The delays have also created risks to the board's ability to meet future financial targets.
But it adds that, while significant challenges remain, NHS 24 is now taking reasonable steps to mitigate the risk of further delay. It maintained the existing IT system, minimising the impact on services for patients and met 14 of its 15 key performance indicators.
While work continues towards successful completion, delivering financial targets will be very difficult and largely depend on achieving efficiency savings.
No quick fix
Auditor General for Scotland Caroline Gardner said there would be “no quick fix” and it will take time to deal with the problems.
As part of this, the auditor has recommended that NHS 24 should agree a business case for the 10-year operational period, reflecting the revised scope of the programme. But the report adds that, until the IT system is successfully launched, there will be plenty of uncertainty around financial planning and sustainability.
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