NHS chief executive David Nicholson has put the future of the £12.7 billion National Programme for IT (NPfIT) in doubt, stating "we can't go on and on like this" following the problematic rollout of patient records in London.
The multi-billion programme to create an electronic health record across the country has reached a "pivotal position", Nicholson has said.
The rollout of Cerner Millennium software, one of the two systems being used to store patient records digitally, has hit hurdles in London, with the Royal Free Hospital losing £7.2 million in six months attempting to roll out the system.
Testing on iSoft software for the north of England has only just begun. The programme is running at least four years late. And the Department of Health is has not been able to replace Fujitsu, the contractor for the south of England that left the programme from the NPfIT in May, blaming extra NHS demands.
Speaking yesterday to a group of MPs in the Commons Health Committee, Nicholson made his first public admission that a rethink could be on the cards. The programme had hit a "pivotal position", where progress was vital, he said.
"If we don't make progress relatively soon, we are really going to have to think it through again."
The NHS will refuse to roll out the programme further until the issues at the Royal Free Hospital are resolved, he said. "We have said to [software supplier] Cerner and [services contractor] BT that they have to solve that problem at the Royal Free before we will think about rolling it out across the rest of the NHS," he said.
While parts of the IT rollout had gone well, such as the electronic prescriptions system and a digital X-ray project, Nicholson said there were some "really difficult issues to tackle".
"We do have to think about how we take it forward. We can't go on and on like this," he said.
When questions by MPs about the delays, Nicholson said he was "confident" that the system would be working by 2015. He also expressed confidence that the problems at the Royal Free would be resolved.
NHS trusts in the south of England still have no lead IT contractor, but a decision would likely be made around February, Nicholson said. BT has often been cited as most likely to take over the programme in that region because it is already rolling out the same software in London. But CSC is also being considered, even though it uses different software, iSoft Lorenzo, instead. A combination of the two, or the use of additional suppliers is also possible.
While testing had begun in the north of England by lead contractor CSC, producing "good results", he warned that the NHS needs to "be careful" before rolling it out further.