12. The Department's benefits statement for the programmes previously managed under the National Programme reported estimated benefits of £3.7 billion to March 2012. This amounts to half the value of the costs incurred to the same point. The benefits include financial savings, efficiency gains and wider benefits to society (for example, where patients spend less time chasing referrals).[24]
13. The benefits statement reported total forecast benefits of £10.7 billion to the end-of-life of the systems. The end-of-life dates for the various systems extend well into the future, to 2024 in the case of the care records programme in the North, Midlands and East. This means two-thirds of the benefits (£7 billion) were still to be realised at March 2012.[25] For three programmes, including the care records programmes in London and the South, 98% of the total estimated benefits were future benefits.[26] The benefits statement does not include any future benefits that may arise from the Lorenzo care records system in the North, Midlands and East.[27]
14. The Department told us that, although the National Programme has been dismantled and the component programmes are being managed separately, it is not proposing to stop monitoring the benefits. The Department acknowledged that, although it has provided guidance to trusts, there has not been sufficient drive either from the centre or at local level to take ownership of the benefits from the various component programmes. The Department stressed that, in order to drive benefits, local NHS staff need to be convinced of the value of business transformation, and this needs leadership from the top of organisations. However, it is not clear that this is happening.[28]
15. There are considerable risks to realising the future benefits. For example, there may be further delays to the deployment of systems, meaning the benefits may be realised later than expected or may not be realised at all. In addition, the transfer of responsibility for the realisation of benefits from strategic health authorities and primary care trusts to NHS trusts and NHS foundation trusts from April 2013 is likely to increase the risks.[29] To support trusts in this new role, the Department and the Health and Social Care Information Centre have agreed to appoint a specific 'benefits lead' for each of the local care records programmes. In addition, the Department told us that the team within the Health and Social Care Information Centre that provides support to trusts on realising benefits is to be strengthened. The Department acknowledged that sharing best practice will be fundamental to the realisation of benefits and told us that it needs to capitalise on the informal networks that already exist for this purpose.[30]
16. The Secretary of State for Health has set the NHS the challenge of being paperless by 2018. The first target towards achieving this ambition is for GP referrals to be paperless by 2015. The Department intends that consistent information standards will apply across the NHS so that a patient's records can be shared between, for example, GPs and hospitals. The Department has set up an 'informatics services commissioning group' to bring the health system together to take such issues forward.[31] However, the Department has not set aside a specific budget for making the NHS paperless.[32]
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24 C&AG's memorandum, Review of the final benefits statement for programmes previously managed under the National Programme for IT in the NHS, para 36, Figure 1
25 C&AG's memorandum, Review of the final benefits statement for programmes previously managed under the National Programme for IT in the NHS, Figure 1, paras 44-45
26 Q 214, C&AG's memorandum, Review of the final benefits statement for programmes previously managed under the National Programme for IT in the NHS, para 45
27 C&AG's memorandum, Review of the final benefits statement for programmes previously managed under the National Programme for IT in the NHS, para 8
29 Q 226, C&AG's memorandum, Review of the final benefits statement for programmes previously managed under the National Programme for IT in the NHS, para 49-50