A History of the UK's Biggest Healthcare IT Procurement Failures

Costly Lessons from £50+ Billion in Failed NHS IT Projects

Published: May 27, 2025

By: Darwinist Team

1. National Programme for IT (NPfIT) – £10 Billion+

  • Timeframe: Launched in 2002, abandoned in 2011.
  • What happened: The NPfIT was an ambitious project aimed at digitizing the NHS, including electronic patient records, national databases, and IT infrastructure standardization.
  • Why it failed:
    • Lack of stakeholder engagement (clinicians weren’t consulted).
    • Overly centralized approach with rigid top-down control.
    • Contracts were awarded to large IT vendors (like CSC and Fujitsu) who struggled with NHS complexities.
    • Technical difficulties and delays.
  • Money wasted: Estimated over £10 billion, making it one of the most expensive IT failures in UK history.

2. Care.data – £100 Million+

  • Timeframe: Launched in 2013, scrapped in 2016.
  • What happened: The Care.data program aimed to collect patient data from GPs and hospitals to improve research and NHS efficiency.
  • Why it failed:
    • Poor communication with the public, leading to privacy concerns.
    • Patients were not properly informed about data sharing opt-out options.
    • Data security concerns regarding commercial third-party access.
  • Money wasted: Over £100 million, with no tangible benefits.

3. e-Borders (Home Office/NHS Border Control Health Screening) – £830 Million

  • Timeframe: 2003-2010.
  • What happened: Although not purely NHS-related, e-Borders was meant to improve health screening for foreign nationals entering the UK.
  • Why it failed:
    • Severe delays and contract disputes with IT suppliers.
    • System failed to integrate properly with NHS health checks.
  • Money wasted: An estimated £830 million in costs before cancellation.

4. Lorenzo (Electronic Patient Record System) – £4.7 Billion

  • Timeframe: 2004-2013.
  • What happened: Part of NPfIT, Lorenzo was meant to be the flagship NHS electronic patient record (EPR) system.
  • Why it failed:
    • Poor usability, leading to clinician resistance.
    • Software development delays.
    • Trusts opted for alternative EPR solutions.
  • Money wasted: Approximately £4.7 billion, as NHS trusts abandoned it.

5. NHSmail (Email System) – £90 Million

  • Timeframe: 2004-2016.
  • What happened: NHSmail was meant to provide a secure and efficient email system for NHS staff.
  • Why it failed:
    • System was outdated before full rollout.
    • Staff found it slow and difficult to use.
  • Money wasted: Roughly £90 million before switching to Office 365.

6. BT’s Spine Upgrade Failure – £400 Million

  • Timeframe: Early 2010s.
  • What happened: The NHS Spine project was designed to handle electronic prescriptions, patient summaries, and appointment scheduling.
  • Why it failed:
    • BT underestimated the complexity and NHS-wide needs.
    • Cost overruns led to contract disputes.
  • Money wasted: An estimated £400 million.

7. NHS 111 IT System (Outsourced Call Handling) – £50+ Million

  • Timeframe: 2013-present (with ongoing issues).
  • What happened: The NHS 111 service, meant to replace NHS Direct, suffered from poor IT implementation.
  • Why it failed:
    • System frequently crashed, delaying urgent care.
    • Lack of integration with GP and hospital records.
  • Money wasted: £50+ million, with ongoing costs to fix issues.

8. E-referrals System (Choose and Book replacement) – £356 Million

  • Timeframe: 2014-2018.
  • What happened: A new electronic referral service was supposed to replace Choose and Book.
  • Why it failed:
    • Overcomplicated system design.
    • Low adoption by GPs due to usability issues.
  • Money wasted: £356 million, as many NHS trusts stuck with old methods.

9. GP at Hand (Babylon Partnership with NHS) – £250+ Million

  • Timeframe: 2018-present.
  • What happened: Digital-first GP services with AI-powered consultations were promoted as the future of NHS primary care.
  • Why it failed:
    • System prioritized young, healthy patients while traditional GPs were left to manage more complex cases.
    • Regulatory concerns over patient safety and AI-driven decision-making.
  • Money wasted: Estimated £250 million, as expansion slowed and traditional GP services had to compensate.

10. Covid-19 Test and Trace App – £37 Billion (Entire Program)

  • Timeframe: 2020-2022.
  • What happened: The NHS Covid-19 app was meant to help with pandemic contact tracing.
  • Why it failed:
    • Initial app (NHSX) scrapped after Apple-Google API issues.
    • Poor adoption due to privacy concerns.
    • Lack of effectiveness in preventing outbreaks.
  • Money wasted: While the app itself cost £12 million, the wider Test and Trace program cost £37 billion, with minimal impact on controlling the pandemic.

Key Takeaways

  • Centralized, top-down NHS IT programs often fail due to lack of clinician involvement.
  • Large IT vendors frequently underestimate NHS complexity, leading to delays and ballooning costs.
  • Security, privacy, and usability concerns often doom public health IT projects.
  • Fragmented procurement means NHS trusts often seek alternative solutions, making national projects redundant.

Would you like a deeper dive into any of these cases?

https://www.theregister.com/2020/05/18/latest_nhs_it_revolution_is/

https://www.theregister.com/2019/10/22/prescriptions_digital_nhs/