By Laura Miller

A catalogue of failures in the government's massive NHS IT project has led health service staff to lose confidence in the records system, and has put the success of the programme in serious jeopardy, a report has concluded.

Essential systems are late or when deployed do not meet the expectations of clinical staff, according to the Public Accounts Committee (PAC).

Local cost estimates are unreliable and many NHS staff remain unenthusiastic about the usability.

"The risks to the successful delivery of the programme are as serious as ever," Edward Leigh, chairman of the committee of PAC, said.

Full implementation of the systems was planned by 2010, but while some are complete or well advanced, major ones, such as the care records systems, are "way off the pace".

By the end of 2008, care records software for the North, Midlands and East had not gone live throughout a single Acute Trust, and a revised completion date of 2014-15 for the late systems - four years behind schedule - looks doubtful in light of the termination last year of Fujitsu's contract covering the South.

Now, even if NHS Trusts decide not to deploy the patient care records systems, the taxpayer would still have to foot the bill.

The estimated cost of the programme is £12.7 billion, including £3.6 billion of local costs, although this figure remains uncertain.

Mr Leigh called on the Department of Health (DoH) to reassess the ability of its IT suppliers to meet their substantial commitments.

"Trusts should not be expected to deploy care records systems that aren't working properly. If there is no improvement to this situation within six months, then the department should consider allowing Trusts to apply for funding for alternative systems," he said.

Commenting on the report, Lib Dem health spokesman, Norman Lamb blamed delays, spiralling costs and totally frustrated staff on minsters' incompetence, calling the programme a "disaster".

Responsibility for delivery is shared with the local NHS and with the chief executives of the ten strategic health authorities.

Mr Lamb criticised the government for its top-down approach, "despite the fact that there was no proper business case and no clinical assessment of what was needed.

"We need to end this centrally imposed system and give power to local health services to organise their own IT needs" he added.

The programme is intended to generate substantial benefits for patients and the NHS, increasing NHS staff's ability to access information stored in the care records system. Delivering the clinical functionality will be key to convincing NHS staff of the benefits of the programme.

Keeping patient data secure will be crucial to the reputation and success of the IT investment, and the department is confident that the mechanisms it is putting in place will provide a high level of security.

Access to the Care Records Service will be controlled through Smartcards and passcodes, and will be auditable.

The security of the IT systems themselves is the responsibility of suppliers, with NHS organisations and their staff responsible for keeping the data secure if they access it.