Table 3.
Case description of the three national programmes studied
| National Programme for Information Technology | Global Digital Exemplar Programme | Artificial Intelligence Lab | |
|---|---|---|---|
| Duration | 2002/2003 - 2011 | 2017 - 2021 | 2019-2024 |
| Funding | £12.7 billion | £302 million | £143.5 million |
| Vision | Aimed at transforming the NHS through IT. Its delivery was planned to establish a national electronic infrastructure, including a broadband network (N3), electronic prescription and appointment booking services, and a “cradle to grave” Electronic Health Record (EHR) for every patient by 2010. | Aimed to drive digitally enabled transformation in selected NHS provider organisations, bringing them to an international standard, and to foster a national learning ecosystem | Core vision to accelerate the safe adoption of AI in health and social care settings. |
| Components |
The Spine (central national database and messaging service). Choose and Book (electronic referrals). Electronic Prescription Service (EPS). Picture Archiving and Communication Systems (PACS) for imaging. Ambition for Electronic Patient Records (EPRs) across all hospitals (focus of our evaluation). |
Exemplar provider organisations (funded to reach international digital standards). Fast Follower provider organisations (paired with exemplars to adopt and adapt blueprints). Blueprints (digital implementation guides for wider replication). Digital maturity assessments (frameworks for benchmarking progress). |
AI Skunkworks (rapid proof-of-concept projects, open-source outputs). AI in Health and Care Awards (funding for promising AI solutions to be tested and scaled). AI Deployment/ Diagnostic Funds (especially in imaging and diagnostics). AI Communities of Practice (guidance, case studies, resources). Ethics, Regulation, and Governance workstreams (safe and responsible adoption). |
| Delivery |
Connecting for Health (CfH) was created in 2005 as the delivery arm within the Department of Health and took operational responsibility for NPfIT. The NHS signed contracts with private sector companies, each covering a large geographic area delivering services. |
Managed by NHS England (digital transformation team). Funding was provided centrally, but settings were responsible for local delivery. |
The AI Lab worked across national, regional, and local levels, but with a distributed structure. Some aspects of the programme operated centrally (e.g. setting strategy, national resources) and others were more localised proofs of concept or implementations. It was delivered jointly by NHS England and the Department of Health and Social Care. |
| Scale | National | National | National |
| Ministerial backing | Launched in 2002 under Prime Minister Tony Blair with strong backing from the Department of Health, led by Secretary of State for Health Alan Milburn and later John Reid; Blair himself personally championed it as a flagship modernisation project. | Announced in 2016 with support from Secretary of State for Health Jeremy Hunt, who made digital transformation a central plank of his patient safety and NHS modernisation agenda. | Launched in 2019 with ministerial support from Secretary of State for Health and Social Care Matt Hancock, who strongly advocated for AI and innovation as central to the NHS Long Term Plan. |
| Public visibility | Highly visible, widely covered in the media as the world’s biggest civilian IT project, but became notorious for delays and cost overruns. | Lower public profile, mainly recognised within NHS and health technology circles as a professional digital transformation initiative. | Moderate visibility, often featured in government announcements and health innovation news, framed around AI’s potential for patient care. |