Category Archives: openness and transparency

Jailed and bankrupt because of “unfit” Post Office IT? What now?

By Tony Collins

post office logoThe BBC’s “PM” programme returned to the topic last week of subpostmasters who were stripped of their post office contracts and bankrupted because of theft, fraud and false accounting. Some went to jail.

“Is it possible they were innocent and that a computer system was to blame instead?” asked Eddie Mair, the programme’s presenter.

The BBC has seen a leaked copy of an independent report the Post Office commissioned into its “Horizon” branch office accounting system. An interim version of the report by consultancy Second Sight was released last year.

The leaked report says the system was unfit for purpose in some branches, says to the BBC. When Post Office investigators checked out shortfalls they did not look for the root cause of the errors – and instead accused the sub-postmasters of theft or false accounting, says the BBC, quoting from the report.

£1bn Horizon system

More than 11,000 post offices use Fujitsu’s £1bn Horizon system for branch accounting and rarely have problems. At the close of each day, the system balances money coming in from customers and money going out, to banks, energy companies, for tax disc sales and for lottery tickets.

If the system showed there was a shortfall, subpostmasters had few options: make up the deficit themselves, sign off the accounts as correct, or refuse to sign off – which might have meant closing the post office (and upsetting customers) while a financial audit took place.

The BBC PM programme last week re-broadcast its interview in June 2012 with a gently-spoken Welshman, Noel Thomas, who worked for the Post Office for 42 years before he had problems with the Horizon branch accounting system at Gaerwen. When he went to balance the accounts the system kept telling him there was a deficit – a shortfall in the daily takings.

post-office-signPrison

After speaking to the Post Office helpline several times he believed the matter would be sorted out in time. He signed off the accounts – and the Post Office took him to court for false accounting. He pleaded guilty and went to prison; and he went bankrupt.

In his interview with Eddie Mair, Thomas came across as a man of guileless integrity.

“I had a very busy post office,” said Thomas. “I am not ashamed to tell you I had a very good income of between £20,000 and £30,000 a year. I worked very hard for it: I looked after my customers.”

Mair: What was the first sign of trouble?

“I did have trouble over about 12 months actually. The last six months it went worse. You just couldn’t balance. It was going in the end (into deficit) at the rate of £2,000-£3,000 a week.”

Mair: This wasn’t your own personal books – you weren’t filling in a ledger – this was the computer system?

“This was the computer system. In the end I was convicted on the basis that I false accounted for over £50,000.”

Mair: They thought you’d stolen it?

“Yes. But when it came to the court case they dropped the theft [charge] very very quickly and just went for false accounting.”

Mair: You went to jail?

“Yes… I was lucky. I only had eight days. Time went very very quickly.”

Mair: But I am guessing for you that was not really the problem, the passing of time. You’d been branded a criminal?

“Yes. That’s what got me you see.”

Mair: The Post Office still says it is confident about this computer system. It is still happy with it.

“It would say [that], wouldn’t it?”

Mair: As for you, are you confident you didn’t make a lot of mistakes?

“Yes. I can say I didn’t make mistakes. I can say with my hand on my heart I didn’t take the money.”

Mair: What effect has this had on you?

“A big effect, because I was declared bankrupt. The Post Office are paying my pension but they took my private pensions away.”

Mair: What would you like to happen?

“Not for me myself but for (other subpostmasters and mistresses). It has ruined their lives hasn’t it? If you pilfer off the Royal Mail you need to be punished –”

Mair: But Noel if you are correct – and obviously the Post Office has a different view of this – if you are right then you have been made bankrupt, you have lost almost everything -

“Yes.”

You have been to jail -

“Yes.”

Over a computer mistake -

“Yes.”

Mair: What do you want from them?

“That we can get justice for everybody.”

post officeCriminals or faulty systems?

Thomas had given up trying to prove his innocence when he received a phone call from retired senior probation officer Roch Garrard who said the same thing had happened to his local postmistress in Hampshire.

In time Thomas found that dozens of middle-aged, middle-class subpostmasters and mistresses who had never put a foot wrong were being branded criminals.

“It didn’t make sense to me so I started to contact some of them and said to them ‘this is what happened to our postmistress, what happened to you’ and the stories were all so similar that I thought there must be something wrong,” he said.

Now, more than 150 sub-postmasters say they were wrongly prosecuted, or made to repay money, because of the system. The Post Office remains defensive. Its public statements express little sympathy. It is, though, in secret talks with the subpostmasters over possible compensation. But can money ever put right injustices that have ruined lives?

New Second Sight report

BBC reporter Dan Johnson said the latest report explains exactly was going on with the Post Office computer system. “The thrust of this report is that it was faults in that computer system as well as communication problems, and issues around training that led to these mistakes. It wasn’t dishonesty,” said Johnson.

The report said training was not good enough for those without IT skills and power failures and communication issues made things worse. Helpline staff gave conflicting advice or said problems would sort themselves out.

Second Sight found in its research on Horizon that bugs were  not unknown. It said in its interim report that “some combinations of events can trigger situations where problems occur”.

A tearful Sarah Burgess Boyd, from Newcastle-upon-Tyne told the BBC she lost her life savings in repaying an incorrect shortfall. She said of the Post Office, “I just don’t know of another business that would conduct themselves in such a callous and inhumane manner.”

The Post Office said the leaking of the report was “unhelpful”. In a statement, the Post Office told the BBC:

“Although we will not comment on the contents of any confidential documents, after two years of investigation it remains the case that there is absolutely no evidence of any systemic issues with the computer system which is used by over 78,000 people across our 11,500 branches and which successfully processes over six million transactions every day.”

The Post Office is in mediation with some of the affected subpostmasters, in part because of campaigning for justice by MPs, particularly North East Hampshire MP James Arbuthnot.

Also leading the campaign is the Justice for Subpostmasters Alliance, which was set up to “raise awareness of the problems around the Post Office Horizon system which for many years Post Office Limited has denied exist”.

Despite the mediation, the relationship between the accused subpostmasters and the Post Office remains strained. Alan Bates, a former subpostmaster in Wales who founded the Justice for Subpostmasters Alliance, continues to submit FOI requests to the Post Office, the latest being August 2014. The Post Office tends to refuse his requests or gives him unsympathetic replies.

In one of his FOI appeals, Bates tells the Post Office that the concern is not about the millions of successful weekly and monthly financial reconciliations that take place but the “numerous unsuccessful reconciliations that take place that Post Office refuses to even consider may occur”. Post Office management “seems blind to such possibilities”.

He told BBC Wales in 2012:

“One of the big problems with Horizon is the inability to fully examine all the data you have put in the system. You were not allowed to interrogate it. They restricted the access. I refused to be held liable for a system that I and my staff were unable to access to check.”

Under the FOI Act, Bates asked the Post Office last month for the total amount in value and number of all “transaction correction” invoices and credit notes issued to post offices in the latest accounts period; and he asked in April 2014

“Has Post Office ever been made aware of faults within the software of their Horizon System that would have impacted in any way on the accuracy of the accounts of any post office?”

The Post Office did not say. Its reply was that the question was not specific enough.

Ministers have been unsympathetic to the accused subpostmasters –  although the campaign to clear the names of the accused has come mostly from Conservative MPs. Minister Jo Swinson told the House of Commons last year that the number of subpostmasters who’d complained about the Horizon system was “tiny, tiny”.

The National Federation of SubPostmasters has also been unsympathetic and has backed the Post Office. The Federation said: “We continue to have complete confidence in the Horizon system, which carries out hundreds of millions of transactions every week at 11,500 Post Office outlets across the country.

“The NFSP has seen no evidence to suggest that Horizon has been at fault and we believe it to be robust.”

Contract Law

Bhavisha Parekh, a case handler at Contact Law, was approached in 2009 by a sub-postmaster whose accounts had been audited that morning – and they’d found a loss of £7,000.

Parekh writes on the Contract Law website:

“The client had found this loss when doing her daily accounts a week earlier and asked the Post Office auditors to assist her and investigate the matter to locate the loss and rectify the accounts.

“Post Office accounts consist of cash, stamps, and postal orders as well as anything else they trade in; everything is given a financial value. The client’s loss was not of cash and all her transactions were showing to be completed correctly.

“However, upon the auditor’s confirmation of the loss she was charged with theft from the Post Office and given notice of being given a statutory demand for the £7,000.

“The client was in tears over the phone as she felt she had been wrongly charged; the client had run the Post Office for many years without fault and had become a pillar of the community.

“She felt victimised, as when trying to resolve this problem with the Post Office she had asked them to audit her branch and now she was being charged with theft.

“That day I gave the client details of a firm local to her (solicitors) to assist her with this matter. A few weeks later when calling the client to get feedback on the outcome of her case, she explained that she had had been investigated by the Post Office but they had not found anything to show she had taken the money.

“When auditing her branch the final accounts showed a loss; however, the auditors were unable to trace where this loss occurred. After further investigation and having a forensic accountant look into the matter, there were still no answers as to where this loss had occurred.

“This seemed pretty strange; the client in the meantime was told she could not work in the Post Office or even enter the building so she was left without an income and fear of being criminally prosecuted.

“However, after a month or so the Post Office wrote to her to state they had dropped the charges. She would however not be able to commence work as a sub-postmaster, and no explanation of the matter was given.

“Since speaking to this client I was approached by two more former sub-postmasters with the same case. However, they have not been as ‘lucky’ as my initial client – one was dismissed as a sub-postmaster and asked to repay this ‘lost’ amount, and the other was charged with theft and imprisoned for 18 months as well as ordered to pay a sum of £75,000.

“In all three cases the Post Office and their trained auditors have been unable to locate what this loss is; further they have not been able to trace any money into the postmasters’ accounts. Apart from there actually being a loss, there has been no evidence of any theft ever taking place.

“I have only spoken to three sub-postmasters; however this is happening at an increasing scale all over England. Computer experts are now stating that the ‘Horizon’ software the Postmasters use is flawed and so showing these losses.

“Potentially, due to this computer error, many sub-postmasters have lost their jobs, been imprisoned, and left traumatised by the Post Office’s actions.”

Comment

The Post Office deserves credit for investigating some of the complaints (after years of pressure from MPs) and it is said to have settled some of the less serious cases. But five years since the accumulation of problems came to light the convictions against subpostmasters remain. Computer Weekly highlighted the plight of subpostmasters in 2009.

Second Sight’s latest report will add to concern that lives were ruined because unexplained deficits on the Post Office’s Horizon system were not thoroughly investigated – and the root cause established – before the Post Office ticked the legal box to prosecute.

There is scope for systems to go wrong when there are multiple interfaces, occasional power failures and faults in networks and communications equipment. The Post Office’s Horizon system has multiple interfaces; and in any case no IT system is perfect. That Horizon works well for tens of thousands of subpostmasters is no guarantee it will work well for all.

Telling the family of someone struck by lightning that millions of people are not struck by lightning every year is extraordinarily insensitive. What’s the point of the Post Office’s continuing to insist that most subpostmasters have no problem with Horizon? Clearly there are no system-wide issues but nobody is saying there are – and why would those sent to prison, made bankrupt or deprived of their livelihoods care if IT issues were systemic or not? They say it happened to them.

Nobody in the general population would believe that 150 or more subpostmasters were dishonest.

Who would put the integrity of a computer system above the integrity of 150 subpostmasters?

The Post Office, as the prosecuting authority, could argue it is only doing its job in protecting its money and the investments of its shareholders. But in doing their jobs Post Office managers seem to be behaving more like machines than humans. They prosecuted for false accounting because they could.

They could, because sub-postmasters, when confronted by a deficit they didn’t understand, signed off accounts after being told by the IT helpdesk that the problems would probably clear in time. Strictly speaking, signing off accounts as correct when they are  known to be incorrect is false accounting. But was it something the Post Office should have prosecuted, given the mounting complaints about the accuracy of the system’s deficit figures?

Still the Post Office is refusing to answer subpostmaster’s questions. Its managers know they have the legal and contractual upper hand; and as owners of the system they possess the facts. What they do not have is the moral upper ground: they lost any claim to neutrality when they took subpostmasters to be dishonest before properly investigating the potential for shortcomings of the system.

It will be damaging to justice and the reputations of the subpostmasters if the Post Office continues to conform to the stereotype of a large organisation that, once it has denied liability for anything, refuses repeatedly to alter its position, whatever the facts.

As individuals, Post Office managers are probably understanding. As an institution the Post Office appears hostile to those whose lives have been ruined. It seems content to allow the cry for justice to stretch out for years, while it remains defensive and unsympathetic.

Shadow business minister Ian Murray asked in the House of Commons last year:

What processes will be put in place to compensate sub-postmasters and former sub-postmasters who have been disadvantaged, fined, lost their businesses, homes or even jailed, as a result of the problems with the Horizon system?

Wronged subpostmasters deserve far more in compensation than the sums originally in dispute. Is the Post Office institutionally capable of righting egregious wrongs?

Are disaffected subpostmasters having to sign gagging orders?

Second Sight interim report

Subpostmasters tell their story

Justice for Subpostmasters Alliance

 

Publish Universal Credit and other project reports, says ex-gov’t CIO

By Tony Collins

John SuffolkJohn Suffolk, the government’s former chief information officer, says warnings that publishing Universal Credit reports will have a chilling effect are “poppycock”.

His comments were prompted by the Department for Work and Pensions’ appeals against a ruling by the first-tier information tribunal that 4 reports on the Universal Credit programme be published.

The DWP has failed in every legal move it has made to stop the reports being published but is continuing its attempts although costs for taxpayers are increasing.

The DWP and its external lawyers argue that publishing the 4 reports would have a chilling effect by inhibiting the candour and boldness of civil servants who contribute to such reports.

But Suffolk says the claims of a chilling effect are “poppycock”. Suffolk was responding to a Campaign4Change blog “DWP tries again to stop disclosure of Universal Credit reports“.  He says:

“As you know I am a great fan of publishing all of the project reports. I note all of the comments on the “chilling effect” but this is poppycock.

“There is no chilling effect and if there was it would be countered by the extra scrutiny change programmes would receive by increased transparency. We should publish everything on projects and programmes.

“Transparency is a good thing. Government does complex work and more eyes on the problem would be a help not a hindrance, accepting we all need to know ‘who is the cook and who is the food critic’.

Suffolk was government CIO for nearly 5 years between 2006 and 2011 where he helped to steer an annual IT budget of billions of pounds.  He is now Head of Cyber Security/SVP at Huawei Technologies

His comments in full:

“It is such a shame that we have reached this position. Part of the Conservative Party (not the coalition) election thrust was on openness, transparency etc.

“Indeed some work has been done on this such as publishing the finance data, a summary report on major projects, but we appear to have gone backwards on no longer publishing an annual report for ICT spend, no longer publishing benchmark data – a prime driver that can reduce costs. According to the NAO some of what is published in terms of progress, is a little, how can I phrase this suspect.

“The realism is the only time a government can introduce transparency is at the beginning of a political cycle, this should have been executed at the beginning of the coalition as it becomes almost impossible to become transparent at the beginning of a new election cycle.

“A few words about UC. Before I left Government we reviewed the outline of UC as part of Francis Maude’s project control. I have to say the Ministers were excellent.

“They fully understood the policy objectives, fully understood the likely benefits and costs, understood the challenges but rightly deferred to officials on execution – how do we get from A to B.

“The Officials were far less impressive… Since then the ICT Team and Executive at DWP have gone through substantial change, the Civil Service have gone through a period of “transition” or “turmoil”; suppliers have gone through similar experiences and here we are trying to undertake one of the largest changes to the benefits system.

“We should not be surprised if there are a few wrinkles, nor should we be surprised if things move around a bit (what doesn’t – big or small) but what we should be surprised at is that Cabinet Office doesn’t appear to be backing the programme.

“I read with some mild amusement that GDS had taken their toys home and withdrew troops from “supporting” the programme.

“Excuse me, but isn’t this a flagship Programme? Won’t this programme save billions of pounds? Won’t this programme begin to change the something-for-nothing culture to nothing-for- nothing culture (unless there are real health reasons etc)?

“So we should have robbed all of the most talented resources of less priority programmes to support this. We didn’t. We went and sulked in the corner because they wouldn’t accept our ideas – instead we go and play around with websites and mess with tactical online services rather than focussing on the things that matter.

“You could also see this manifested in the major projects report where they singled out UC in a special category. Boys boys your job is to work together not squabble like little children.

“Get the best resources on UC, accept it is complex and dates will move around, take steady small steps and prove the programme and then get your shoulders behind it to make the implementation a success.

“Without doubt the Government have made many substantial improvements but when it comes to getting big changed implemented there is a long way to go.”

Millions of pounds of secret DWP reports

Judge refuses DWP leave to appeal ruling on Universal Credit reports

Minister didn’t lie over UC business case – but did officials deliberately mislead?

By Tony Collins

Comment

DWP minister Esther McVey is facing criticism that she misled Parliament by saying that the Universal Credit business case had been approved when it hadn’t.

A close look at the facts shows that the minister spoke the truth, and the DWP officials who wrote her Parliamentary answer also told the truth. But MPs were still misled, perhaps deliberately so.

The officials who wrote the minister’s reply knew that there is an early and very basic business case for Universal Credit,  the strategic outline business case, which had been approved.

All big projects in central government have strategic outline business case approval before they get underway. Universal Credit was the same as any other big programme in this respect.

What hadn’t been approved was the full business case which requires much more detail than the strategic outline case – and it requires plans and costs to be finalised among other things.

When, on 30 June 2014,  Rachel Reeves, Labour’s spokeswoman on work and pensions, asked the government whether the business case for Universal Credit had been approved officials wrote a cleverly deceptive answer.

They wrote that the strategic outline business case had been approved. They did not mention that the full business case had not been approved. It’s certain that the minister did not realise that this answer was deceitful.

That said, the  answer was in line with the DWP’s culture which is to project good news and conceal bad news (NAO report Universal Credit: early progress, September 2013).

This was the original Parliamentary question and answer on 30 June 2014.

Rachel Reeves (Shadow Secretary of State for Work and Pensions; Leeds West, Labour)  

To ask the Secretary of State for Work and Pensions … whether he has approved the Department for Work and Pensions’ business case for the implementation of universal credit.”

Esther McVey (The Minister of State, Department for Work and Pensions; Wirral West, Conservative)

“The Chief Secretary to the Treasury has approved the UC Strategic Outline Business Case plans for the remainder of this Parliament (2014-15) as per the ministerial announcement.”

It’s difficult to avoid the conclusion that the DWP, in drafting the minister’s reply to Reeves, intended to mislead.

That’s politics. On the other hand it is an extraordinary misuse of power by senior civil servants.

A strategic outline business case is very different to a full business case.

The strategic outline case merely sets out the strategic context and the case for change, together with the supporting investment objectives for the scheme. It sets out likely funding needs and speculates that the scheme is achievable and meets best practice principles.

The full business case has finalised arrangements including key contractual arrangements , costs,  agreed implementation timescales, main risks, constraints, dependencies, benefits and “dis-benefits”. It sets out an argument on the affordability of the scheme.

The controversy over whether Parliament was misled – which it was – shows the ease with which the senior civil service can protect the government of the day from embarrassment. Except that this time the truth came out; and it came out unexpectedly because a tenacious Margaret Hodge, chairman of the Public Accounts Committee, kept asking civil servants whether the business case for UC had been approved. Eventually, though with some reluctance, they told her the truth.

If a little truth comes out in such an unplanned way, one can only guess at how much other information on the Universal Credit programme is being hidden. Perhaps deliberately so.

Are passport officials hiding IT problems?

By Tony Collins

Are Passport Office systems crashing regularly – for up to half a day – without anyone outside knowing?

passport officeLast month a Home Office spokesman told Government Computing that IT was “not to blame” for delays in issuing passports.

But yesterday a Passport Office insider gave the opposite impression to Eddie Mair’s BBC R4 “PM” programme. She said that passport systems are sometimes out of action for up to half a day.

It also emerges that the Passport Office’s contract with one of its contractors, Steria, takes into account, in peak periods, the sorts of numbers of applications that offices are receiving – about 150,000 a week.

Home Office minister James Brokenshire told the House of Commons yesterday (7 July 2014) that there have been about 4 million applications so far this year, implying that the number is unexpectedly high.

But 4 million applications is not out of line with Steria’s contractual expectations of up to 150,000 applications a week.

This raises the question of whether the delays are due to a combination of IT problems and high numbers of applications – rather than high numbers alone.

On the BBC “PM” programme the comments by the Passport Office insider were spoken by an actor.  She said the backlog of passport applications has increased since the government announced emergency measures last month.

” The numbers have increased significantly and they are just the ones in the system.  What you need to take into account – and I don’t think people have realised – is that we have another huge backlog of applications that have not been scanned onto the system and are not in process.

“The backlog of applications – what they call “work in progress” – is not a true figure because but you still have another backlog that has not been scanned …”

BBC reporter: So there is another set of passports that don’t appear in official figures?

“That’s correct.”

She said that increasing backlogs are indicated on figures on boards around offices that give dates of which offices are working on what on certain dates.

“Her Majesty’s Passport Office is in total crisis. It’s a total mess …  it is chaos.”

BBC reporter:  A member of my family phoned up to try and make an appointment to sort out a passport last week and while she was on the phone she was told the computer kept crashing. Is that a common problem?

“Yes.  Once the system crashes you cannot issue anything or do anything. You just have to sit there until the technicians or the IT experts reboot the system or put a patch in to get it up and running again.”

BBC: How long does that last? How long are the computers and therefore the people handling the passports out of action for?

“Sometimes I would say a minimum of half an hour up to half a day.”

passportsShe said that passports are being stored in meeting and conference rooms which are locked. The windows have been “blacked out or covered with paper so no photos can appear, for instance, in the Guardian“.

She does not believe the Home Secretary Theresa May or her ministers have a grip of the situation. “I don’t think they understand. I am not too sure whether it is because they haven’t been fed the correct information or whether they are just putting their heads in the sand.”

The Home Office said a minister was not available to speak to the BBC.  It provided a statement instead – which gave no response to the insider’s claims of computer problems.

The statement said:

“These allegations are false. We receive thousands of application every week with their numbers constantly changing. We aim to log applications within 48 hours of receipt at which point they become active work in progress…”

Update 18.00 8 July 2014

Paul Pugh, Chief Executive of the Passport Office, appeared before MPs on the Home Affairs Committee this afternoon and was not asked about IT problems and made no mention of any.

He declined to say how many applications have been received by the Passport Office which have not been scanned into the systems. He said the number varied daily. He conveyed a quiet self-confidence which wasn’t in any way dented by committee members who in general did not put him under pressure.

They thanked him repeatedly for dealing with complaints from their constituents.  Committee chairman Keith Vaz handed Pugh 180 emails from people who are facing delays and need a passport urgently.

He denied the Passport Office was in chaos and said the “vast majority” of people working there would disagree with the comments of the anonymous contributor to the BBC “PM” programme.

Comment

The insider’s comments may be relevant given that the Passport Office had serious IT processing difficulties when it has changed its main processing systems in 1989 and 1999.   Has it had a third IT-related calamity as a result of an upgrade of passport systems in 2013?

US-based supplier CSC helped with the upgrade last year but no information has been released on the change-over.  The new system was installed as part of a $570m services contract the Passport Office awarded CSC in 2009.

Steria manages the front-end of passport application processing. It receives applications from the public, scans them digitally, verifies the contents, checksthe scanned documents for accuracy and makes corrections where necessary, and banks payments received. It then passes applications to Her Majesty’s Passport Office to complete the examination.

Steria expected up to 150,000 passport applications a week at peak times and it appears that actual applications have been around this number for much of this year. So why are ministers and officials blaming delays on a record number of applications?

There may be IT problems that nobody in officialdom is mentioning.

The most worrying thing is that they do not have to mention them. Perhaps the cause or causes are complex and they are unsure who bears most of the responsibility.

In politics nobody seems to expect the truth to be told. So it’s likely that ministers and officials will continue to blame the delays in issuing passports on record numbers of applications, and not mention anything to do with IT, except to deny it has anything to do with the backlog.

BBC PM programme (approx 47 minutes into the programme).

HP’s tacit threat to government not to bid for contracts?

By Tony Collins

HP has written to the Treasury  questioning whether it is worthwhile competing for contracts if the Government is no longer interested in doing business with multinationals, says The Independent.

Cabinet Office minister Francis Maude is encouraging departments to spend more with SMEs and be less reliant on a small number of major IT suppliers. He wants departments to avoid signing long-term contracts which lock-in ministers to one major supplier.

The Independent says:

“In a striking case of Goliath accusing David of bullying, the American giants Microsoft and Hewlett Packard have complained that they are being unfairly picked on by the Cabinet Office minister Francis Maude.

“…the Government’s largest IT supplier Hewlett Packard has written to the Treasury to express its concern at plans by Mr Maude to award more Government contracts to smaller suppliers.

“At the same time Microsoft is fighting a rearguard action against the Cabinet Office to protect the million pounds it gets each year from Whitehall by selling popular Office programmes such as Word and Excel.

“Both companies are concerned that they are being singled out by ministers as unpopular and easy targets in their rhetoric about cutting public sector waste…

“Microsoft is attempting to prevent the Government from migrating its own computer systems from those that rely on the multinational to open-source documents that are free to use…

“Both companies look set to be disappointed – at least unless there is a change in Government. Mr Maude is understood to be looking to next year – when a significant number of big IT contracts are up for renewal – to push ahead with the new policy that could significantly denude the profits of IT multinationals.”

A Cabinet Office spokesman said it was unaware of HP’s letter to the Treasury and added: “We value the contribution companies of all sizes make to the UK economy, driving innovation, growth and jobs.”

A spokeswoman for HP told The Independent:  “HP is a proud and long-standing supplier of IT products and services to Her Majesty’s Government and provides vital public services to UK citizens.  We maintain an ongoing dialogue with government about our programme of work.”

A report by the Institute for Government Government Contracting:  Public data, private providers says that HP is the largest supplier to government with earnings in excess of 1.7bn in both 2012 and 2013.

In 2013, 86% (£1.49bn) of HP’s revenue from central government came from a DWP contract to supply infrastructure and systems for DWP and its job centres. “This contract is likely to be the largest single non-defence contract in central government,” says the Institute.

Capgemini, BT and Capita were the next largest suppliers to central government. Capgemini’s work is mainly from HMRC through the “Aspire” contract which is worth about £850m a year.

Departments are more open than they used to be but the Institute found big gaps in the information provided.

These gaps include:

- Contractual transparency –  contracts and contractual terms, including who will bear financial liabilities in the event of failures

- Information about how well contractors perform, allowing a vital assessment of value for money

- Supply chain transparency – information including the proportion of work subcontracted to others, terms of subcontracting (particularly levels of risk transfer), and details on the types of organisation (for example, voluntary and community sector organisations) in the supply chain.

Comment

What concerns Maude and his team is not the existence of major suppliers in central government contracts but the reliance by central departments on long-term contracts that lock-in ministers and lead to costly minor changes.

Nobody wants the major suppliers to stop bidding for contracts. What’s needed is for departments to have the in-house expertise to manage suppliers adroitly, and not to be adroitly managed by their suppliers which seems to be the position at present.

Thank you to openness campaigner Dave Orr for the information he sent me which helped with this article.

The IT giants who fear losing the government’s favour

Opening the door to data transparency

 

 

 

50,000 on waiting list and cancer test delays after NPfIT go-live

By Tony Collins

Croydon hospitals have built up a waiting list of 50,000 patients since a Cerner electronic patient record system go-live last October, according the trust’s latest board papers.

And, since the go-live, more than 2,200 patients have waited at least 6 weeks for diagnostic tests, of which 160 have been identified as “urgent suspected cancer and urgent patients”.  This backlog may take until the end of August to clear, say the board papers of the Croydon Health Services NHS Trust which includes Croydon’s Mayday Hospital, now the University Hospital.

The trust has declared a “serious incident” as a result of the diagnostics backlog. An SI can be reported when there is possibility of unexpected or avoidable death or severe harm to one or more patients.

“No harm”

The trust concedes that its waiting times pose a “potential clinical risk” but the board papers say several times that there is no evidence any patient has come to harm.  This assurance has been questioned by some trust board members. The trust continues to investigate.

Croydon is the latest in a long line of trusts to have had serious disruption after a Cerner go-live under the NPfIT, with BT as the installation partner.

The trust has kept the implications for patients confidential. This may contravene the NHS’s “duty of candour” – to report publicly on things that go wrong. The duty has come about in the wake of the suffering of hundreds of people in the care of Mid Staffordshire NHS Trust.

Croydon Health Services NHS Trust has decided not to publish its “Cerner Deep Dive” or Cerner “Lessons Learnt” reports, and discussions on the reports have been in Part 2 confidential sections of board meetings.

The trust defended its “Part 2″ approach in its statement (below).

Meanwhile the Health and Social Care Information Centre, which runs the NPfIT local service provider contracts, including BT’s agreement to supply Cerner to hospitals in London,  has commissioned Cerner to capture the benefits nationally of Cerner installations.

Q&A

My questions and points to the trust, and its responses are below.

From me to the trust:

Croydon had good reasons to go live with Cerner, and DH funding was a further incentive but the trust does not appear to have been in a position to go live – at any stage – with a Big Bang Cerner implementation. The 7 aborted official go-live dates might have been a sign of why.  It would have been a brave decision to cancel the implementation, especially as:

-  the trust had spent 2 years preparing for it

- DH, BT and Cerner had put a lot of work into it

- there was DH pressure to go live especially after all the missed go-live dates.

The latest board papers say 6 or more times in different places that there has been no harm to patients as a result of the delays and waits.  Some members have raised questions on this and there is the matter of whether the trust is commissioning its own assessments (marking its own work).

On this:

- 50,000 on waiting list

- Cerner deep dive not published

- Lessons Learnt not published (concealment of failures, against the spirit of duty of candour called for by Robert Francis QC and Jeremy Hunt?)

- Diagnostics – an SI reported. The trust has considered the contributing issues which related to Cerner implementation but has not published details of the discussion. Again a concealment of failures?

- An accumulation of over 2,200 patients that were waiting over 6 weeks for diagnostics. Out of that number 160 patients were identified as urgent suspected cancer (USC) and urgent patients.  Can the trust – and patients – be sure there has been no harm?

- “… external assurance through an external clinician will provide the assurance that no patients have suffered harm as a result of the length of the waiting times”. Bringing in an external clinician to provide an assurance no patients have been harmed seems to pre-judge the outcome.  The trust appears to be marking its own work, especially as the backlog of patients awaiting diagnostics may not be cleared until the end of August.

- Managing public and GP perceptions? “Members agreed that GP interactions should be held off until the investigations had produced definite findings. However the Communications Department are on standby to publish information to GPs if required, and the Trust is ready to react to other enquiries. The Trust will in any event publish the incident report after the investigation has been completed.”

- “… the implementation of Cerner in October 2013 had an impact on activity levels and the delivery of RTT standards”. Again no report on this published.

- “An independent assessor would re-check all patients to assure that no harm has resulted. The Committee noted the progress report and requested that this is referred to a Part 2 meeting of the Trust Board …” Concealment of failures again?

- In the past the DH has been prepared to treat patients as guinea pigs in Cerner Big Bang implementations. The philosophy appears to be that the implementations will inevitably be disruptive but it’s for the good of patients in the longer term. That this approach may be unfair on patients in the short term, however, seems not to trouble the NHS hierarchy.

It’s clear clinicians and IT staff are doing their best and working hard for the benefit of patients but the implementation was beyond their control. Meanwhile complaints are increasing, Croydon Health Services was one of the lowest rated trusts for overall patient experience and a sizeable minority of local residents don’t choose the local hospitals for care or treatment. That said some patients rate their care very highly on NHS Choices (although some don’t). The University hospital is rated 2.5 stars out of 5.

One of the most surprising statements in the board papers is this: “… despite the weaknesses in the programme, the overall success of the deployment had been recognised at a national level”. A success? Can the trust in essence say what it likes? Nobody knows for sure what the facts are, given that the trust decides on what to publish and not to publish.

The trust’s response to the above points and questions:

“Due to a temporary failure of our administrative systems, the Trust found in February 2014 that a number of patients who needed to be seen by the imaging service were in breach of the six week waiting standard.

“We have taken immediate action to correct this and are undertaking a thorough review to confirm that no patients were harmed as a result.  The Trust is now working hard to treat patients currently on our waiting lists.  This is referenced in our publicly available Board papers.

“CRS Millennium has delivered a number of improvements that support improving patient experience at the Trust, including more efficient management of medicines, more detailed patient information being conveyed between shifts and departments and better management of beds within the organisation.”

Lessons?

Below are some of the lessons from Croydon’s Cerner go-live. Although the trust hasn’t published its “Lessons Learnt” report, some of lessons are mentioned in its latest board papers:

  • Insufficient engagement from operational and clinical colleagues
  • Time pressures were felt when a full dress rehearsal stretched the capabilities of the information team.
  • Insufficient time and resources were allocated to completion of the outline business and full business cases, as well as to due diligence on the options and costs.  [Business cases for Cerner are still unpublished.]
  • Trust directors agreed that a business case for a project of the size and complexity of the CRS Millennium should have taken longer than 6 weeks to prepare.
  • A failure of senior managers to take stock of the project at its key stages.
  • Too strong a focus on technical aspects
  • Clinicians not always fully appreciating the impact of the changes the system would deliver
  • The hiring of an external change manager to lead the deployment who proved to be “less than wholly successful because of the resulting deficiency in previous experience or knowledge of the culture of the organisation”.
  • The individual left the organisation part way through deployment which led to further challenges.
  • The right people with the right skills mix were not in place at the outset to achieve the transformational change necessary to successfully deploy a new system such as CRS

Comment 

NHS trusts have good reason to modernise their IT using the widely-installed  Cerner electronic patient record system, especially  if it’s a go-live under the remnants of the NPfIT, in which case hospitals receive DH funding and gain from having BT as their installation partner.

But why does a disruption that borders on chaos so often follow NPfIT Cerner implementations? Perhaps it’s partly because the benefits of Cerner, and the extra work required by nurses and doctors and clerical staff to harvest the benefits, is underestimated.

It is in any case difficult to convey to busy NHS staff that the new technology will, in the short-term, require an increase in their workload. Staff and clinicians will need to capture more data than they did on the old system, and with precision. The new technology will change how they work, so doctors may resent it initially, especially as there may be shortcomings in the way it has been implemented which will take time to identify and solve.

The problem with NPfIT go-lives is that they take place in an accountability void. Nobody is held responsible when things go badly wrong, and it’s easy for trusts to play down what has gone wrong. They have no fear of authoritative contradiction because they keep their implementation assessments confidential.

What a difference it would make if trusts had an unequivocal duty of candour over electronic health record – EHR – deployments. They would not be able to go live until they were ready.

The disruption that has followed NPfIT Cerner go-lives has been serious. Appointments and tests for suspected cancer have been lost in the administrative confusion that follows go-live. There have been backlogs of appointments for tens of thousands of patients. Operating theatres have gone under-used because of mis-scheduled appointments.

Now and again a patient may die unnecessarily but the problems have been regarded by the NHS centrally as collateral damage, the price society pays for the technological modernisation of the NHS.

Richard Granger, when head of the NPfIT, said he was ashamed of some Cerner installations. He described some of them as “appalling” but since he made his comments in 2007, some of the Cerner installations have been more disruptive than those he was referring to.

Provided each time there is no incontrovertible evidence of harm to patients as a result of a go-live, officials give the go ahead for more NPfIT Cerner installations.

Guinea pigs?

Disruption after go-live is too often treated as an administrative problem. Croydon’s statement refers to a “temporary problem with our administrative systems”. But new patient record systems can harm patients, as the inquest on 3-year-old Samuel Starr heard.

It’s time officials stopped regarding patients as guinea pigs in IT go-lives. It compounds the lack of accountability when trusts such as Croydon keep the reports from the go-live secret.

Trusts need better technological support but not at the cost of treating any harm to patients as collateral damage.

A tragic outcome for Cerner implementation at Bath?

Openness and honesty is a rarity after health IT problems

Mishandled electronic health record transition

A botched Cerner EHR implementation?

Trinity Medical Center reaches Cerner settlement

Has DWP suppressed a “red” rating on Universal Credit project?

By Tony Collins

The Cabinet Office’s Major Project Authority gave the Universal Credit programme a “red” rating which IDS and the Department for Work and Pensions campaigned successfully to turn into a neutral “reset” designation, says The Independent.

Universal Credit was “only given a reset rating after furious protests by Iain Duncan Smith and his department,” says the newspaper.

A “reset” rating is unprecedented. All major projects at red will need a reset. That is one of the reasons the Major Projects Authority gives a red rating: to signal to the senior responsible owner that the project needs resetting or cancelling. A “reset” designation is a non-assessment.

The MPA’s official definition of a red rating is:

“Red: Successful delivery of the project appears to be unachievable. There are major issues on project definition, schedule, budget, quality and/or benefits delivery, which at this stage do not appear to be manageable or resolvable. The project may need re-scoping and/or its overall viability reassessed.”

The suppression of Universal Credit’s red rating may indicate that the project, at the top, is driven by politics – the public and Parliamentary perception of the project being all-important – rather than pragmatics.

It is a project management aphorism that serious problems cannot be tackled until their seriousness is admitted.

Normally the Major Projects Authority will give even newly reconfigured projects traffic light ratings, to indicate its view of the risks of the revised plans.

The Independent calls for the replacement of Iain Duncan Smith as political head of the project.

Comment

The National Audit Office warned last September of the DWP’s fortress mentality and “good news” culture.

The suppression of Universal Credit’s red rating on top of the DWP’s repeated refusals to publish the Universal Credit project assessment report, risk register, issues register and milestone schedule shows that the DWP still avoids telling it like it is. That will make successful delivery of Universal Credit’s complexities impossible.

Well-run IT projects are about problem-solving not problem-denying.

The Independent is right to say that IDS is not the person to be running Universal Credit. He has too much emotional equity to be an objective leader. He sees himself as having too much to lose. The programme needs to be run by an open-minded pragmatist.

In asking the Cabinet Office to agree with a “reset” rating for Universal Credit IDS is acting like a schoolboy who has done something wrong and asks the school not to tell his parents. That’s no way to run something as important as Universal Credit.

IDS and DWP accused of hiding bad news on Universal Credit - The Independent

 

Judge refuses DWP leave to appeal ruling on Universal Credit reports

By Tony Collins

An information tribunal judge has unexpectedly refused consent for the Department of Work and Pensions to appeal his ruling that four reports on the Universal Credit programme be published.

The ruling undermines the DWP’s claim that there would be “chilling effect” if the reports were published.

The judge’s decision, which is dated 25 April 2014, means the DWP will have to publish the reports under the FOI Act  - or it has 28 days to appeal the judge’s refusal to grant consent for an appeal.  The DWP is certain to appeal again. It has shown that money is no object when it comes to funding appeals to keep the four reports secret.

In 2012 John Slater, who has 25 years experience working in IT and programme and project management, had requested the UC Issues Register, Milestone Schedule and Risk Register. Also in 2012 I requested a UC project assessment review by the Cabinet Office’s Major Projects Authority.

Last month the “first-tier” information tribunal ruled that all four reports should be published. It rejected the DWP’s claim that disclosure would inhibit the candour and boldness of civil servants who contributed to the reports – the so-called chilling effect.

The DWP sought the tribunal’s leave to appeal the ruling, describing it as “perverse”. It said the tribunal had wholly misunderstood what is meant by a “chilling effect”, how it is manifested and how its existence can be proved.

It claimed the misunderstanding and the perverse decision were “errors of law”.  For the first-tier tribunal’s finding to go to appeal to the “Upper Tribunal”, the DWP would have needed to prove “errors in law” in the findings of the first-tier tribunal.

Now Judge David Farrer QC says his tribunal has understood the chilling effect but found no evidence that it was relevant to the four reports in question. Indeed the judge implies that if the chilling effect existed there would be evidence of it.

“The so-called chilling effect implies Government departments and other public authorities have by now extensive experience of decisions requiring them to disclose information which they sought to withhold for the reasons advanced by DWP here,” says the judge in dismissing the DWP’s request for permission to appeal.

“If the chilling effect is a widespread and damaging result of the fear of disclosure, there is every reason for central government to investigate the matter, enabling a government department to present a case based on its research.

“Quite apart from that, those receiving reports, conducting discussions and reading advice might be expected to observe, over a period, any trend in changing style and content of their colleagues` written work, so as to be able to present examples and relate them to the perceived threat of disclosure.

“Obviously the form of document will remain the same but it is hard to believe that the experienced observer could not spot and demonstrate a general loss of trenchancy, of innovation or of boldness in the content over a period if that were indeed the effect of possible public exposure.

“Such changes would constitute ‘concrete and specific effects’, adopting DWP`s wording.”

Although the reports requested under the FOI Act are now old – they date back to 2011 – their publication could throw light on how much DWP ministers and civil servants knew about the many problems with Universal Credit IT at a time when the department was issuing unswervingly positive press releases about the UC programme.

Judge Farrer hinted that DWP ministers and civil servants could have misled the public about the real state of UC programme.

Having read the four reports in question, the judge said in his ruling that the Tribunal was “struck by the sharp contrast with the unfailing confidence and optimism of a series of press releases by the DWP or ministerial statements as to the progress of the Universal Credit Programme during the relevant period”.

At the information tribunal in January 2014 a senior civil servant Sarah Cox, on behalf of the DWP, spoke on the supposed effects of disclosure on the candour and boldness of reviewers.

But the Tribunal noted that a Starting Gate review of Universal Credit was published [in 2011] which the DWP had refused to release under FOI. The Information Tribunal noted that Ms Cox did not suggest that the revelation of this document had inhibited frank discussion within the Universal Credit programme.

The Tribunal said reports such as the risk register and project assessment review are important indicators of the state of a project. Their disclosure can give the public a chance to test whether ministers and civil servants are giving out correct information on the state of a project.

This week the judge says that the Tribunal “read and heard the evidence of Ms. Cox, considered the subject matter and the withheld material, took account of her experience, applied its own experience of these cases and its commonsense and, on this issue, found her testimony unpersuasive, as it was entitled to do.”

In conclusion the judge says the Tribunal “rejects the claim that its handling of the ‘chilling effect’ issue involved an error of law.”

Comment:

The DWP was claiming in 2012 that all was well with the UC programme when in reality they knew there wasn’t even an agreed project plan.

That is a good reason for the DWP to want to keep the reports secret – but the main reason its senior civil servants want to stop publication is tradition. The DWP does not publish any of its reports on the state of big IT-enabled projects and programmes.

It’s perhaps because the DWP has always buried itself under the covers of secrecy that it is so imperious – to the point of arrogance – in its handling of FOI requests and appeals. It acts like an institution that is not used to having outsiders, including the information tribunal and National Audit Office – peep into its affairs.

Perhaps this is why the NAO found that the UC programme was being managed so badly. When complex institutions operate in secrecy and without effective day to day scrutiny standards can continue to fall to a point when even the best leaders are powerless to intervene.

There may come a time – if that time hasn’t been reached already – when the DWP will be held together, and only remain credible in the eyes of the public and Parliament, because of the solid work of its major IT suppliers that have been there for decades, bolstered by a plethora of media announcements and ministerial assurances.

We are certainly getting the media announcements and ministerial statements, but without the publication of reports on UC’s progress, do the official pronouncements mean anything at all?

FOI ruling judge refuses DWP leave to appeal

Is IDS losing his cool over Universal Credit IT?

By Tony Collins

IDS was polite and calm, almost deferential, when he went before MPs of the Work and Pensions Committee in September 2012.  “Can I say it is always a privilege to be here?” he said.

At at Monday’s hearing of the same committee, though, he was at times tetchy, patronising and mildly bullying. “I don’t think this committee can run the department,” he replied when asked why he hadn’t told the committee in 2012 of problems with the Universal Credit IT project.

Several times he talked over the MP who was asking him questions, with the result neither could be clearly heard.

[If he’s like that at meetings with DWP officials would anyone want to tell him something he doesn’t want to hear? Perhaps his loss of cool on Monday reflected the baffling complexity, and rising costs, of the waterfall part of  Universal Credit’s  IT programme.]

IDS might also have been shaken by the absence of his most authoritative ally, Howard Shiplee, who has been off sick since shortly before Christmas.

Hidden 

Over a period of more than a year, the DWP and IDS fed the work and pensions committee good news about progress on the Universal Credit IT project. The truth didn’t surface until the National Audit Office published its report on UC in September 2013.

Unknown to the committee in 2012, the DWP was struggling at that time to set out how the detailed design of systems and processes would fit together and relate to the objectives of Universal Credit. This was raised repeatedly in 2012 by internal audit, the Major Projects Authority and a supplier-led review. The committee wasn’t told.

Hence Dame Anne Begg, the softly-spoken chairman, came to Monday’s meeting with a direct question. Why, when IDS came before the Work and Pensions committee in September 2012, did he make no mention of having commissioned a red team review into the Universal Credit project several months earlier.

“Because it was an internal review,” replied IDS. “We were looking the results of that and trying to take whatever decisions were necessary. It was about some of the issues that were going on in the UC team…”

Begg: “But why didn’t you tell us a review was going on?”

IDS: “I don’t tell the committee everything that is happening within the Department until we have reached a conclusion about what is actually happening.”

Begg: “It was an ideal opportunity when you appeared before us in September [2012] that you could have said there were concerns about what was happening with Universal Credit but at that session you were very bullish about how successful everything was.”

IDS: “I still remain very confident about how successful it will be. [Note a difference in tenses between the question and answer]. At the time we were working out how we would make the reset.”

Sir Humphrey

At IDS’s sided was Robert Devereux, Permanent Secretary at the DWP, who seemed at times a parody of Sir Humphrey. [Animated in the delivery of some of his answers Devereux looked as if he was saying something interesting until you listened to the words.]

One MP asked Devereux why the DWP had given written evidence to the committee in 2012 that Universal Credit was on track when it wasn’t. Devereux said that UC was a large and complex programme. “You are constantly evaluating and re-evaluating your forward plans … as you go along things change.” MPs were none the wiser.

Misled?

Begg [to IDS]: Did you not think it appropriate that this scrutiny committee of the House of Commons, which oversees the work the department does, [should have been kept] informed about changes?

IDS: “With respect we did keep the Committee informed as and when we had clarified what we were actually doing and what we thought the problem was and where it existed and how you isolate it and what changes you made. I don’t for one moment agree in any way at all that we hid stuff. We knew we would be accountable to the committee and all would become public… I don’t think this committee can run the department.”

Begg pointed out that IDS had failed to mention a report of the Cabinet Office’s Major Projects Authority in February 2013. That report had notified the DWP of flaws in UC governance, management and programme design – despite the same matters having been raised in previous MPA reports.

Begg:  “You gave oral evidence to us on 10 July [2012] … but you did not refer at that session to the critical Major Projects Authority report or the reset which had already taken place earlier that year.”

IDS: “I cannot remember what I said to the committee. I have no desire to look back.”

Begg said the DWP told the committee that the pathfinder projects demonstrated that the IT systems worked. “You cannot get any more definitive than that,” said Begg. IDS gave no clear answer.

Obfuscation

T9DFQDU8Mid-way through the hearing, the mood of some of the exchanges was summed up by Labour MP Debbie Abrahams who told IDS:

“I cannot say with the strongest feeling my concern about the hubris that you have demonstrated in the tone to this committee. You haven’t explained, certainly to my own satisfaction – anybody who is watching will draw their own conclusions – you have not given any satisfactory explanation about how you have informed, or kept this committee informed, about the difficulties the department was experiencing.

“There have been obfuscation and smoke and mirrors even up to a few weeks before the report from the National Audit Office [in September 2013]. The memorandum that was released in August – this was clearly saying everything was fine and dandy. It is clearly not. I give you one more opportunity to answer, so you can explain to this committee, why such poor information is provided by your department.”

IDS replied: “I just don’t agree with you, and I don’t agree that we have done anything else but be open and honest about what the issues are, as and when they have been identified and what we would do about them as and when we have made our decisions about them…

Open?

“When we found something wrong we went and sorted it out. As we sorted it out we made clear direction about that, and eventually through the NAO, the PAC [Public Accounts Committee and the [Work and Pensions] committee.

“I think we have been pretty open about it. I don’t think there’s anything more. In fact in a sense we are going round and round in circles here at this committee hearing at the moment.”

Begg:  “We are not convinced you have got it sorted out.”

Comment

Monday’s hearing shows how ministers and officials justify the hiding of reports on costly IT-enabled projects that are going wrong. IDS didn’t even tell MPs in July 2013 that the Major Projects Authority had four months earlier recommended an immediate pause in the programme.

Most worrying of all, officials and IDS seem content that the DWP gave the work and pensions committee – in September 2012 and July 2013 – a good news story on the state of the Universal Credit IT project while truth about the project’s problems stayed hidden.

IDS suggested it was not necessary to tell MPs about reports until ministers have “reached a conclusion about what is actually happening” That may be never.

It’s time for public accounts and work and pensions MPs to insist on seeing Major Projects Authority reviews, and other reports, on the progress or otherwise of big government IT-enabled programme such as UC. MPs should not have to wait for an NAO report to get the truth.

Governments, whatever their hue, will always refuse to publish these reports contemporaneously, such is the will of departmental heads. They have been refusing to publish the reports for more than 20 years.

But if MPs keep insisting with an unbreakable tenacity on their publication  – and for publication before they are out of date – it may eventually happen, and gone will be the power of ministers and officials to mislead MPs on the state of big IT-enabled programmes.

Until publication happens, is there much point in MPs questioning IDS or his officials on the UC IT programme? They will get only the public relations version of the truth.

 

Dare anyone criticise this IT project – with the CEO as leader?

By Tony Collins

Croydon Health Services NHS Trust has had mixed success with its go-live of the Cerner Millennium system.

It is said to be a technical success but last week board members of the Croydon Clinical Commissioning Group expressed concerns about ongoing problems with the system.

Fouzia Harrington, director of quality and governance told the Croydon Advertiser: “The implementation [of Cerner] itself went well in technical terms, but there have been some implications about how it has been used by staff.

“It’s had far more impact in terms of the time it takes to book people in, for example. There have also been implications in terms of lost information about patients.

“There has been a lack of information about hospital activity, which has an impact on finances and, potentially,the quality of services patients are receiving…”

David Hughes, a lay member of the board, was not satisfied with that reassurance.

“You say that no harm has occurred,” he said,  “but while we’ve had no direct incident so far, patient care has definitely suffered.

“You talk about increased waiting times and there’s a risk that harm may occur because of the difficulty in getting in touch with clinicians who actually know what is going on with the patient.

“I’m very concerned from a quality point of view that our main provider has a serious problem with its information systems.”

Hughes called for action. Although the trust may not be aware of an incident yet it may “come out through further investigation that there has been”.

Some waiting times have increased,  the CCG cannot be certain of exact levels of activity at the hospital, and missing information has made it difficult to commission some services.

The concerns were raised at a board meeting on Tuesday.

Dr Tony Brzezicki, chairman of the CCG, said new system would eventually lead to improvements.  “Hospital patients had five sets of notes before. That in itself posed a risk that Cerner will mitigate,” he said.

“However, there have been administrative delays which mean longer waiting times for patients.There are also issues for the service to primary care which is a significant risk. Some of the problems have been resolved though I am concerned at the time scale because they are certainly impacting on my practice.”

Success

John Goulston is the Croydon Health Services NHS Trust CEO. One of his previous jobs was as Programme Director of the London Programme for IT at NHS London. The LPfIT was formerly part of the National Programme for IT. 

As well as CEO, he chairs the trust’s Informatics Programme Board which has taken charge of bringing Cerner Millennium to Croydon’s community health services and the local University Hospital, formerly the Mayday.

Goulston reported to his board that the Cerner go-live - on 30 September and 1 October last year – was a success.

“Our partners Cerner, BT and Ideal have commented that the Trust has undertaken one of the most efficient roll-outs of the system they have worked on, with more users adopting the system more quickly and efficiently than other trusts … the success we have achieved to date is the result of the efforts of every single system user and all staff members,” said Goulston.

Goulston has said the trust deployed the “largest number of clinical applications in a single implementation in the NHS”. 

The Department of Health provided central funding, and the trust paid for implementation “overheads”.  The Health and Social Care Information Centre was the trust’s partner for the go-live.

The Croydon Advertiser asked Croydon Health Servicesa series of questions about Cerner, including its cost to the NHS, but was sent a short statement.

A spokesman told the Advertiser the system would improve patient administration and means that nurses have access to “quality, detailed information” when delivering care.

He added: “During the initial switch over of systems in September while staff were getting used to the system, some patients did need to wait slightly longer to check in for their clinic appointments.

“The trust has maintained and surpassed our 18 week referral to treatment targets from the initial roll out.”

Croydon’s response

Campaign4Change put some questions to the Croydon trust. These are the questions and its responses: .

Is the trust being completely open – taking seriously the duty of candour -  about problems arising from the Cerner Millennium go-live?

“The Trust takes its duty of candour on all issues very seriously; we believe that transparency is essential in running a modern NHS organisation. We are held to account by our board at public meetings, where the public are able to attend and question our senior management team, by our local health overview and scrutiny committee and our commissioners.

“Recent press coverage on CRS Millennium appeared in the local press when the system was discussed in a public meeting of our commissioners.”

As the CEO is leading the Cerner Millennium project, does this make it difficult for trust staff and trust directors to say anything even mildly critical about the implementation?

“Staff opinions on the implementation of CRS Millennium, both positive and negative, are welcomed by the Trust. Staff have given their frank opinions of the system directly to the Chief Executive both in our monthly all staff meetings and at the open staff engagement surgeries held by our Chief Executive and Chairman. All staff opinions are taken seriously and are acted upon appropriately.”

Given the CEO’s enthusiasm for the implementation is there a special onus on the press office to defend the implementation and play down problems? [I note that the Croydon Advertiser implied its questions had not been answered, and that the Trust gave a short statement instead.]

“The communications team respond to and facilitate a large number of external requests, including from the media, in a transparent, timely and appropriate manner. This same approach is followed on questions about CRS Millennium.

“CRS Millennium will bring about many improvements to patient care and Trust efficiency and we are enthusiastic about communicating these; it is unfortunate that recent press coverage did not consider these positive benefits in any depth.”

A comment on the Croydon Advertiser’s website says:

“When I checked in to out-patients I supplied all my personal details; however the post code I gave was declared invalid by the new system. That filled me with confidence. I also gave my contact as a mobile; however they tried to ring me using an old landline number.”

Comment

It’s generally accepted that having a high-level sponsor for an IT project is essential but when the lead is the CEO, does that make it difficult for people to challenge and constructively criticise?

A “good news” culture tends to prevail – as happened on Universal Credit, on the BBC’s Digital Media Initiative, and within the Department of Health on the NPfIT. Nobody dared to speak the whole truth to power. The truth tends to surface only when a new administration takes over or, in the case of Universal Credit, the minister obtained his own independent reports on project progress.

Campaign4Change put it to the Croydon trust that board directors see reports on the Cerner implementation only every two months and much can happen in the intervening period. This it did not deny.

Even if the trust’s directors met daily would they dare to challenge the CEO? And will the full facts  ever emerge? Things could be much better than CCG directors believe  - or much worse.

After nearly every major NPfIT implementation of the Cerner Millennium system in London and beyond (such as North Bristol) the facts were scarce, and reassurances that no patients had come to harm were plentiful. 

Here we go again?

**

Should lessons have been learned from these Cerner go-lives?

Barts and The London

Royal Free Hampstead

Weston Area Health Trust

Milton Keynes Hospital NHS Trust

Worthing and Southlands

Barnet and Chase Farm Hospitals NHS Trust

Nuffield Orthopaedic

North Bristol.

St George’s Healthcare NHS Trust

University Hospitals of Morecambe Bay NHS Foundation Trust

Birmingham Women’s Foundation Trust

NHS Bury

GPs asked to contact hundreds of patients who may have missed treatment after hospital’s cancer referrals blunder  - Pulse

London LMCs alert over Imperial cancer waits mix-up – Pulse.

GPs kept in the dark over hospital cancer blunder – Pulse

 IT system has increased waiting times and led to lost patient data.

Patient records go-live success – or NPfIT failure