Cambridge University trust to end 10-year £200m outsourcing deal early?

cuh

By Tony Collins

Two years after going live with an electronic patient record system as part of a 10-year IT outsourcing contract – one of the biggest in the NHS – Cambridge University Hospitals is going out to tender for similar services.

The Trust, which runs Addenbrook’s and the Rosie hospitals in Cambridge, describes the exercise as “market testing”, according to Government Computing.

Last year trust regulator Monitor put the trust into special measures after it over-spent an average of £1.2m a week, in part because of the huge costs of eHospital.

“The Trust underestimated the scale and challenges of implementing its new electronic patient record system, e-Hospital, and the impact this would have on its provision of healthcare for its patients. These issues led to significant cost increases and a failure to realise the benefits the system could provide,” Monitor said.

A Care Quality Commission report last year also criticised the implementation of the trust’s eHospital systems.

But in July this year the trust was shortlisted in three categories of a national award for using IT to improve patient care.

The trust went through to the finals in three categories: digital NHS trust or health board of the year; best use of IT to support integrated healthcare services, and the CCIO award for clinical informatics leadership.

ehospiital-logoEpic and HP

On 26 October 2014 that the trust went live with the “eHospital” project, which allowed clinicians to access patient information wherever they were in the hospital.

Clinicians use hand-held devices and computers on wheels to record care at the bedside. The devices enable the trust to record details of care in real-time into the new electronic patient record system.

The cost of the eHospital project over 10 years was expected to be £200m. The project involves software from US-based electronic patient records supplier Epic and hardware, services, infrastructure and support from Hewlett Packard Enterprise.

The trust’s board decided to spend the equivalent of a substantial new hospital building in an attempt to get the IT to match its reputation.

The eHospital project began in 2012, though the go-live of the patient records system was not until 2014.

cambridge-univrrsity-trust-logo

In a statement to Government Computing, Zafar Chaudry, Chief Information Officer at Cambridge University Hospitals, said of the latest tender,

“Almost four years into the eHospital programme, CUH [Cambridge University Hospitals] has exponentially increased the use of its Electronic Patient Records and seen a growing demand in the size and types of commodity IT services needed by the Trust.

“As such, we are market testing to ensure best value for public money to meet these needs, whilst recognising our partners, HP, have and continue to meet their contractual obligations.”

The trust’s tender dated 14 September 2016 says it is looking for “outsourced commodity IT services for enterprise infrastructure, service desk and end user computing including the provision of server, storage, electronic patient record application, LAN and WAN”.

The estimated contract value is £140m over seven years, with an option to renew for a further three years. From the tender document it does not appear that the trust is seeking to replace the Epic software.

In its 2015/2016 annual report, the trust was positive about the results of the Epic eHospital project.

“We are also now in our second year of operating with a comprehensive electronic patient record system in the form of Epic, as part of a ten year eHospital programme.

“The period following deployment saw a number of significant challenges, but we are now entering a phase where Epic has become very much a part of daily life and, as we consolidate our position, we are settling to the task of ensuring that we realise the many benefits of the system.”

Although there are still challenges – mainly a shortage of staff and money, with the trust anticipating a budget deficit of £74m in 2016/17  – eHospital’s benefits so far include:

  • the deployment of “business grade wifi in all clinical areas.
  • a refresh of the desktop estate of 6,750 PCs and 500 laptops.
  • the deployment of “workstations on wheels” and 420 “rover” devices (iPod touch with a barcode) for mobile working in clinical areas.
  • direct integration of physiological monitors and ventilators in all theatres and critical care areas, along with connectivity of point-of-care testing devices for integrated near-patient testing.
  • electronic patient record in full use for all aspects of care across all clinical areas in-patient and outpatient areas, typically with 3,200 concurrent users in the system at peak times, apart from paediatric chemotherapy.

Comment

On the face of it, Cambridge University Hospitals NHS Foundation Trust is seeking to replace its 10-year £200m outsourcing deal long before it’s even half way through.

But all of its literature implies it is happy – indeed proud – of the Epic system. It also seems content with Hewlett Packard Enterprise’s infrastructure and other services, though it’s not so clear whether it’s happy with its prices.

The tender could be merely an exercise to compare the prices it is paying with the prices available on the market, which could leave Hewlett Packard Enterprise, in essence, competing to keep its work at the trust.

The trust’s CIO told Government Computing that Hewlett Packard Enterprise has and continues to meet its contractual obligations.  That’s not in dispute, but it’s possible for users to be unhappy about suppliers even when contractual obligations are being met. The trust could have discovered that a new or revised contract is needed.

On the other hand, the tender could be the trust’s way of proving to the regulators that it is paying market prices for its patient record systems, outsourcing and ICT services.

The trust may have nothing to lose and everything to gain by an open tender while it’s only three years into a £200m 10-year outsourcing deal.

On the other hand, will IT companies want to spend large sums on bids none may be able to win?

Cambridge University Hospitals £140m market test – Government Computing, September 2016

Capita and NHS England apologise after continuing problems on £330m contract

By Tony Collins

NHS England to GP Committee of the BMA

NHS England to GP Committee of the BMA

GP magazine Pulse has published a succession of articles on varying problems arising out of NHS England’s seven-to-ten year £330m outsourcing deal with Capita. Now the two sides have issued separate apologies.

NHS England’s national director for transformation and corporate operations, Karen Wheeler, has issued an apology for the ‘unacceptable level of performance’ from Capita in the letter to the British Medical Association’s General Practitioners Committee chairman Dr Chaand Nagpaul.

Wheeler wrote that NHS England had applied “financial service credits” to Capita due to ‘agreed performance targets missed’.

A Capita spokesperson told Pulse,  ‘We fully recognise that the services we provide play a key role in supporting primary care providers and apologise for the level and varied quality of service we have provided across a number of PCSE [Primary Care Support England] services.’

Some of the problems on the contract are outlined here.

Missing records

The Guardian reported last week (14 September 2016) that,

“In some cases, GPs have had to hold their first appointment with a new patient without their medical records to guide their decision-making, because Capita has not transferred them in time. Even some urgent requests to process records quickly because a patient had a medical emergency have not been acted upon.”

It added,

“Local GPs are reporting to the BMA that they are facing unacceptable delays in patient record transfers and mistakes in maintaining supplies of crucial medical equipment like syringes and even prescription pads”, said Dr Chaand Nagpaul.

The Guardian said a new survey of local medical committees, which represent GPs, found that family doctors in almost every area of England had experienced problems with Capita’s performance.

Comment

It’s unusual for any major technology company to apologise publicly for problems on an outsourcing contract, in part because of commercial sensitivities and also because it’s not the supplier that has the ultimate responsibility for a service provided to end-users, in this case GPs.

However, what makes this outsourcing contract unusual is the open and forceful complaints of GPs – and medical organisations that represent them.

Usually in any major public sector outsourcing deal – such as those involving local councils, central government or NHS trusts –  both sides, supplier and client,  have a mutual interest in keeping any problems secret.

In the case of the GP Support Services contract, the end-users are doctors who, as a profession, will tend to express their concerns about private contractors publicly.

What a refreshing change. It’s only through openness when things go wrong that there is a likelihood of effective accountability for the way public money has been spent, or misspent.

It’s clear the problems are not all Capita’s fault. In trying to save money by outsourcing, officials at NHS England probably dismissed negative stories about failings on some outsourcing deals as ungrounded media speculation.

Anyone accountable?

Now that things continue to go wrong – despite months of assurances that problems are being resolved – will anyone at NHS England be held responsible for underestimating the impact on GPs of risks materialising – and underestimating the likelihood of those risks materialising?

Were anyone ever to be held responsible it would probably be the wrong person, such as a middle-grade manager who was only doing what senior officials expected.

id officials fail to probe deeply enough into the many things that could go wrong on such a complex contract?

NHS England has expected Capita, in essence, to learn a foreign language in a matter of weeks. Should anyone be surprised that what some GPs warned about before Capita took over has come about?

In 2015, when Capita was chosen as preferred bidder for the outsourcing of GP support services,  the General Practitioners Committee’s then deputy chairman Dr Richard Vautrey  said the committee had ‘grave concerns’ over the plans.

But even before NHS England received bids for the outsourcing contract, the then head of the contracts and regulation subcommittee of the GP Committee, Dr Robert Morley, told Pulse,

“The portents are absolutely horrendous for general practice I’m afraid…There’s nothing at all that reassures me this isn’t going to be an absolute bloody disaster.”

NHS England letter on Capita contract – September 2016

Capita NHS contract under scrutiny after “teething” problems – June 2016

GPs decry Capita’s privatised services as shambles – The Guardian

Did NHS England consider us in the Capita take-over?

NHS England vows to hold Capita to account

Capita mistakenly flags up to 15% of GP practice patients for removal  

Capita primary care support service performance “unacceptable”

 

 

Atos pleased after it’s cleared of “sharp practice”

By Tony Collins

atos

A Cabinet Office review of the Whitehall contracts of IT services company Atos following a Public Accounts Committee allegation of “sharp practice” has more than  exonerated the supplier.

After looking at 12 Atos government contracts, the Cabinet Office has written to the Public Accounts Committee praising Atos for going beyond its contractual obligations. Where the company has fallen short, it has taken remedial steps.

Rarely are any government statements on an IT supplier replete with praise.

It’s likely the vindication will take some MPs by surprise after failings in a project to gather and collect in one place data from all the various GP practice systems – the so-called General Practice Extraction Service.

Now Atos may in future be a position to use the statement as evidence, when bidding, of its success in delivering government IT services and projects.

Millions written off

In December 2015 the Public Accounts Committee was highly critical of Atos in its report on the extraction service project.

The NHS Information Centre accepted the system from Atos although it didn’t work properly. The Centre also made public announcements at the time on the system’s success.  In fact the system had “fundamental design flaws” and millions of pounds was written off.

The Committee said,

“Very common mistakes from past projects were repeated, such as failing to adopt the right contracting approach, failing to ensure continuity of key staff on the project, and failing to undertake proper testing before accepting the system.

“GPES [General Practice Extraction Service] started some five years later than planned; it is over-budget; and it still does not provide the full service required.

“Atos, supplier for a key part of the system, may have met the letter of its contractual obligations but took advantage of a weak client by taking the client’s money while knowing full well that the whole system had not been properly tested.”

The Committee said that the NHS official who was chief executive of the Information Centre when it accepted the flawed system was “awarded total emoluments of £470,000 for the financial year 2012–2013 including a redundancy payment of £330,000”.

Tests

The Committee found that in its approach to the project, “Atos did not show an appropriate duty of care to the taxpayer”.

“We are not satisfied Atos provided proper professional support to an inexpert client and are very concerned that it appears to have acted solely with its own short term best interests in mind.

“Atos admitted that end-to-end testing should always be undertaken and that it was supposed to have happened in this case. However, NHS IC and Atos agreed a more limited test of the Atos component due to delays in completing other parts of the system.

“The Atos software passed this test, but after NHS IC accepted the system—and to Atos’s professed surprise—the system as a whole was found not to work. Atos claims it fixed the issues relating to its software at its own expense and that the additional £1.9 million it received while doing so was for additional work related to 15 new features.

“We found that Atos’s chief executive, Mr Adrian Gregory—the company’s witness in our enquiry—appeared rather indifferent to the plight of the client; we expect more from those contracting with government and receiving funds from the taxpayer.”

“Sharp practice”

The Committee recommended that the Cabinet Office undertake a “full review of Atos’s relationships as a supplier to the Crown”.

“We expect the Cabinet Office to note carefully this example of sharp practice when determining what obligations a duty of care on contractors should entail and what sanctions would apply when performance falls short.”

The government agreed to have a review.

Findings of Cabinet Office review of Atos contracts

The Cabinet Office found no “examples of behaviour that might be described as sharp commercial practice in the course of this review”.

The review team looked at 12 Atos contracts worth a total of more than £500m a year – 80% of Atos’s work with central government.

 

No: Department Contract Name
1 Department for Work and Pensions (DWP) Personal Independence Payments (PIP)
2 Department for Work and Pensions (DWP) Government Gateway Agreement
3 Department for Work and Pensions (DWP) ICT in support of medical assessments
4 HM Treasury (HMT) National Savings and Investments (NS&I)
5 Ministry of Justice (MOJ) Development, Innovation and Support Contracts (DISC) Infrastructure Services Agreement
6 Ministry of Justice (MOJ) End User Computing Services (EUCS)
7 Nuclear Decommissioning Authority (NDA) Shared Service Alliance
8 Home Office (HO) IND Procurement of Infrastructure Development and Support (IPIDS) Agreement
9 Home Office (HO) Contain Agreement
10 Department of Health (DH) Information Management Services (IMS 3)
11 Ministry of Defence (MOD) Strategic Partner Framework Defence Core Network Services (DCNS01)
12 Driver and Vehicle Standards Agency (DVSA) ICT Managed Services Agreement (IS2003)

Far from finding examples of sharp practice, the review team found “examples to the contrary”. In some of the contracts, Atos was “working at risk” and going “beyond their contractual obligations to act in the client’s interests”.

“Specific examples include expediting change control notices at the client’s request in advance of formal approval, taking financial risk ahead of contract extensions and proactively supporting the redeployment of resource to assist in the avoidance of client cost. On one contract, a notice period for a number of major decommissioning events lapsed and Atos continued to deliver the services flexibly to the client’s requirements until the service could be safely decommissioned.”

Where Atos did not meet monthly performance targets, service penalties were incurred and charged to Atos. “It was evident that when operational performance fell short appropriate sanctions were applied.”

Commitment

The Cabinet Office went on to say that Atos proactively and constructively engaged in the review and provided information as requested, “sometimes over and above their contractual commitments”.

The review team added,

“It is clear that Atos values its relationship as a supplier to the Crown; it has a comprehensive approach to the governance of all the contracts reviewed and the Atos leadership team shows commitment to its customers.

“In response to the PAC [Public Accounts Committee] hearing Atos has undertaken a number of initiatives to address PAC’s concerns.

“The Atos corporate programme ‘Client at the Heart’ aims to deepen the client-focussed culture within the organisation by embedding a set of values and action plans to deliver improved service for each contract they run, including all government contracts.

“In addition, whilst employees have always been recognised for achievement in quantitative and qualitative objectives, financial targets vary but typically account for only a small proportion of total reward packages.

“We see this as evidence that Atos client executives are incentivised to provide the appropriate professional support.”

An Atos spokesman told civilserviceworld that the company was “proud to be a trusted supplier” and had welcomed the review as an opportunity to demonstrate the quality of its services.

“We are pleased that the Cabinet Office has concluded that we deliver the appropriate level of professional support to our government clients,” he said.

Comment

It’s clear that Atos deserves credit for going beyond the call of duty on some contracts. It is also clear that those departmental officials the Cabinet Office spoke to as part of the review were happy with Atos.

What’s not so clear is the extent to which civil servants in general are in a position to know how well their major IT suppliers are performing.

Evidence from National Audit Office reports is that departments may not always have comprehensive, accurate and up-to-date information – and enough staff time – to give sound judgements on how well a major IT supplier is performing on a complex contract.

Indeed the National Audit Office can be scathing about the quality of contract management within departments.

In 2013 the Audit Office, in its report “Universal Credit: early progress” identified a series of astonishing failings that, taken together,  suggested that the DWP had little understanding of what its major IT suppliers were charging for, or why, let alone what their performance was like.

The DWP is the largest central government department – which leaves one to wonder whether some other departments, which have smaller budgets and fewer staff, are better or worse off in terms of understanding their IT contracts.

These were some of the contract management weaknesses at the DWP as identified by the National Audit Office in 2013:

  • Over-reliance on performance information that was provided by suppliers without Department validation.
  • Inadequate controls over what would be supplied, when and at what cost because deliverables were not always defined before contracts were signed.
  • Weak contractual relationships with supplier
  • The Department did not enforce all the key terms and conditions of its standard contract management framework, inhibiting its ability to hold suppliers to account.
  • Limited line of sight on cost of delivery, in particular between expenditure incurred and progress made in delivering outputs.
  • Poorly managed and documented financial governance, including for delegated financial authorities and approvals; for example 94 per cent of spending was approved by just four people but there is limited evidence that this was reviewed and challenged.
  • Limited IT capability and ‘intelligent client’ function leading to a risk of supplier self-review.
  • Insufficient review of contractor performance before making payments – on average six project leads were given three days to check 1,500 individual timesheets, with payments only stopped if a challenge was raised.
  • Ministers had insufficient information to assess the value for money of contracts before approving them.
  • Insufficient challenge of supplier-driven changes in costs and forecasts because the programme team did not fully understand the assumptions driving changes.

The Cabinet Office, in its review of Atos, found “inconsistencies” in departmental compliance with guidelines on contract management. It said,

“Where the evidence suggests that contract management is inconsistent [with National Audit Office guidelines on contract management] the Cabinet Office is discussing improvements with the contract owners in the Departments concerned.”

Praise where praise is due and Atos may well be a good – and perhaps outstanding – IT supplier to central government.

But if departments don’t have enough solid information on how well their major IT suppliers are performing, to what extent is any Cabinet Office statement praising an IT supplier likely to be a hopeful panegyric, based on what officials in departments believe they are expected to say?

Cabinet Office statement on Atos to the Public Accounts Committee – 8 September 2016

Public Accounts Committee report on Atos and the General Practice Extraction Service – December 2015

 

Pay-for-a-GP service due for national roll-out

By Tony Collins

GPs have mixed views on a new service that allows paying patients to book a private GP appointment online.

People can use the “Doctaly” website to choose a GP and book a 15-minute appointment slot, paying from £39.99 to £69.99 depending on the time and day of the week, GP magazine Pulse reports today (16 September 2016).

The Doctaly website says:

“Why wait for an appointment? See a private GP near you today, from £39.99.” People can specify the appointment type requested, and have the option of giving their postcode.

The booking process requires the patient to confirm that they are not registered with the particular GP practice they choose.

Patients are also advised that Doctaly does not provide emergency care, and that patients needing care for psychological problems or long-term condition management are better off going to their regular GP who understands their medical history.

After a Doctaly consultation, the GP will give the patient a printed copy of the consultation notes. It’s up to the patient to decide whether to share the information with their NHS GP.

The new service has caused a stir among GPs in general, judging by the comments on Pulse’s website.  Some GPs have welcomed the service, in part because it will enable them to earn extra money in their spare time. They point out that consultants who work for the NHS and see paying patients privately have long had to juggle NHS and private appointments.

Other GPs say the service will destabilise the NHS, and may make it harder for non-paying patients to see their GP. They call the new service “queue-jumping”.

Doctaly has been running for the past month at ten practices in Barnet and Enfield, with around 50 GPs signed up to offer appointments at various times, reports Pulse. The new service doesn’t employ any GPs. Instead GPs give Doctaly a list of their available appointments.

Company founder Ben Teichman told Pulse that the service should “help drive queues down in surgeries and also take traffic away from A&E”.

Success of the national roll-out will depend to a large extent on how many GPs register appointments with the service. At the moment it’s unclear how much GP support the service will get.

 

DWP derides claimant complaints over digital rollout of Universal Credit

By Tony Collins

dwpLess than 24 hours after the Institute for Government criticised the DWP’s “tendency not to acknowledge bad news”, the department’s press office has poured scorn on complaints to an MP about problems with the rollout of Universal Credit’s “digital” system.

A spokesman for the Department for Work and Pensions has described as “anecdotal” complaints by the public about the “full” digital Universal Credit system in south London.

The DWP has declined to publish reports that would give a factual account of the performance of the Universal Credit digital system during rollout.  Its spokespeople can therefore describe claimant complaints as “anecdotal”.

Cheap

Ministers hope that the in-house and cheaply-developed “full”  digital system will ultimately replace a “live” service that has many workarounds, has cost hundreds of millions of pounds,  has been built by the DWP’s traditional IT suppliers, and deals with only limited groups of claimants.

But the agile-developed digital system has had its problems at a pilot site in Scotland – where the DWP described claimant complaints of being left penniless as “small-scale”.

Now similar problems with the digital system have emerged in south London.

Carshalton and Wallington Liberal Democrat MP Tom Brake told the Guardian yesterday that “on a weekly basis I see residents who don’t receive payments or are forced to use a clunky system which is unusable and unsuitable for people with disabilities.”

He added,

“Every day new problems arise as a result of poor staff training, IT failures and poor IT systems.”  He said problems with a local pilot scheme of the digital system is having a serious effect on many people’s lives.

Problems highlighted by Brake include:

  • Flaws in the online system that prevent people from uploading copies of bank statements and other documents needed to secure payments for childcare places.
  • Long administrative delays and mix-ups over payments to claimants, frequently resulting in their running up arrears or being forced to turn to food banks.
  • Failure to pay, or abruptly ceasing without warning to pay, housing costs on behalf of vulnerable claimants, leaving them at risk of eviction.

A DWP spokesman told the Guardian, “It’s misleading to draw wider conclusions from the anecdotal evidence of a small number of people.

“The reality is people claiming universal credit are moving into work faster and staying in work longer than under the previous system. We are rolling out the UC service to all types of benefit claimants in a safe and controlled way so we can ensure it is working effectively for everyone.”

universal creditNot accepting bad news

Yesterday the Institute for Government published two reports on Universal Credit, focusing on the political, managerial and IT aspects. One of the reports “Learning Lessons from Universal Credit” by Emma Norris and Jill Rutter referred to the DWP’s need to combat its ‘no bad news’ culture.

It said the DWP had a “tendency to not acknowledge bad news, or to acknowledge it insufficiently”. It said “good news culture that prevailed within the DWP, with a reluctance to tell ministers of emerging problems, was a real barrier to identifying and addressing them”. 

Two Parliamentary committees, the Public Accounts Committee and the Work and Pensions have criticised the DWP’s inability to face up to bad news, and its selective approach to the dissemination of information.

“Burst into tears”

The other Institute for Government report published yesterday on Universal Credit – Universal Credit, from disaster to recovery? –  quoted an insider as saying that some of those in the  DWP’s IT team at Warrington burst into tears, so relieved were they to discover that they could tell someone the truth about problems with Universal Credit’s digital system.

In a DWP paper that an FOI tribunal judge has ruled can be disclosed, the DWP conceded that officials lacked “candour and honesty throughout the [Universal Credit IT] Programme and publicly”.

Comment

Problems with the digital system are to be expected.

What’s not acceptable is the DWP’s patronising or scoffing attitude towards claimants who’ve experienced problems with the systems.

In describing the complaints to MP Tom Brake as “anecdotal” the DWP’s hierarchy is aware that it is keeping secret reports that give the facts on the performance of the digital system at pilot sites.

Indeed the DWP is habitually refusing FOI requests to publish reports on the performance of its IT systems. Which enables it to describe all clamant complaints as “anecdotal”.

Test and see

The DWP is taking a “test and see” approach to the roll-out of Universal Credit’s digital system. This means in essence it is using the public as test guinea pigs.

Harsh though this will sound, the DWP’s testing philosophy is understandable. Trying out the digital system on claimants may be the only practical way to bring to the surface all the possible problems. There may be too many complexities in individual circumstances to conduct realistic tests offline.

But why can’t the DWP be open about its digital test strategy? Are its officials – including press officers – locked forever into the culture of “no bad news”?

This denial culture, if it’s maintained, will require the DWP to mislead Parliamentary committees, MPs in general, the public and even stakeholders such as local authorities.

Two select committee reports have criticised the DWP’s prevarications and obfuscations. A chairwoman of the Work and Pensions Committee Dame Anne Begg referred to the DWP’s  tendency to “sweep things under the carpet”.

The Institute for Government referred to even ministers being kept away from bad news.

Other evidence emerged in July 2016 of the DWP’s deep antipathy to external scrutiny and criticism.

It seems that the DWP, with its culture of denial and accepting good news only, would be more at home operating in the government administrations of China, North Korea or Russia.

Isn’t it time the DWP started acknowledging complaints about Universal Credit systems, apologising and explaining what it was doing about resolving problems?

That’s something the governments of China, North Korea and Russia are unlikely to do when something goes wrong.

For decades the DWP has been defensive, introspective and dismissive of all external criticism. It has misled MPs.

And it has done so with an almost eager, cheerful willingness.

But it’s never too late to change.

Digital Universal Credit system is plagued with errors, says MP

Excellent reports on lessons from Universal Credit IT are published today – but who’s listening?

Analysis of Universal Credit IT document the DWP didn’t want published

 

Excellent reports on lessons from Universal Credit IT project published today – but who’s listening?

By Tony Collins

“People burst into tears, so relieved were they that they could tell someone what was happening.”

The Institute for Government has today published one of the most incisive – and revelatory – reports ever produced on a big government IT project.

It concludes that the Universal Credit IT programme may now be in recovery after a disastrous start, but recovery does not mean recovered. Much could yet floor the programme, which is due to be complete in 2022.

The Institute’s main report is written by Nick Timmins, a former Financial Times journalist, who has written many articles on failed publicly-funded IT-based projects.

His invaluable report, “Universal Credit – from disaster to recovery?” – includes interviews with David Pitchford, a key figure in the Universal Credit programme, and Howard Shiplee who led the Universal Credit project.

Timmins also spoke to insiders, including DWP directors, who are not named, and the former secretary of state at the Department for Work and Pensions Iain Duncan Smith and the DWP’s welfare reform minster Lord Freud.

Separately the Institute has published a shorter report “Learning the lessons from Universal Credit which picks out from Timmins’ findings five “critical” lessons for future government projects. This report, too, is clear and jargon-free.

Much of the information on the Universal Credit IT programme in the Timmins report is new. It gives insights, for instance, into the positions of Universal Credit’s major suppliers HP, IBM, Accenture.

It also unearths what can be seen, in retrospect, to be a series of self-destructive decisions and manoeuvres by the Department for Work and Pensions.

But the main lessons in the report – such as an institutional and political inability to face up to or hear bad news – are not new, which raises the question of whether any of the lessons will be heeded by future government leaders – ministers and civil servants – given that Whitehall departments have been making the same mistakes, or similar ones, for decades?

DWP culture of suppressing any bad news continues

Indeed, even as the reports lament a lack of honesty over discussing or even mentioning problems – a “culture of denial” – Lord Freud, the minister in charge of welfare reform, is endorsing FOI refusals to publish the latest risk registers, project assessment reviews and other Universal Credit reports kept by the Department for Work and Pensions.

More than once Timmins expresses his surprise at the lack of information about the programme that is in the public domain. In the “acknowledgements” section at the back of his report Timmins says,

“Drafts of this study were read at various stages by many of the interviewees, and there remained disputes not just about interpretation but also, from some of them, about facts.

“Some of that might be resolvable by access to the huge welter of documents around Universal Credit that are not in the public domain. But that, by definition, is not possible at this stage.”

Churn of project leaders continues

Timmins and the Institute warn about the “churn” of project leaders, and the need for stable top jobs.

But even as the Institute’s reports were being finalised HMRC was losing its much respected chief digital officer Mark Dearnley, who has been in charge of what is arguably the department’s riskiest-ever IT-related programme, to transfer of legacy systems to multiple suppliers as part of the dismantling of the £8bn “Aspire” outourcing venture with Capgemini.

Single biggest cause of Universal Credit’s bad start?

Insiders told Timmins that the fraught start of Universal Credit might have been avoided if Terry Moran had been left as a “star” senior responsible owner of the programme. But Moran was given two jobs and ended up having a breakdown.

In January 2011, as the design and build on Universal Credit started, Terry Moran was given the job of senior responsible owner of the project but a few months later the DWP’s permanent secretary Robert Devereux took the “odd” decision to make Moran chief operating officer for the entire department as well. One director within the DWP told Timmins:

“Terry was a star. A real ‘can do’ civil servant. But he couldn’t say no to the twin posts. And the job was overwhelming.”

The director claimed that Iain Duncan Smith told Moran – a point denied by IDS – that if Universal Credit were to fail that would be a personal humiliation and one he was not prepared to contemplate. “That was very different from the usual ministerial joke that ‘failure is not an option’. The underlying message was that ‘I don’t want bad news’, almost in words of one syllable. And this was in a department whose default mode is not to bring bad news to the top. ‘We will handle ministers’ is the way the department operates…”

According to an insider, “Terry Moran being given the two jobs was against Iain’s instructions. Iain repeatedly asked Robert [Devereux] not to do this and Robert repeatedly gave him assurances that this would be okay” – an account IDS confirms. In September 2012, Moran was to have a breakdown that led to early retirement in March 2013. He recorded later for the mental health charity Time to Talk that “eventually, I took on more and more until the weight of my responsibilities and my ability to discharge them just grew too much for me”.

Timmins was told, “You cannot have someone running the biggest operational part of government [paying out £160bn of benefits a year] and devising Universal Credit. That was simply unsustainable,”

Timmins says in his report, “There remains a view among some former and current DWP civil servants that had that not happened (Moran being given two jobs), the programme would not have hit the trouble it did. ‘Had he been left solely with responsibility for UC [Universal Credit], I and others believe he could have delivered it, notwithstanding the huge challenges of the task,’ one says.”

Reviews of Universal IT “failed”

Timmins makes the point that reviews of Universal Credit by the Major Projects Authority failed to convey in clear enough language that the Universal Credit programme was in deep trouble.

“The [Major Projects Authority] report highlighted a lack of sufficient substantive action on the points raised in the March study. It raised ‘high’ levels of concern about much of the programme – ‘high’ being a lower level of concern than ‘critical’. But according to those who have seen the report, it did not yet say in words of one syllable that the programme was in deep trouble.”

Iain Duncan Smith told Timmins that the the Major Projects review process “failed me” by not warning early enough of fundamental problems. It was the ‘red team’ report that did that, he says, and its contents made grim reading when it landed at the end of July in 2012.

Train crash on the way

The MPA [Cabinet Office’s Major Projects Authority] reviewed the programme in March 2011. “MPA reports are not in the public domain. But it is clear that the first of these flagged up a string of issues that needed to be tackled …

” In June a member of the team developing the new government’s pan-government website – gov.uk – was invited up to Warrington [base for the Universal Credit IT team] to give a presentation on how it was using an agile approach to do that.

“At the end of the presentation, according to one insider, a small number from the audience stayed behind, eyeing each other warily, but all wanting to talk. Most of them were freelancers working for the suppliers. ‘Their message,’ the insider says, ‘was that this was a train crash on the way’ – a message that was duly reported back to the Cabinet Office, but not, apparently, to the DWP and IDS.”

Scared to tell the truth

On another occasion when the Major Projects Authority visited the IT team at Warrington for the purposes of its review, the review team members decided that “to get to the truth they had to make people not scared to tell the truth”. So the MPA “did a lot of one-on-one interviews, assuring people that what they said would not be attributable. And under nearly every stone was chaos.

“People burst into tears, so relieved were they that they could tell someone what was happening.

” There was one young lad from one of the suppliers who said: ‘Just don’t put this thing [Universal Credit] online. I am a public servant at heart. It is a complete security disaster.’

IBM, Accenture and HP

“Among those starting to be worried were the major suppliers – Accenture, HP and IBM. They started writing formal letters to the department.

‘Our message,’ according to one supplier, ‘was: ‘Look, this isn’t working. We’ll go on taking your money. But it isn’t going to work’.’ Stephen Brien [then expert adviser to IDS] says of those letters: ‘I don’t think Iain saw them at that time, and I certainly didn’t see them at the time.”

At one point “serious consideration was given to suing the suppliers but they had written their warning letters and it rapidly became clear that that was not an option”.

Howard Shiplee, former head of the project, told Timmins that he had asked himself ‘how it could be that a very large group of clever people drawn from the DWP IT department with deep experience of the development and operation of their own massive IT systems and leading industry IT suppliers had combined to get the entire process so very wrong? Equally, ‘how could another group of clever people [the GDS team] pass such damning judgement on this earlier work and at the stroke of a pen seek to write off millions of pounds of taxpayers’ money?’

Shiplee commissioned a review from PwC on the work carried out to date and discovered that the major suppliers “were genuinely concerned to have their work done properly, support DWP and recover their reputations”.

In addition, when funding had been blocked at the end of 2012, the suppliers “had not simply downed tools but had carried on development work for almost three months” as they ran down the large teams that had been working on it.

“As a result, they had completed the development for single claimants that was being used in the pathfinder and made considerable progress on claims for couples and families. And their work, the PwC evaluation said, was of good quality.”

On time?

When alarm bells finally started ringing around Whitehall that Universal Credit was in trouble,  IDS found himself under siege. Stephen Brien says IDS was having to battle with the Treasury to keep the funding going for the project. He had to demonstrate that the programme was on time and on budget.

‘The department wanted to support him in that, and didn’t tell him all the things that were going wrong. I found out about some of them, but I didn’t push as hard as I should have. And looking back, the MPA [Major Projects Authority] meetings and the MPA reports were all handled with a siege mentality. We all felt we had to stand shoulder to shoulder defending where we were and not really using them to ask: ‘Are we where we should be?’

‘As a result we were not helping ourselves, and we certainly were not helping others, including the MPA. But we did get to the stage between the end of 2011 and the spring of 2012 where we said: ‘Okay, let’s get a red team in with the time and space to do our own challenge.’”

The DWP’s “caste” system

A new IT team was created in Victoria Street, London – away from Warrington but outside the DWP’s Caxton Street headquarters. It started to take a genuinely agile approach to the new system. One of those involved told Timmins:

“It had all been hampered by this caste system in the department where there is a policy elite, then the operational people, and then the technical people below that.

“And you would say to the operational people: ‘Why have you not been screaming that this will never work?’ And they’d say: ‘Well, we’re being handed this piece of sh** and we are just going to have to make it work with workarounds, to deal with the fact that we don’t want people to starve. So we will have to work out our own processes, which the policy people will never see, and we will find a way to make it work.’

Twin-track approach

IBM, HP and Accenture built what’s now known as the “live” system which enabled Universal Credit to get underway, and claims to be made in jobcentres.

It uses, in part, the traditional “waterfall” approach and has cost hundreds of millions of pounds. In contrast there’s a separate in-house “digital” system that has cost less than £10m and is an “agile” project.

A key issue, Shiplee told Timmins, was that the new digital team “would not even discuss the preceding work done by the DWP and its IT suppliers”. The digital team had, he says, “a messiah-like approach that they were going to rebuild everything from scratch”.

Rather than write everything off, Shiplee wanted ideally to marry the “front-end” apps that the GDS/DWP team in Victoria Street was developing with the work already done. But “entrenched attitudes” made that impossible. The only sensible solution, he decided, was a “twin-track” approach.

“The Cabinet Office remained adamant that the DWP should simply switch to the new digital version – which it had now become clear, by late summer, would take far longer to build than they anticipated – telling the DWP that the problem was that using the original software would mean ‘creating a temporary service, and temporary will become permanent’.

“All of which led to the next big decision, which, to date, has been one of the defining ones. In November 2013, a mighty and fraught meeting of ministers and officials was convened. Pretty much everyone was there. The DWP ministers, Francis Maude (Cabinet Office minister), Oliver Letwin who was Cameron’s policy overlord, Sir Jeremy Heywood, the Cabinet Secretary, Sir Bob Kerslake, the head of the home civil service, plus a clutch of DWP officials including Robert Devereux and Howard Shiplee as the senior responsible owner along with Danny Alexander and Treasury representatives.

“The decision was whether to give up on the original build, or run a twin-track approach: in other words, to extend the use of the original build that was by now being used in just over a dozen offices – what became dubbed the ‘live’ service – before the new, and hopefully much more effective, digital approach was finished and on stream.

“It was a tough and far from pleasant meeting that is etched in the memories of those who were there…

“One of those present who favoured the twin-track approach says: There were voices for writing the whole of the original off. But that would have been too much for Robert Devereux [the DWP’s Permanent Secretary] and IDS.

” So the twin-track approach was settled on – writing a lot of the original IT down rather than simply writing it off. That, in fact, has had some advantages even if technically it was probably the wrong decision…

“It has, however, seen parts of the culture change that Universal Credit involves being rolled out into DWP offices as more have adopted Universal Credit, even if the IT still requires big workarounds.

“More and more offices, for example, have been using the new claimant commitment, which is itself an important part of Universal Credit. So it has been possible to train thousands of staff in that, and get more and more claimants used to it, while also providing feedback for the new build.”

Francis Maude was among those who objected to the twin-track approach, according to leaked minutes of the project oversight board at around this time.

Lord Freud told Timmins,

‘Francis was adamant that we should not go with the live system [that is, the original build]. He wanted to kill it. But we, the DWP, did not believe that the digital system would be ready on anything like the timescales they were talking about then …But I knew that if you killed the live system, you killed Universal Credit…”

In the end the twin-track approach was agreed by a majority. But the development of the ‘agile’ digital service was immediately hampered by a spat over how quickly staff from the GDS were to be withdrawn from the project.

Fury over National Audit Office report

In 2013 the National Audit Office published a report Universal Credit – early progress –  that, for the first time, brought details of the problems on the Universal Credit programme into the public domain. Timmins’ report says that IDS and Lord Freud were furious.

“IDS and, to an only slightly lesser extent, Lord Freud were furious about the NAO report; and thus highly defensive.”

IDS tried to present the findings of the National Audit Office as purely historical.

In November 2014, the NAO reported again on Universal Credit. It once more disclosed something that ministers had not announced – that the timetable had again been put back two years (which raises further questions about why Lord Freud continues to refuse FOI requests that would put into the public domain – and inform MPs – about project problems, risks and delays without waiting for an NAO report to be published)..

Danny Alexander “cut through” bureaucracy

During one period, the Treasury approval of cash became particularly acute. Lord Freud told Timmins:

“We faced double approvals. We had approval about any contract variation from the Cabinet Office and then approvals for the money separately from the Treasury.

“The Government Digital Service got impatient because they wanted to make sure that the department had the ability to build internally rather than going out to Accenture and IBM, who (sic) they hate.

“The approvals were ricocheting between the Cabinet Office and the Treasury and when we were trying to do rapid iteration. That was producing huge delays, which were undermining everything. So in the end Danny Alexander [Lib-dem MP who was chief secretary to the Treasury] said: ‘I will clear this on my own authority.’ And that was crucial. Danny cut through all of that.”

Optimism bias

So-called optimism bias – over-optimism – is “such a common cause of failure in both public and private projects that it seems quite remarkable that it needs restating. But it does – endlessly”.

Timmins says the original Universal Credit white paper – written long before the start of the programme – stated that it would involve “an IT development of moderate scale, which the Department for Work and Pensions and its suppliers are confident of handling within budget and timescale”.

David Pitchford told Timmins,

“One of the greatest adages I have been taught and have learnt over the years in terms of major projects is that hope is not a management tool. Hoping it is all going to come out all right doesn’t cut it with something of this magnitude.

“The importance of having a genuine diagnostic machine that creates recommendations that are mandatory just can’t be overstated. It just changes the whole outcome completely. As opposed to obfuscation and optimism bias being the basis of the reporting framework. It goes to a genuine understanding and knowledge of what is going on and what is going wrong.”

Sir Bob Kerslake, who also identified the ‘good news culture’ of the DWP as being a problem, told Timmins,

“All organisations should have that ability to be very tough about what is and isn’t working. The people at the top have rose-tinted specs. They always do. It goes with the territory.

And unless you are prepared to embrace people saying that ‘really, this is in a bad place’… I can think of points where I have done big projects where it was incredibly important that we delivered the unwelcome news of where we were on that project. But it saved me, and saved my career.”

Recovery?

Timmins makes good arguments for his claim that the Universal Credit programme may be in recovery – but not recovered – and that improvements have been made in governance to allow for decisions to be properly questioned.

But there is no evidence the DWP’s “good news” culture has changed. For instance the DWP says that more than 300,000 people are claiming Universal Credit but the figure has not been audited and it’s unclear whether claimants who have come off the benefit and returned to it – perhaps several times – are being double counted.

Timmins points out the many uncertainties that cloud the future of the Universal Credit programme  – how well the IT will work, whether policy changes will hit the programme, whether enough staff will remain in jobcentres, and whether the DWP will have good relations with local authorities that are key to the delivery of Universal Credit but are under their own stresses and strains with resourcing.

There are also concerns about what changes the Scots and Northern Irish may want under their devolved powers, and the risk that any ‘economic shock’ post the referendum pushes up the volume of claimants with which the DWP has to deal.

 Could Universal Credit fail for non-IT reasons?

Timmins says,

“In seeking to drive people to higher earnings and more independence from the benefits system, there will be more intrusion into and control over the lives of people who are in work than under the current benefits system. And there are those who believe that such an approach – sanctioning people who are already working – will prove to be political dynamite.”

The dire consequences of IT-related failure

It is also worth noting that Universal Credit raises the stakes for the DWP in terms of its payment performance, says Timmins.

“If a tax credit or a Jobseeker’s Allowance payment or any of the others in the group of six go awry, claimants are rarely left penniless in the sense that other payments – for example, Housing Benefit in the case of Jobseeker’s Allowance or tax credits, – continue.

“If a Universal Credit payment fails, then all the support from the state, other than Child Benefit or disability benefits not included within Universal Credit, disappears.”

This happened recently in Scotland when an IT failure left hundreds of families penniless. The DWP’s public response was to describe the failure in Scotland as “small-scale”.

Comment

What a report.

It is easy to see how much work has gone into it. Timmins has coupled his own knowledge of IT-related failure with a thorough investigation into what has gone wrong and what lessons can be learned.

That said it may make no difference. The Institute in its “lessons” report uses phrases such as “government needs to make sure…”. But governments change and new administrations have an abundance – usually a superfluity – of confidence and ambition. They regard learning lessons from the past as putting on brakes or “nay saying”. You have to get with the programme, or quit.

Lessons are always the same

There will always be top-level changes within the DWP. Austerity will always be a factor.  The culture of denial of bad news, over-optimism about what can be achieved by when and how easily it can be achieved, over-expectations of internal capability, over-expectation of what suppliers can deliver, embarking on a huge project without clearly or fully understanding what it will involve, not listening diligently to potential users and ridiculously short timescales are all well-known lessons.

So why do new governments keep repeating them?

When Universal Credit’s successor is started in say 2032, the same mistakes will probably be repeated and the Institute for Government, or its successor, will write another similar report on the lessons to be learned.

When Campaign4Change commented in 2013 that Universal Credit would probably not be delivered before 2020 at the earliest, it was an isolated voice. At the time, the DWP press office – and its ministers – were saying the project was on budget and “on time”.

NPfIT

The National Audit Office has highlighted similar lessons to those in the Timmins report, for example in NAO reports on the NPfIT – the NHS IT programme that was the world’s largest non-military IT scheme until it was dismantled in 2011. It was one of the world’s biggest IT disasters – and none of its lessons was learned on the Universal Credit programme.

The NPfIT had an anti-bad news culture. It did not talk enough to end users. It had ludicrous deadlines and ambitions. The politicians in charge kept changing, as did some of programme leaders. There was little if any effective internal or external challenge. By the time it was dismantled the NPfIT had lost billions.

What the Institute for Government could ask now is, with the emasculation of the Government Digital Service and the absence of a powerful Francis Maude figure, what will stop government departments including the DWP making exactly the mistakes the IfG identifies on big future IT-enabled programmes?

In future somebody needs the power to say that unless there is adequate internal and external challenge this programme must STOP – even if this means contradicting a secretary of state or a permanent secretary who have too much personal and emotional equity in the project to allow it to stop. That “somebody” used to be Francis Maude. Now he has no effective replacement.

Victims

It’s also worth noting in the Timmins report that everyone seems to be a victim, including the ministers. But who are perpetrators? Timmins tries to identify them. IDS does not come out the report smelling of roses. His passion for success proved a good and bad thing.

Whether the direction was forwards or backwards IDS  was the fuel that kept Universal Credit going.  On the other hand his passion made it impossible for civil servants to give him bad news – though Timmins raises questions about whether officials would have imparted bad news to any secretary of state, given the DWP’s culture.

Neither does the DWP’s permanent secretary Robert Devereux emerge particularly well from the report.

How it is possible for things to go so badly wrong with there being nobody to blame? The irony is that the only people to have suffered are the genuine innocents – the middle and senior managers who have most contributed to Universal Credit apparent recovery – people like Terry Moran.

Perhaps the Timmins report should be required reading among all involved in future major projects. Competence cannot be made mandatory. An understanding of the common mistakes can.

Thank you to FOI campaigner Dave Orr for alerting me to the Institute’s Universal Credit reports.

Thanks also to IT projects professional John Slater – @AmateurFOI – who has kept me informed of his FOI requests for Universal Credit IT reports that the DWP habitually refuse. 

Update 18.00 6 September 2016

In a tweet today John Slater ( @AmateurFOI ) makes the important point that he asked the DWP and MPA whether either had held a “lessons learned” exercise in the light of the “reset” of the Universal Credit IT programme. The answer was no.

This perhaps reinforces the impression that the DWP is irredeemably complacent, which is not a good position from which to lead major IT projects in future.

Universal Credit – from disaster to recovery?

Learning the lessons from Universal Credit

 

Is Sir Humphrey trying to kill off GDS and the innovations it stands for?

Tony Collins

After much progress in recent years, Government IT is at risk of going into reverse. But a return to ways of the past, and routine costly failures of big technology projects, is not inevitable.

You don’t have to be a conspiracy theorist to see what has been happening at, and to, the Government Digital Service.

Much has been achieved by GDS. Some of its best work has been to encourage thousands of civil servants across government – mainly aged under 40 – to believe it’s possible to simplify their work, and do it better and more cheaply.

GDS is far from perfect but its philosophy when it makes mistakes is to fail cheaply. Its culture of always questioning, always challenging runs counter to Whitehall’s hierarchical traditions.

Since the creation of GDS it has become possible for the citizen to interact with government in ways that were not possible before. For example it’s possible to replace an old paper driving licence and update your address entirely online, once your photo has been digitised as part of, say, a (largely online) passport renewal.

trust-picIndeed the influence of GDS has been a breeze of fresh air blowing through fusty Whitehall corridors. A GDS rule is to put the interests of citizens, rather than the interests of departments and agencies, at the centre of its activities.

Weird hippies

But it is becoming clear that the old guard in Whitehall still see GDS people as “weird hippies”. That’s how some in government have regarded GDS people, according to former Cabinet Office minister Francis Maude.

Something similar was said by Mike Bracken, former executive director of GDS. In a conversation last month with the Centre for Public Impact, Bracken said the civil service old guard saw GDS people as “insurgent, incoming rule-breakers”.

Maude and Bracken’s recent comments suggest that Sir Humphrey has an unshakeable belief that government administration is a smooth-running machine that needs the occasional service but no major repairs. GDS favours pervasive reform.

Sabotage

Maude created GDS in 2011. He was an ardent reformer of Government IT and the civil service. But since he left last year Sir Humphrey appears to be regaining the control that he ceded temporarily to Maude and GDS’s innovators. This is some of what has happened since Maude’s departure:

  • GDS has lost Mike Bracken its highly-regarded executive director. He has gone to the Co-op as CIO.
  • GDS has just lost Bracken’s successor Stephen Foreshew-Cain who has fanned the breeze of fresh air referred to above. Foreshew-Cain said in his blog in June 2016 that cultures and behaviours in central government are “years behind the rest of the world”. He said, “At GDS, we’re fortunate because we’re a relatively new organisation. We were able to build our own culture from scratch.”
  • Mark DearnleyHMRC is to lose its plain-speaking reformer Mark Dearnley. His continued role in replacing the department’s “Aspire” contract was seen by public accounts MPs as vitally important. Attempts to renew his three-year CIO contract when it expires in September 2016 appear to have failed, or perhaps have not been earnest enough.
  • The department whose introspective, defensive and secretive culture has remained largely intact since the days when it was called the Department for Social Security – and whose main systems have been run by the same big IT suppliers for decades – is gaining influence in the Government IT field in the post-Maude era.
  • Maude said in his Centre for Public Impact interview that some senior bureaucrats were capable of “sabotage” if they disapproved strongly of an externally-imposed development in their department – such as a Cabinet Office “shared service” initiative. Maude said.

“Things like shared services – we struggled getting departments to give up their shared services, even when there had been a collective policy agreement that it should happen. What you then get is sniping. You get the different bits of government who want it to fail, who will sometimes, actually sabotage things, which is pretty disgraceful. That’s pretty outrageous, but it did happen; and it does happen; and that won’t be over yet.”

  • GDS lost Tom Loosemore, its deputy director, who initially led      the development of the gov.uk website and tweeted on 1 August 2016 – the date of Fanshew-Cain’s announced departure – about “a day of the long digital knives”.

tom loosemore tweets

 

Digital chiefs evicted?

Derek Du Preez at Diginomica suggests that, according to his sources, “digital chiefs at the Home Office, DWP and HMRC have either been evicted by their permanent secretaries or are leaving their posts”.

UKAuthority reports rumours of “sustained resistance to the work of GDS in some Whitehall departments. Several departments were resisting GDS’s Government as a Platform programme in favour of working on their own digital solutions.

The article said that John Manzoni, as head of the civil service, “has not been in favour of it [GDS] setting a strong lead for other parts of Whitehall”.

Andrew Greenway, formerly of GDS, says the loss of two GDS leaders in less than a year “feels like a victory for those who believe a government organised along Victorian lines is fit for fixing today’s problems”.

Greenway writes:

“What’s playing out in the shadows of this strange summer is a timeless Whitehall battle. On one side those who seek to direct from the centre; on the other big departments who prefer to be left to their own devices. It’s a battle that goes back 150 years. The centre is not holding.

“That’s OK if everyone is on the path towards improvement. Whitehall’s watchers are not saying this.

“Meanwhile, GDS is following the course charted by other successful centralised reformers in government. Icarus-like soaring for a few years. The occasional flutter of feathers. Then a headlong dive into the timeless, inky depths of the bureaucratic abyss. The sun always rises, Whitehall always wins.

“The defenestration of GDS has accelerated under the reign of John Manzoni. This is perplexing.

“The Civil Service’s CEO is there to drive big institutional priorities past departmental parochialism. Digital is one of these, giving it a seat at the top table. Yet as GDS’ influence has degraded. Chief Digital Officer roles in departments are also disappearing. Kevin’s departure comes hard on the heels of the Home Office scrapping their own CDO role.

“Manzoni came in to manage relations between the centre and the departments from a position of strength. From the outside, it now looks like he is being toyed with by the Civil Service’s most experienced turf warriors in HMRC and DWP.

“Permanent secretaries are gleefully reclaiming their territory…”

Fizzle out?

Does all this mean that Maude’s reforms of Government IT will soon fizzle out, heralding the return of the “powerful oligopolies” that Maude referred to when speaking of IT suppliers that presided over large costly IT project failures?

Comment

Leading bureaucrats approve of changes when it means more money is spent on policy implementation that brings with it a commensurate increase in power and influence of their department.

What some leading officials deeply resent is change that diminishes the power and influence of the department, especially if the change is instigated by people outside the department. It’s understandable, therefore, that some but not all permanent secretaries and their senior officials will resent any interference in their IT affairs by the Cabinet Office and GDS.

But interference there has to be. Chris Chant, former CIO at DEFRA, said in 2011 that the vast majority of Government IT was “outrageously expensive”. He said, “Things have changed and we haven’t.”

Under Maude, Bracken and GDS’s influence, things have gradually changed for the better.

But if Sir Humphrey now succeeds to getting GDS broken up it will show that, when it comes to the administration of central government, it is the leading civil servants who are in charge, not short-term ministers. Bracken says that if departmental and agency bureaucrats strongly disapprove of a centrally-agreed initiative they should debate it or leave.

Says Bracken,

“When you have a chief executive who says: ‘I don’t accept the rule of the government of the day and I am just not accepting it’, then you can’t tolerate that. You can have a debate around it but to just [drop] anchor and go ‘I am not moving’ is just not on. If you feel that strongly you should leave in my opinion. You should say, ‘I can’t tolerate this so I’ll do something else’.”

But who is going to persuade Sir Humphrey to leave or take early retirement?

When, as prime minister,  David Cameron said,

“I believe the creation of the Government Digital Service is one of the great unsung triumphs of the last Parliament.”

he was speaking as a politician who has a temporary job. On the other hand, bureaucratic resistance to change – the Whitehall culture – will last forever unless intervention is deep, effective and continual. That type of intervention cannot be expected of any short-term minister, not even a prime minister.

The hope now is that GDS’s influence within departments  and agencies has been far-reaching enough to encourage thousands of younger civil servants to try and effect change themselves – make the running of government simpler and much cheaper – at least for the sake of taxpayers.

As Maude says,

“You need people who are passionate about it (genuine transformation); and who don’t mind pissing people off frankly – don’t mind annoying people and upsetting the system.”

Sir Humphrey will oppose any change that diminishes his power base – but could his innate defence of old traditions be drowned out by an overwhelming chorus of reasoned sensibleness from thousands of GDS advocates?

Even when Sir Humphrey eventually retires and is replaced by another old crock (an arch defender of the status quo), some of GDS’s work will endure.  Bracken said in his Centre for Public Impact interview last month,

“Where I am hugely optimistic is that we left a way of working that will not revert. When we got there [GDS], there were pockets of people all over government who would struggle for years to do good digital stuff… they would be blocked at every turn and were absolutely fed up.

“What we did was give them validity; you can do it this way. Now there is a manual. There are guides; there are networks; there are communities. Treasury’s rules are published rules on how you do technology services and we wrote them.

“People saw us as insurgent, incoming rule-breakers. That’s how the old guard of the civil service would present itself. It’s hugely disrespectful because we put a great degree of intellectual thought into writing the new rules… Those Treasury rules on how you fund and build an agile technology service is the new norm.

“That’s not going to get changed anytime soon. In that system now there are, I suspect, 10,000 to 15,000 people probably under 40 who are all committed to working in an agile, open way.

“The point about working that way is you can’t go back. [If someone suggests] spending a year writing some requirements down and then outsourcing that to a third party, they are never going to do that. And they are the leaders of the future.

” I am not quite sure of the bumps along the road, the trajectories. It may wax and wane for a bit, but committed public servants will be working this way for the rest of their career. That will be our legacy.”

 Thank you to Derek Du Preez whose Diginomica article prompted this post.

Inside Universal Credit IT – analysis of document the DWP didn’t want published

dwpBy Tony Collins

Written evidence the Department for Work and Pensions submitted to an FOI tribunal – but did not want published (ever) – reveals that there was an internal “lack of candour and honesty throughout the [Universal Credit IT] Programme and publicly”.

It’s the first authoritative confirmation by the DWP that it has not always been open and honest when dealing with the media on the state of the Universal Credit IT programme.

FOI tribunal grants request to publish DWP's written submission

FOI tribunal grants request to publish DWP’s written submission

According to the DWP submission, senior officials on the Programme became so concerned about leaks that a former member of the security services was brought in to lead an investigation. DWP staff and managers were the subjects of “detailed interviews”. Employee emails were “reviewed”, as were employee access rights to shared electronic areas.

Staff became “paranoid” about accidentally leaving information on a printer. Some of the high-security measures appear still to be in place.

Unpublished until now, the DWP’s written legal submission referred, in part, to the effects on employees of leak investigations.

The submission was among the DWP’s written evidence to an FOI Tribunal in February 2016.

The Government Legal Service argued that the DWP’s written evidence was for the purposes of the tribunal only. It should not be published or passed to an MP.

The Legal Service went further: it questioned the right of an FOI Tribunal to decide on whether the submission could be published. Even so a judge has ruled that the DWP’s written evidence to the tribunal can be published.

Excerpts from the submission are here.

Analysis and Comment

The DWP’s submission gives a unique glimpse into day-to-day life and corporate sensitivities at or near the top of the Universal credit IT programme.

It reveals the lengths to which senior officials were willing to go to stop any authoritative “bad news” on the Universal Credit IT programme leaking out. Media speculation DWP’s senior officials do not seem to mind. What appears to concern them is the disclosure of any credible internal information on how things are progressing on Universal Credit IT.

Confidential

Despite multiple requests from IT suppliers, former government CIOs and MPs, for Whitehall to publish its progress reports on big IT-based change programmes (some examples below), all central departments keep them confidential.

That sensitivity has little to do with protecting personal data.

It’s likely that reviews of projects are kept confidential largely because they could otherwise expose incompetence, mistakes, poor decisions, risks that are likely to materialise, large sums that have been wasted or, worst of all, a project that should have been cancelled long ago and possibly re-started, but which has been kept going in its original form because nobody wanted to own up to failure.

Ian watmore front cover How to fix government IROn this last point, former government CIO and permanent secretary Ian Watmore spoke to MPs in 2009 about how to fix government IT. He said,

“An innovative organisation tries a lot of things and sometimes things do not work. I think one of the valid criticisms in the past has been when things have not worked, government has carried on trying to make them work well beyond the point at which they should have been stopped.”

Individual accountability for failure?

Oblivious to MPs’ requests to publish IT progress reports, the DWP routinely refuses FOI requests to publish IT progress reports, even when they are several years old, even though by then officials and ministers involved will probably have moved on. Individual accountability for failure therefore continues to be non-existent.

Knowing this, MPs on two House of Commons select committees, Public Accounts and Work and Pensions, have called for the publication of reports such as “Gateway” reviews.

This campaign for more openness on government IT projects has lasted nearly three decades. And still Whitehall never publishes any contemporaneous progress reports on big IT programmes.

It took an FOI campaigner and IT projects professional John Slater [@AmateurFOI] three years of legal proceedings to persuade the DWP to release some old reports on the Universal Credit IT programme (a risk register, milestone schedule and issues log). And he had the support of the Information Commissioner’s legal team.

universal creditWhen the DWP reluctantly released the 2012 reports in 2016 – and only after an informal request by the then DWP secretary of state Stephen Crabb – pundits were surprised at how prosaic the documents were.

Yet we now know, thanks to the DWP’s submission, the lengths to which officials will go to stop such documents leaking out.

Understandable?

Some at the DWP are likely to see the submission as explaining some of understandable measures any government department would take to protect sensitive information on its largest project, Universal Credit. The DWP is the government largest department. It runs some of the world’s biggest IT systems. It possesses personal information on nearly everyone in Britain. It has to make the protection of its information a top priority.

Others will see the submission as proof that the DWP will do all it can to honour a decades-old Whitehall habit of keeping bad news to itself.

Need for openness

It’s generally accepted that success in running big IT-enabled change programmes requires openness – with staff and managers, and with external organisations and agencies.

IT-based change schemes are about solving problems. An introspective “good news only” culture may help to explain why the DWP has a poor record of managing big and successful IT-based projects and programmes. The last time officials attempted a major modernisation of benefit systems in the 1990s – called Operational Strategy – the costs rose from £713m to £2.6bn and the intended objective of joining up the IT as part of a “whole person” concept, did not happen.

Programme papers“watermarked”

The DWP’s power, mandate and funding come courtesy of the public. So do officials, in return, have the right to keep hidden mistakes and flawed IT strategies that may lead to a poor use – or wastage – of hundreds of millions of pounds, or billions?

The DWP’s submission reveals that recommendations from its assurance reports (low-level reports on the state of the IT programme including risks and problems) were not circulated and a register was kept of who had received them.

Concern over leaks

The submission said that surveys on staff morale ceased after concerns about leaks. IT programme papers were no longer sent electronically and were delivered by hand. Those that were sent were “double-enveloped” and any that needed to be retained were “signed back in”. For added security, Universal Credit programme papers were watermarked.

When a former member of the security services was brought in to conduct a leaks investigation, staff and mangers were invited by the DWP’s most senior civil servant to “speak to the independent investigator if they had any information”. This suggests that staff were expected to inform on any suspect colleagues.

People “stopped sharing comments which could be interpreted as criticism of the [Universal Credit IT] Programme,” said the submission. “People became suspicious of their colleagues – even those they worked closely with.

“There was a lack of trust and people were very careful about being honest with their colleagues…

“People felt they could no longer share things with colleagues that might have an honest assessment of difficulties or any negative criticism – many staff believed the official line was, ‘everything is fine’.

“People, even now, struggle to trust colleagues with sensitive information and are still fearful that anything that is sent out via email will be misused.

“For all governance meetings, all documents are sent out as password protected, with official security markings included, whether or not they contain sensitive information.”

“Defensive”

dwpLines to take with the media were added to a “Rolling Brief”, an internal update document, that was circulated to senior leaders of the Universal Credit IT programme, the DWP press office and special advisors.

These “lines to take” were a “defensive approach to media requests”. They emphasised the “positive in terms of progress with the Programme without acknowledging the issues identified in the leaked stories”.

This positive approach to briefing and media management “led to a lack of candour and honesty through the Programme and publically …”

How the DWP’s legal submission came about is explained in this separate post.

Were there leaks of particularly sensitive information?

It appears not. The so-called leaks revealed imperfections in the running of the Universal Credit programme; but there was no personal information involved. Officials were concerned about the perceived leak of a Starting Gate Review to the Telegraph (although the DWP had officially lodged the review with the House of Commons library).

The DWP also mentioned in its statement a leak to the Guardian of the results of an internal “Pulse” survey of staff morale – although it’s unclear why the survey wasn’t published officially given its apparent absence of sensitive commercial, personal, corporate or governmental information.

NPfIT

The greater the openness in external communications, the less likely a natural scepticism of new ways of working will manifest in a distrust of the IT programme as a whole.

The NHS’s National Programme for IT (NPfIT) – then the UK’s biggest IT programme costing about £10bn – was dismantled in 2011 after eight fraught years. One reason it was a disaster was the deep distrust of the NPfIT among clinicians, hospital technologists, IT managers, GPs and nurses. They had listened with growing scepticism to Whitehall’s oft-repeated “good news” announcements.

Ex-Government CIO wanted more openness on IT projects

When MPs have asked the DWP why it does not publish reports on the progress of IT-enabled projects, it has cited “commercial confidentiality”.

But in 2009, Ian Watmore (the former Government CIO) said in answer to a question by Public Account Committee MP Richard Bacon that he’d endorse the publication of Gateway reviews, which are independent assessments of the achievements, inadequacies, risks, progress and challenges on risky IT-based programmes.

“I am with you in that I would prefer Gateway reviews to be published because of the experience we had with capability reviews (published reports on a department’s performance). We had the same debate (as with Gateway reviews) and we published them. It caused furore for a few weeks but then it became a normal part of the furniture,” said Watmore.

Capability reviews are no longer published. The only “regular” reports of Whitehall progress with big IT programmes are the Infrastructure and Projects Authority’s annual reports. But these do not include Gateway reviews or other reports on IT projects and programmes. The DWP and other departments publish only their own interpretations of project reviews.

In the DWP’s latest published summary of progress on the Universal Credit IT programme, dated July 2016, the focus is on good news only.

But this creates a mystery. The Infrastructure and Projects Authority gave the Universal Credit programme an “amber” rating in its annual report which was published this month. But neither the DWP nor the Authority has explained why the programme wasn’t rated amber/green or green.

MPs and even IT suppliers want openness on IT projects

Work and Pensions Committee front coverIn 2004 HP, the DWP’s main IT supplier, told a Work and Pensions Committee inquiry entitled “Making IT work for DWP customers” in 2004 that “within sensible commercial parameters, transparency should be maintained to the greatest possible extent on highly complex programmes such as those undertaken by the DWP”.

The Work and Pensions Committee spent seven months investigating IT in the DWP and published a 240-page volume of oral and written in July 2004. On the matter of publishing “Gateway” reviews on the progress or otherwise of big IT projects, the Committee concluded,

“We found it refreshing that major IT suppliers should be content for the [Gateway] reviews to be published. We welcome this approach. It struck us as very odd that of all stakeholders, DWP should be the one which clings most enthusiastically to commercial confidentiality to justify non-disclosure of crucial information, even to Parliament.”

The Committee called for Gateway reviews to be published. That was 12 years ago – and it hasn’t happened.

Four years later the Committee found that the 19 most significant DWP IT projects were over-budget or late.

DWP headline late and over budget

In 2006 the National Audit Office reported on Whitehall’s general lack of openness in a report entitled “Delivering successful IT-enabled business change”.

The report said,

“The Public Accounts Committee has emphasised frequently the need for greater transparency and accountability in departments’ performance in managing their programmes and projects and, in particular, that the result of OGC Gateway Reviews should be published.”

But today, DWP officials seem as preoccupied as ever with concealing bad news on their big IT programmes including Universal Credit.

The costs of concealment

The DWP has had important DWP project successes, notably pension credits, which was listed by the National Audit Office as one of 24 positive case studies.

But the DWP has also wasted tens of millions of pounds on failed IT projects.

Projects with names such as “Camelot” [Computerisation and Mechanisation of Local Office Tasks] and Assist [Analytical Services Statistical Information System) were cancelled with losses of millions of pounds. More recently the DWP has run into problems on several big projects.

“Abysmal”

On 3 November 2014 the then chairman of the Public Accounts Committee Margaret Hodge spoke on Radio 4’s Analysis of the DWP’s ‘abysmal’ management of IT contracts.”

1984

As long ago as 1984, the House of Commons Public Accounts Committee called for the civil service to be more open about its progress on major computer projects.

Today there are questions about whether the Universal Credit IT will succeed. Hundreds of millions has already been spent. Yet, as mentioned earlier, current information on the progress of the DWP’s IT programmes remains a state secret.

It’s possible that progress on the Universal Credit IT programme has been boosted by the irregular (but thorough) scrutiny by the National Audit Office. That said, as soon as NAO reports on Universal Credit are published, ministers and senior officials who have seen copies in advance routinely dismiss any criticisms as retrospective and out-of-date.

Does it matter if the DWP is paranoid about leaks?

A paper published in 2009 looks at how damaging it can be for good government when bureaucracies lack internal challenge and seek to impose on officials a “good news” agenda, where criticism is effectively prohibited.

The paper quoted the then Soviet statesman Mikhail Gorbachev as saying, in a small meeting with leading Soviet intellectuals,

“The restructuring is progressing with great difficulty. We have no opposition party. How then can we control ourselves? Only through criticism and self-criticism. Most important: through glasnost.”

Non-democratic regimes fear a free flow of information because it could threaten political survival. In Russia there was consideration of partial media freedom to give incentives to bureaucrats who would otherwise have no challenge, and no reason to serve the state well, or avoid mistakes.

The Chernobyl nuclear disaster, which occurred on April 26, 1986, was not acknowledged by Soviet officials for two days, and only then after news had spread across the Western media.

The paper argued that a lack of criticism could keep a less democratic government in power. But it can lead to a complacency and incompetence in implementing policy that even a censored media cannot succeed in hiding.

As one observer noted after Chernobyl (Methvin in National Review, Dec. 4, 1987),

“There surely must be days—maybe the morning after Chernobyl—when Gorbachev wishes he could buy a Kremlin equivalent of the Washington Post and find out what is going on in his socialist wonderland.”

Red team

Iain DuncanSmithA lack of reliable information on the state of the Universal Credit IT programme prompted the then secretary of state Iain Duncan Smith to set up his own “red team” review.

That move was not known about at the time. Indeed in December 2012 – at a point when the DWP was issuing public statements on the success of the Universal Credit Programme – the scheme was actually in trouble. The DWP’s legal submission said,

“In summary we concluded (just before Christmas 2012) that the IT system that had been developed for the launch of UC [Universal Credit] had significant problems.”

One wonders whether DWP civil servants kept Duncan Smith in the dark because they themselves had not been fully informed about what was going on, or because they thought the minister was best protected from knowing what was going on, deniability being one key Whitehall objective.

But in the absence of reliable internal information a political leader can lose touch completely, said the paper on press freedom.

“On December 21, 1989, after days of local and seemingly limited unrest in the province of Timi¸ Ceausescu called for a grandiose meeting at the central square of Bucharest, apparently to rally the crowds in support of his leadership. In a stunning development, the meeting degenerated into anarchy, and Ceausescu and his wife had to flee the presidential palace, only to be executed by a firing squad two days later.”

Wrong assumptions

Many times, after the IT media has published articles on big government IT-based project failures, TV and radio journalists have asked to what extent the secretary of state was responsible and why he hadn’t acted to stop millions of pounds being wasted.

But why do broadcast journalists assume ministers control their departments? It is usually more likely that ministers know little about the real risks of failure until it is too late to act decisively.

Lord Bach, a minister at DEFRA, told a House of Commons inquiry in 2007 into the failure of the IT-based Single Payment Scheme that he was aware of the risks but still officials told him that systems would work as planned and farmers would receive payments on time. They didn’t. Chaos ensued.

Said Lord Bach,

“I do think that, at the end of the day, some of the advice that I received from the RPA [Rural Payments Agency] was over-optimistic.”

Lord WhittyAnother DEFRA minister at the time Lord Whitty, who was also party in charge of the Single Payment Scheme, told the same inquiry,

“Perhaps I ought also to say that this was the point at which I felt the advice I was getting was most misleading, and I have used the term ‘misleading’ publicly but I would perhaps prefer to rephrase that in the NAO terms …”

Even the impressive Stephen Crabb – who has now quit as DWP secretary of state – didn’t stand much of chance of challenging his officials. The department’s contracts, IT and other affairs, are so complex and complicated – there are bookcases full of rules and regulations on welfare benefits – that any new ministers soon find themselves overwhelmed with information and complexity.

They will soon realise they are wholly dependent on their officials; and it is the officials who decide what to tell the minister about internal mistakes and bad decisions. Civil servants would argue that ministers cannot be told everything or they would be swamped.

But the paper on press freedom said that in order to induce high effort within a bureacucracy, the leader needs “verifiable information on the bureaucrats’ performance”.

The paper made a fascinating argument that the more complacent the bureaucracy, the more aggressively it would control information. Some oil-rich countries, said the paper, have less media freedom than those with scarcer resources.

“Consistent with our theory, [some] non-democratic countries … have vast resources and poor growth performance, while the Asian tigers (South Korea, Taiwan, Hong Kong, and Singapore), while predominantly non-democratic in the 1970s and 1980s, have high growth rates and scarce natural resource.”

In an apparent opening up of information, the government in China passed a law along the lines of the U.S. Freedom of Information Act (“China Sets Out to Cut Secrecy, but Laws Leave Big Loopholes,” New York Times, Apr. 25, 2007). But was this law self-serving? It, and the launch of local elections, provided the central government with relatively reliable information on the performance of provincial bosses.

These stories from less democratic countries may be relevant in Britain because politicians here, including secretaries of state, seem to be the last to know when a big IT-based programme is becoming a disaster.

Bad news

Whtehall’s preoccupation with “good news only” goes well beyond the DWP.

T auditors Arthur D Little, in a forensic analysis of the delays, cost over-runs and problems on the development of a huge air traffic control IT project for National Air Traffic Services, whose parent was then the Civil Aviation Authority, which was part of the Department for Transport, referred to an “unwillingness to face up to and discuss bad news”.

Ministers helpless to force openness on unwilling officials?

Francis Maude came to the Cabinet Office with a reforming zeal and a sophisticated agenda for forcing through more openness, but the effects of his efforts began to evaporate as soon as he left office. Even when he was at the height of his power and influence, he was unable to persuade civil servants to publish Gateway reviews, although he’d said when in opposition that he intended to publish them.

His negotiations ended with central departments agreeing to publish only the “traffic light” status of big projects – but only after a minimum delay of at least six months. In practice the delay is usually a year or more.

Brexit

Brexit campaigners argue that the EC is undemocratic, that decisions are taken in Brussels in secret by unelected bureaucrats. But the EC is at least subject to the scrutiny, sometimes the competing scrutiny, of 29 countries.

Arguably Whitehall’s departments are also run by unelected bureaucrats who are not subject to any effective scrutiny other than inspections from time to time of the National Audit Office.

Yes Minister parodied Sir Humphrey’s firm grip on what the public should and should not be told. Usually his recommendation was that the information should be misleadingly reassuring. This was close enough to reality to be funny. And yet close enough to reality to be serious as well. It revealed a fundamental flaw in democracy.

Nowhere is that flaw more clearly highlighted than in the DWP’s legal submission. Is it any surprise that the DWP did not want the submission published?

If officials had the choice, would they publish any information that they did not control on any of their IT projects and programmes?

That’s where the indispensable work of the National Audit Office comes into the picture – but it alone, even with the help of the Public Accounts Committee, cannot plug the gaping hole in democracy that the DWP’s submission exposes.

These are some thoughts I am left with after reading the legal submission in the light of the DWP’s record on the management of IT-based projects …

  • Press freedom and the free flow of information cannot be controlled in a liberal democracy. But does Whitehall have its own subtle – and not so subtle – ways and means?
  • In light of the DWP’s track record, the public and the media are entitled to distrust whatever ministers and officials say publicly about their own performance on IT-related programmes, including Universal Credit.
  • More worryingly, would the DWP’s hierarchy care a jot if the media and public didn’t believe what the department said publicly about progress on big projects such as Universal Credit?
  • Is the DWP’s unofficial motto: Better to tell a beautiful lie than an ugly truth?
  • AL Kennedy mentioned the “botched” Universal Credit programme  when she gave a “point of view” on Radio 4 last week. Not referring specifically to Universal Credit she said facts can be massaged but nature can’t be fooled. A girder that won’t hold someone’s weight is likely to fail however many PR-dominated assurance reports have gone before. “Facts are uncompromising and occasionally grim. I wish they weren’t. Avoiding them puts us all at increased risk,” she said.

 Excerpts from the DWP submission

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Paper on Universal Credit IT programme the DWP didn’t want published

By Tony Collins

Below are excerpts from a paper on the Universal Credit IT programme that a judge has ruled can be published.

Judge Chris Ryan has granted my request to publish written evidence that the DWP had submitted to an FOI Tribunal for a hearing in February 2016.

The tribunal was over the DWP’s prolonged refusal to publish three reports on the Universal Credit IT programme. The DWP lost the case and in April 2016 released the reports in question: a risk register, issues log and project assessment review. Subsequently the Government Legal Service, representing the DWP, refused permission for the department’s written evidence to the tribunal to be published.

My comments on the contents of the DWP’s written evidence are in a separate article.

Lawyers for the DWP had argued that its written evidence to an FOI Tribunal was for the purposes of the hearing only. The Government Legal Department told the FOI Tribunal,

“The open justice principle has been in this case; the proceedings were held in public; reporting of the proceedings was permitted; and the issues were ventilated very fully in open court.

“We do not consider that it is necessary to go further and for Mr Collins to be permitted to publish the witness statements themselves, outside of the proceedings for which they were made”.

But Judge Ryan,who had heard the original FOI case, granted my application citing this: Guardian Case – provision of documents used in an appeal

He said there would have been no issue if the evidence in question had been given in full during the hearing. To save time such evidence is not heard in full. Instead written statements are given to the judge, which can make it difficult for reporters or anyone listening to the case in court to pick up what is going on.

Said the judge in ruling,

“I am satisfied that Mr Collins has a genuine journalistic interest in referring to the material in his blog …

“I am satisfied, therefore, that the combination of a public hearing (at which the evidence was not heard) and a published determination (which referred to only parts of the evidence) does not do enough to satisfy the principle of open justice and that the contents of the open witness statements should be generally available, including being quoted in journalistic writing of the kind envisaged by Mr Collins.”

The statement in question

The DWP’s written evidence refers, in part, to the effects on staff and managers of leaks on the Universal Credit IT programme.

The DWP’s argument was, in essence, that the release of sensitive information as a result of leaks or an FOI ruling to disclose the three reports in question, would change the behaviours and attitudes of staff and managers.

The DWP’s written evidence gives a rare insight into how the department dealt with its own fear of leaks.

One interpretation of the DWP’s written evidence is that it shows the extent to which the DWP was careful to control information to the media, the public, stakeholders, MPs and the public to ensure that only the correct information about the Universal Credit IT programme was released, and then only by authorised persons.

Another interpretation is that it shows the extent to which the DWP was preoccupied with control of any bad news about the Universal Credit IT programme, to the point of frightening staff and managers by leak investigations, one led by a former member of the security services.

The leaks the DWP refers to in its evidence related to low-level information such as the results of a staff survey of morale or the release of a “starting gate review” that the DWP had lodged with the House of Commons library.

Part of the written evidence below gives several examples of how the fear of leaks manifested itself. For governance meetings, “all documents are sent out as password protected, with official security markings attached, whether or not they contain sensitive information”.

In a leak investigation, staff were subjected to detailed interviews and individual mailboxes “reviewed”, as were access rights to electronic shared areas.

Assurance reports (low-level reports on the state of the IT programme including risks and problems) were watermarked, numbered and password protected, and a register kept of who received them. Recommendations in the assurance reports were not circulated.

The submission said managers distrusted staff and there was a “lack of candour and honesty throughout the Programme and publicly”.

People became “paranoid that they might have accidentally caused a leak, for example by leaving information on a printer”.

At one point the permanent secretary posted a message on the DWP intranet informing everyone of the leak investigations and “inviting people to speak to the independent investigator if they had any information”.

(Please note)…

I have left out the names of the senior DWP executives who wrote the submissions. This is because the executives represented the position and views of the department rather than those of any individual. The submissions were given to the tribunal,  “on behalf of the Department for Work and Pensions”.

Little in the contents of the evidence is surprising. On the other hand it is rare, and perhaps unprecedented, for the DWP’s preoccupation with controlling information on any of its big IT programmes to be articulated so clearly.

This website would argue that suppressing bad news is not conducive to good project management, and can alienate stakeholders who are likely to view a project with suspicion once they believe they are fed only good news.

Excerpts

Parts of the written statement of a senior executive on the Universal Credit IT programme follow.

The executive has been a civil servant at the Department for Work and Pensions, and its predecessor departments and agencies, for more than 25 years.

“I therefore have a very good understanding of the general workings and culture of the DWP as a whole…”

The executive also has a “considerable experience of delivering large change programmes (although none as large as UC, which is unique in scale).

“Within my change management experience I have reviewed and managed risk registers and issue logs as part of the Senior Management team.”

The executive explained that the Universal Credit programme constitutes a massive investment of public money.

It is being delivered by a central programme staff of about 500 at present and eventually by “thousands of staff in our operational sites”.

The UC programme went through a “reset” instigated by the Major Projects Authority in 2013.

“This meant a considerable amount of re-planning and scrutiny from other Government Departments.

“There are very few senior level staff still working in the Department who worked on the Universal Credit Programme in 2011/2012. I have been asked to provide this witness statement as I joined the Programme in 2012 and have a good understanding of what happened on the Programme before that date as well as of DWP more generally.”

When joining the Universal Credit IT programme, the executive found that many of the senior management team were relatively new and, as colleagues were taken on board, “we were expected to learn about the Programme and deliver our critical areas of work simultaneously”.

“I was placed on temporary promotion … and asked to take on a fact-finding/troubleshooter role on behalf of the Programme Director, undertaking a stocktake and reporting back within 6 weeks on areas of known concern.

“As a Director I was also a member of the senior management team of the (Universal Credit) programme. It rapidly became apparent that many issues were being addressed within the Programme but that there were significant problems in some areas – including my area of expertise.

Significant problems

“I worked closely with the Secretary of State’s Special Adviser (Stephen Brien) and other security specialists to investigate the position. In summary, we concluded (just before Christmas 2012) that the IT system that had been developed for the launch of UC had significant problems.

“This was difficult news for the Programme and our conclusions were very sensitive. Having been told and having understood our discussions, ministers and the programme leaders (including me) needed to consider how the rollout of UC could proceed and the “art of the possible” in respect of launching UC in April 2013 as previously planned and announced. This was under discussion in late December/January.

“The Major Projects Authority undertook a review of the Programme in February 2013, where all Programme leaders and others, including me, were interviewed.

“The decision was taken that the Programme would be reset under the leadership of David Pitchford, then the Chief Executive of the Major Prpojects Authority. We were told that he would bring his own team with him and our own role remained uncertain for a few weeks. On arrival Mr Pitchford convened a workshop of all senior leaders of the Programme to set out the way forward for the Programme.

Mr Pitchford and his MPA team were in place for 13 weeks. I attended workshops and discussions with them and made them aware of the issues in relation to the Programme that my pre-Christmas stocktake had uncovered.

“I also continued to work with DWP teams to decide what recovery and improvement action was needed to support UC in the future, whatever the reset outcome. During this period Mr Pitchford was appointed as ‘Chief Executive of Universal Credit’, and suspended other governance meetings with decisions made by him at the centre of the Programme.

“In February 2013 an extraordinary ‘Ministerial Oversight Group’ was put in place, which was made up of the Secretary of State for Work and Pensions, the Chief Secretary to the Treasury, the Minister for the Cabinet Office, the Cabinet Secretary and very senior officials from each of the Departments concerned. I presented to this group on the issues I had been working on. This group met a small number of times during 2013 to monitor progress of the Programme.

“Mr Pitchford and his team departed in May 2013, leaving what they referred to as a ‘blueprint’ for the Programme for Ann Harris (the new programme Director) and Howard Shiplee (the new SRO).

On taking up appointment Mrs Harris and Mr Shiplee further reviewed staffing levels and expenditure on contracted resource, reducing both significantly.

“This inevitably created further confusion and concern in some areas of the Programme. They also re-established formal governance, a new Programme Board with an external non-executive chair and strong project management structures, including risks and issues management, and realised that further planning was required. As well as being part of the senior management team under Mr Pitchford’s direction, I was also part if the new senior management team from May 2013…

“I make these statements not only to describe my work on the Programme – and therefore my good understanding of the sort of pressures the Programme faced, and the nature of the culture within the Programme – but also more generally to try and give a picture of the extreme pressures that working on a Programme of sort of size and complexity can create.

“I also believe that those pressures emphasise the very great importance of ensuring that in the teeth of management change, and external and internal pressure, those responsible for the programme can nevertheless be assured that they receive accurate, frank and timely advice and information about the state of the programme. These sorts of pressures made it more difficult to ensure that this type of advice can be provided and is available for those who need it, even though it is vitally required…

The effect of Freedom of Information disclosures

“I will now turn to the effect of disclosing information that DWP seems sensitive under the FOI Act. It is very difficult to document actual cases of the effect of disclosure as, in my experience, the exemptions under the Act and decisions of the Information Commissioner and Tribunals mean that such sensitive information does not get released in the first place.

“It is therefore inevitable that the effect of disclosure has to be inferred from other types of disclosure (e.g. leaks); from knowledge of human behaviour under the sort of pressures that arise in the Programme of this kind: and from knowledge of departmental behaviour and culture.

“To give a flavour of this, if we take 2012 as an example (as the year that these requests were made) DWP disagreed with the decisions to order the release of information in just 7 cases which came before the Information Commissioner. This is out of a caseload of 4,778 FOIA requests that year.

“Of the cases where we disagreed with the decisions, 2 are the ones before the Tribunal now, 3 are joined with each other as they relate to the same information and are scheduled before the Court of Appeal in June 2016 and on the remaining 2 the Tribunal agreed with the DWP’s judgement and the information did not get released.

“It is therefore difficult for me to give examples of where inappropriate disclosure has caused harm, precisely because the mechanisms designed to protect against that are generally effective.

“Whilst there will undoubtedly be specific reasons relating to each case, considering PARs [project assessment reviews], Risk and Issues Registers in general terms, release of the sensitive information commonly held in these documents would inhibit candour .

“In lookalike cases across government this position has been supported by the Information Commissioner and Tribunals, or the government has as I understand it decided to use the executive override (the FOI “veto”) under section 53 of FOIA.

“DWP rarely receives requests for a PAR or Risk or Isssues Register relating to a major programme and has not released one to date.

“The initial requests for information in these cases also included the request for the Universal Credit milestone schedule. This was released by the Department earlier this year (2015), so I should explain here why we did not feel its release would unduly affect candour.

“Previous submissions from the Department have clearly stated that the “chilling effect” applies in a very minor way to milestone schedules, as they are by their nature a lit of milestones and dates to achieve those milestones.

“A limited chilling effect may occur if information disclosures led to future milestone schedules containing vaguely labelled milestones and deadlines that were unrealistically long, but this sort of minor chilling effect is likely to be picked up by the robust Programme Management which we have in place. Given that, and the passage of time that has now elapsed since the milestone schedule was requested, I agree that it was appropriate to release that document rather than continue to withhold it.

“Given the lack of evidence that I am able to draw on regarding the damage caused by the release of information through FOI, the evidence I can present must come from a different source, namely that of unauthorised leaks of information. Both leaks and disclosure of sensitive information through FOI result in civil servants losing trust in the sanctity of the information sharing systems and processes, resulting in a loss of trust and diminished openness and candour.

“Whilst this is different for FOIs and leaks in that one can be planned for and managed, the damage to trust is still essentially the same. Leaks caused additional damage in that trust of colleagues is also undermined, which is unlikely to be the case with the release of sensitive information under FOI (though there may be a little distrust in colleagues, as some people contributing to risk registers and issues registers may not be aware of FOI rules so may think colleagues have chosen to release documents inappropriately).

My own experience, and those of my colleagues, on the effect of leaks.

I now turn to my own experience of leaks and how they have undermined candour. During 2011 and through to 2013 there were a number of leaks and unauthorised disclosures that came out of the Programme.

“Leaks cannot be managed and considered in the same way as freedom of information requests. Leaks are managed in a reactive and defensive way: however, the impact on staff can be similar. With leaks, staff grow to distrust their colleagues and managers; with the release of data through FOIs, staff grow distrustful of the system and, if they are aware their work can be released this way, will be less candid in the information they record.

Major Projects Authority Review

“In 2011, the Major Projects Authority undertook an independent review of Universal Credit – this was a Starting Gate Review on behalf of the Senior Responsible Owner. The report of the review is confidential to the SRO, and if it is to be helpful it must contain candid advice, both in terms of processes and individuals.

“In this instance the Universal Credit Programme underwent a Programme Assurance Review from the Major Projects Review Group (MPRG), (Cabinet Office, HM Treasury and invited independent experts). The meeting was to provide further recommendations to the SRO and to write to HM Treasury in support of the Treasury Approval Point, which was the ultimate source of funding for the Programme.

“After the meeting of MPRG the Starting Gate Review report and elements of the costs and benefits for Universal Credit were leaked in the Daily Telegraph. These documents are clearly marked as confidential and sensitive. The Business Case provides the economic, commercial and financial argument to allow Government to make key decisions on investment when it comes to large Programmes. It contains sensitive financial and commercial information.

“The various leaks took place at a time (late 2011) when there was press speculation about ‘tension’ between DWP and HM Treasury officials over Universal Credit, and the MPA report was candid in its appraisal of the strengths and weaknesses of the Programme, identifying areas for improvement, and risk areas to manage.

“The leaking of these various documents made DWP officials feel more defensive and built a sense of being ‘under siege’ and having to take extreme care about what information was being shared and with whom. This was observed by others such as the National Audit Office (NAO), who felt that the Universal Credit Programme was building a ‘fortress culture’.

“The extreme care that was taken had particular consequences. One was that it was harder for people on the Programme, and throughout Government, to obtain the information they needed to do their jobs – even the members of the Programme Board could no longer receive their papers electronically, which meant twenty packs of up to 200 pages delivered by hand every month.

“As is clear from this example, extra time had to be taken in relation to protecting information when the time needed to be spent on introducing UC.

“Valuable resource, both people and time, was taken up ensuring all documents were marked securely in the correct way, all papers were numbered and signed for, any that were sent were ‘double-enveloped’, and any papers that needed to be retained were ‘signed back in’. People were focused on physically protecting information when the time needed to be spent on planning and delivering UC.

“This, then, was the effect of leaking the Starting Gate Review, which for the reasons I have already explained above was a less sensitive document and leaked at a much less sensitive time than either the PAR report in this case, or indeed the Risk Register, or Issues Register.

Pulse Survey

In 2013, the results of a Universal Credit ‘Pulse Survey’ were shared with the Programme. A Pulse Survey is used to gain a quick and simple snapshot of how people feel about the workplace.

“The covering note, sent only to UC staff, acknowledged how difficult it had been to work in the Programme, but explained that there had been a lot of work done to develop a more positive culture, that things were improving and that the leadership team were committed to improving this. There was an embedded file in the note that included personal comments made by the staff in response to some of the questions, and some of these comments were very negative in nature.

“These were included to give an honest picture of how it felt to work in the Programme to ensure staff recognised that their concerns were understood and that changes would be made for the better. The letter and comments were leaked to the Guardian Newspaper and made the front page. The comments in the Guardian included:

Working on UC was ‘soul-destroying’ and ‘unbelievably frustrating’.

People were under so much pressure that they could only engage in ‘fire-fighting and panic management’.

One civil servant writes of a ‘near complete absence of anything that looks like strategic leadership in the programme’.

‘There is a divisive culture of secrecy around current programme developments and very little in the way of meaningful messages for staff or stakeholders explaining what will happen and when.’

‘I have never worked somewhere where decision making was so apparently poor at senior levels …’

“As a consequence of these leaks and others a number of leak investigations were instigated by the Permanent Secretary and the Secretary of State. One was led by a former member of the Security Services. They involved detailed interviews with a wide variety of staff – where direct questions were asked about colleagues – and interrogation of email systems and reviews of staff access to documents.

“People became suspicious of their colleagues – even those they worked closely with. There was a lack of trust and people were very careful about being honest with their colleagues. People were very careful who they shared information with, and became paranoid that they might have accidentally caused a leak, for example by leaving information on a printer.

“People also stopped sharing comments which could be interpreted as criticism of the Programme, even when those comments would be useful as part of something like an MPA review.

“Colleagues also became concerned about the sanctity of the information systems and processes – which were also examined as part of the investigation where elements such as access rights to electronic shared areas and individual mailboxes were reviewed.

“The leaks had a considerable impact on the member of staff who sent out the note on the pulse survey and those that read the note, including those who contributed the anonymous comments in the embedded document.

“People felt they could no longer share things with colleagues that might have an honest assessment of difficulties or any negative criticism – many staff believed the official line was ‘everything is fine’.

“People, even now, struggle to trust colleagues with sensitive information and are still; fearful that anything that is sent out via email will be misused. For all governance meetings, all documents are sent out as password protected, with official security markings included, whether or not they contain sensitive information.

How did it change the way we did things?

“All future MPAs, other assurance reports, risk registers and issues registers were all treated with utmost care.

“For assurance reports, only the SRO and Programme Director could have electronic copies (and the password protected) and other recipients received printed, watermarked, numbered copies, with a register kept of who had received them.

“While the business case tem has copies of the recommendations, these were not circulated, and while the team did pursue progress against this clearly could not be set in the full context of the report outside a small number of people.

“This was damaging to the programme because people felt management did not trust them, leading to a lack of loyalty and commitment and further distrust of the system. Releasing what Programme staff would have seen as sensitive and ‘official’ information in the form of the PAR report or risk or issues register at that time would have exacerbated an already difficult situation in the Programme.

“At the time of the leaks and the investigations that followed, Programme senior leaders were expected to speak to their teams about what had happened and what the ‘lines to take’ were.

“The lines to take were also added to the Rolling Brief (an internal update document) and circulated to senior leaders in the Programme, press office, special advisors and so on. The lines were a ‘defensive’ approach to media requests, emphasising the positive in terms of progress in the Programme without acknowledging the issues identified in leaked stories.

“This positive approach to briefing and media management built on the effect of the leaks and led to a lack of candour and honesty throughout the Programme and publically – it contributed to the to the ‘fortress mentality’ spoken of by the National Audit Office.

“Subsequent to the various leaks, the Permanent Secretary posted a message on the DWP internal intranet informing every one of the investigations and inviting people to speak to the independent investigator if they had any information. This was at a time when the Permanent Secretary needed to give as much focus as possible to the Programme itself.

“The arrangements around sensitive documents, such as assurance reports, business cases and risk logs, are still tightly controlled in the Universal Credit programme, both as a consequence of the leaks and the investigations and because of the perception that these fostered that anything that did not reflect well on the Programme was likely to be leaked.

“Further release of information, either through the FOI route or another leak would have piled pressure both on management and on the Programme staff, with everyone feeling limited in what they could say, and how honest they could be when recording their concerns about Programme progress.

“One of the broader consequences of this was that the level and frequency of communications was reduced because of this lack of trust in systems for recording information. ‘Temperature checks’ and similar ‘pulse surveys’ were no longer carried out.

“This led to people feeling ‘disengaged’ and the level of commitment from people reduced. This low level of engagement was evident in the 2013 and 2014 People Survey results, with those feeling proud of working in the Programme being significantly less than those who were proud of working for the Department as a whole.

“Part of this lack of candour caused by leaks relates to dedicated civil servants not wanting to harm the Programme and risk its delivery. Universal Credit is the most profound change to the welfare state that most will work on in their career. The benefits that will stem from the change will have a significant impact on millions of lives and save billions of pounds.

“Undermining trust in the information-sharing systems and processes that are used by a group of people dedicated to wanting to see this positive change will almost certainly result in them stepping back from the frankness and candour that is so necessary for effective Programme Management.

“This may be done with the best of intentions. Officials will not want to be the source of information made public, that reflects badly on a Programme they consider will have a positive effect on so many. But (to give one example) toning down, even unconsciously, the wording of a risk makes effective programme management much harder.

“This in turn increases the risk of issues occurring, which might otherwise have been drawn out, planned for and avoided. This may be a relatively slight issue in a small programme with a small number of staff, but on a Programme the size and scale of Universal Credit, that candour is vital to ensure we make the most effective decisions, since they ultimately affect the lives of millions of citizens.

The above facts are true to the best of my knowledge and belief.

Signed electronically

6th November 2015

I make this statement on behalf of the Department for Work and Pensions in support of the DWP’s position in three appeals under the Freedom of Information Act 2000 (FOIA).”

My submission to the tribunal, which includes responses to the above DWP points is here:  Tony Collins statement to FOI DWP tribunal January 2016.doc

[Thank you to FOI campaigner and IT projects professional John Salter [@AmateurFOI] who provided invaluable help with my submissions to the FOI tribunal. It was largely through Slater’s efforts – including his own submissions and attendance at two FOI tribunal hearings where he cross examined DWP witnesses  – that the DWP eventually released the reports in dispute.]

Comment and analysis on the DWP’s written evidence.

NHS “Wachter” digital review is delayed – but does it matter?

By Tony Collins

The Wachter review of NHS technology was due to be published in June but has been delayed. Would it matter if it were delayed indefinitely?

A “Yes Minister” programme about a new hospital in North London said it all, perhaps. An enthusiastic NHS official shows the minister round a hospital staffed with 500 administrators. It has the latest technology on the wards.

“It’s one of the best run hospitals in the country,” the NHS official tells the minister, adding that it’s up for the Florence Nightingale award for the standards of hygiene.

“But it has no patients,” says the minister.

Another health official tells the minister,

“First of all, you have to sort out the smooth running of the hospital. Having patients around would be no help at all.” They would just be in the way, adds Sir Humphrey.

In the Wachter’s review’s terms of reference (“Making IT work: harnessing the power of health IT to improve care in England“)  there is a final bullet point that refers, obliquely, to a need to consider patients. Could the Wachter terms of reference have been written by a satirist who wanted to show how it was possible to have a review of NHS IT for the benefit of suppliers, clinical administrators and officialdom but not patients?

The Wachter team will, according to the government,

• Review and articulate the factors impacting the successful adoption of health information systems in secondary and tertiary care in England, drawing relevant comparisons with the US experience;

• Provide a set of recommendations drawing on the key challenges, priorities and opportunities for the health and social care system in England. These recommendations will cover both the high levels features of implementations and the best ways in which to engage clinicians in the adoption and use of such systems.

In making recommendations, the board will consider the following points:

• The experiences of clinicians and Trust leadership teams in the planning, implementation and adoption of digital systems and standards;

• The current capacity and capability of Trusts in understanding and commissioning of health IT systems and workflow/process changes.

• The current experiences of a number of Trusts using different systems and at different points in the adoption lifecycle;

• The impact and potential of digital systems on clinical workflows and on the relationship between patients and their clinicians and carers.

Yes, there’s the mention of “patients” in the final bullet point.

Existing systems?

nhsSome major IT companies have, for decades, lobbied – often successfully – for much more public investment in NHS technology. Arguably that is not the priority, which is to get existing systems to talk to each other – which would be for the direct benefit of patients whose records do not follow them wherever they are looked at or treated within the NHS.

Unless care and treatment is at a single hospital, the chances of medical records following a patient around different sites, even within the same locality, are slim.

Should a joining up of existing systems be the main single objective for NHS IT? One hospital consultant told me several years ago – and his comment is as relevant today –

“My daughter was under treatment from several consultants and I could never get a joined-up picture. I had to maintain a paper record myself just to get a joined-up picture of what was going on with her treatment.”

Typically one patient will have multiple sets of paper records. Within one hospital, different specialities will keep their own notes. Fall over and break your leg and you have a set of orthopaedic notes; have a baby and you will have a totally different set of notes. Those two sets are rarely joined up.

One clinician told me, “I have never heard a coroner say that a patient died because too much information was shared.”

And a technology specialist who has multiple health problems told me,

“I have different doctors in different places not knowing what each other is doing to me.”

As part of wider research into medical records, I asked a hospital consultant in a large city with three major hospitals whether records were shared at least locally.

“You must be joking. We have three acute hospitals. Three community intermediate teams are in the community. Their records are not joined. There is one private hospital provider. If you get admitted to [one] hospital and then get admitted to [another] the next week your electronic records cannot be seen by the first hospital.  Then if you get admitted to the third hospital the week after, again not under any circumstances will your record be able to be viewed.”

Blood tests have to be repeated, as are x-rays; but despite these sorts of stories of a disjointed NHS, senior health officials, in the countless NHS IT reviews there have been over 30 years, will, it seems, still put the simplest ideas last.

It would not cost much – some estimate less than £100m – to provide secure access to existing medical records from wherever they need to be accessed.

No need for a massive investment in new technology. No need for a central patient database, or a central health record. Information can stay at its present location.  Just bring local information together on local servers and provide secure access.

A locum GP said on the Pulse website recently,

“If you are a member of the Armed Forces, your MO can get access to your (EMIS-based) medical record from anywhere in the world. There is no technical reason why the NHS cannot do this. If need be, the patient could be given a password to permit a GP to see another Surgery’s record.”

New appointments

To avoid having patients clog up super-efficient hospitals, Sir Humphrey would have the Wachter review respond to concerns about a lack of joined up care in the NHS by announcing a set of committees and suggesting the Department of Health and NHS England appoint a new set of senior technologists.

Which is just what has happened.

Last week NHS England announced  “key appointments to help transform how the NHS uses technology and information”. [One of the NHS appointments is that of a Director of Digital Experience, which is not a fictional title, incidentally. Ironically it seems to be the most patient-facing of the new jobs.]

Said the announcement,

“The creation of these roles reflects recommendations in the forthcoming review on the future of NHS information systems by Dr Bob Wachter.

“Rather than appoint a single chief information and technology officer, consistent with the Wachter review the NHS is appointing a senior medical leader as NHS Chief Clinical Information Officer supported by an experienced health IT professional as NHS Chief Information Officer.

“The first NHS Chief Clinical Information Officer will be Professor Keith McNeil, a former transplant specialist who has also held many senior roles in healthcare management around the world, including Chief Executive Officer at Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust and Chief Executive Officer at the Royal Brisbane and Women’s Hospital in Australia.

“The new NHS Chief Information Officer will be Will Smart, currently Chief Information Officer at the Royal Free London NHS Foundation Trust. Mr Smart has had an extensive career in IT across the NHS and in the private sector.

“The NHS CCIO and NHS CIO post-holders will act on behalf of the whole NHS to provide strategic leadership, also chairing the National Information Board, and acting as commissioning ‘client’ for the relevant programmes being delivered by NHS Digital (previously known as the Health and Social Care Information Centre).

“The roles will be based at NHS England and will report to Matthew Swindells, National Director: Operations and Information, but the post-holders will also be accountable to NHS Improvement, with responsibility for its technology work with NHS providers.

“In addition, Juliet Bauer has been appointed as Director of Digital Experience at NHS England. She will oversee the transformation of the NHS Choices website and the development and adoption of digital technology for patient ‘supported self-management’, including for people living with long term conditions such as diabetes or asthma. Ms Bauer has led delivery of similar technology programmes in many sectors, including leading the move to take Times Newspapers online…”

Surely a first step, instead of arranging new appointments and committees, and finding ways of spending money on new technology, would be to put in place data sharing agreements between hospitals?

A former trust chief executive told me,

“In primary care, GPs will say the record is theirs. Hospital teams will say it is our information and patient representative groups will say it is about patients and it is their nformation. In maternity services there are patient-held records because it is deemed good practice that mums-to-be should be fully knowledgeable and fully participating in what is happening to them.

“Then you get into complications of Data Protection Act. Some people get very sensitive about sharing information across boundaries: social workers and local authority workers. If you are into long-term continuous care you need primary care, hospital care and social care. Without those being connected you may do half a job or even less than that potentially. There are risks you run if you don’t know the full information.”

He added that the Summary Care Record – a central database of every patient’s allergies, medication and any adverse reactions to drugs, was a “waste of time”.

“You need someone selecting information to go into it [the Summary Care Record]so it is liable to omissions and errors. You need an electronic patient record that has everything available but is searchable. You get quickly to what you want to know. That is important for that particular clinical decision.”

Is it the job of civil servants to make the simple sound complicated?

Years ago, a health minister invited me for an informal meeting at the House of Commons to show me, in confidence, a one-page civil service briefing paper on why it was not possible to use the internet for making patient information accessible anywhere.

The minister was incredulous and wanted my view. The civil service paper said that nobody owned the internet so it couldn’t be used for the transfer of patient records.  If something went wrong, nobody could be blamed.

That banks around the world use the internet to provide secure access to individual bank accounts was not mentioned in the paper, nor the existence of the CHAPS network which, by July 2011, had processed one quadrillion (£1,000,000,000,000,000) pounds.

Did the briefing paper show that the civil service was frightened by the apparent simplicity of sharing patient information on a secure internet connection? If nothing else, the paper showed how health service officials will tend, instinctively, to shun the cheapest solutions. Which may help to explain how the (failed) £10n National Programe for IT came into being in 2002.

Jargon

Radiation_warning_symbolNobody will be surprised if the Wachter review team’s report is laden with  jargon about “delays between technology being introduced and a corresponding rise in output”. It may talk of how new technology could reduce the length of stay by 0.1528 of a bed day per patient, saving a typical hospital £1.8m annually or 7,648 bed days.

It may refer to visions, envisioning fundamental change, establishing best practice as the norm, and a need for adaptive change.

Would it not be better if the review team spoke plainly of the need for a patient with a fractured leg not having to carry a CD of his x-ray images to different NHS sites in a carrier bag?

Some may await the Wachter report with a weary apprehension that its delay – even indefinitely – will make not a jot of difference. Perhaps Professor Wachter will surprise them. We live in hope.

Wachter review terms of reference.

Review of IT in the NHS

Another NPfIT IT scandal in the making?

Hunt announces Wachter review

What can we learn from the US “hospitalist” model?