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NHS England’s Capita contract repeats past blunders

By Tony Collins

A National Audit Office report published today on NHS England’s £330m Capita contract highlights blunders that will be familiar to anyone who recalls the mistakes and false assumptions that floored the £10bn National Programme for IT [NPfIT] in the NHS.

Labour MP Meg Hillier, who heads the Public Accounts Committee, said of the Capita contract,

“Trying to slash costs by more than a third at the same time as implementing a raft of modernisation measures was over-ambitious, disruptive for thousands of doctors, dentists, opticians and pharmacists and potentially put patients at risk of serious harm.

“Neither NHS England nor Capita properly understood the scale of the challenge before agreeing the contract and are still in dispute over future payments.

“Yet again this is poor contracting by Government with one of its major suppliers and it must learn lessons.”

But will any lessons be learned? Those who have followed the problems that beset the NPfIT and the NHS Capita contracts will see a similar pattern of mistaken beliefs, false assumptions, flawed risk assessments and over-optimistic reviews on both deals.

The NPfIT was “dismantled” in 2011. The Capita contract, which was signed in 2015 and started in September that year, has improved, says the National Audit Office, but there are still disputes between Capita and NHS England over the supplier’s performance.

These are some of the main findings of today’s National Audit Office report NHS England’s management of the primary care support services contract with Capita. The Capita (and NPFIT) contracts were floored by:

– over-ambitious, unrealistic plans that were not challenged by anyone who was taken seriously

– too little involvement of prospective end-users

– – a lack of Whitehall understanding of how people worked at the coal-face

– inadequate piloting of proposed changes

– a false assumption that IT on its own can standardise diverse working practices

– a false assumption that IT suppliers will be able to take over and understand a complex and problematic safety-related public service while at the same time transforming it.

– a false assumption that the contract will make up for a suppliers’ inadequacies

– over-optimistic internal project “review” reports by civil servants for civil servants which will say what civil servants want them to say

– the wrong risks being assessed – in this case whether the savings would be achieved rather than whether Capita would provide a good service

– the alienation of medical professionals by the NHS’s issuing statements claiming the problems were teething when they were going on for years and getting worse.

Numerous complaints by GPs and their trade association the BMA and campaigning articles in Pulse magazine eventually caused NHS England to act on the contract.

[In the case of the NPfIT, a Whitehall and House of Commons reaction was eventually triggered by GPs, hospital staff and others complaining to Computer Weekly, national newspapers and broadcasters.]

Below are some of the detailed findings of today’s National Audit Office report on Capita’s NHS contract. My sub-headings on the lessons not learned from the NPfIT are in italics:

Was NHS England in control of Capita contract – or was Capita in full control?

  • Capita initially denied being in breach of service obligations
  • Capita argued there was no pre-contract baseline data on which to judge its performance
  • NHS England assured itself Capita’s improvement plan was fit for purpose – then found it was “ineffectual”.
  • Despite Capita’s improvement plan issues became “more widespread”.

National Audit Office report:

“On 27 May 2016, NHS England wrote to Capita formally expressing concerns about performance issues and seeking to enact the recovery arrangements set out in the contract. Capita initially denied being in breach of its service obligations. It argued that there were no baseline data from before the contract to benchmark its performance against and confirm whether service standards were being met. In its response of 17 June 2016, NHS England stated that the lack of performance data meant that Capita could not yet prove that it was meeting performance standards. It considered that there was enough evidence to place Capita in a formal process to rectify services, given the delays in setting up the customer support centre, the medical records service, and payments to opticians. However, NHS England considered that the improvement plan that Capita had developed would be sufficient to resolve the problems.
“NHS England formally intervened in Capita’s management of the contract in September 2016. It told us that by the end of summer 2016, it had become clear that Capita’s improvement plans were ineffectual in some key areas and that issues had become more widespread. NHS England served default notices, placing five of Capita’s nine services in a formal rectification process: the customer support centre; the medical records service; the patient registration service; the national performers lists service; and payments to opticians. It also embedded an ‘expert management team’ in Capita, to work alongside operational staff and provide additional oversight and support. 

Just because outsourcing together with standardising systems and working practices seem justified doesn’t mean you should

 NHS England aimed to reduce its costs by 35% from the first year of the contract and transform and modernise the service. The government’s mandate to NHS England required it to make significant reductions in its administrative running costs. NHS England also wanted to provide a high-quality and standardised service.
When NHS England took responsibility for primary care support services in 2013 they were being delivered by 1,650 staff from 47 local offices, managed under separate local arrangements, with no national leadership, no common standards in service specification or operating processes, and with limited data on performance. Services were supported by a 20-year-old IT system that NHS England considered was unsustainable and in urgent need of replacement, and many processes relied on the manual processing of paper‑based documents. NHS England considered that it would not be possible to deliver the required savings in‑house as it did not have the necessary skills in transforming services through better use of IT.

Major Projects Authority blunder – no wonder its reports are secret

The final review by the Major Projects Authority – which is now the Infrastructure and Projects Authority – noted that this was a well-run programme and that successful delivery appeared probable… The procurement was supported by commercial experts in the Cabinet Office … and was approved by the then Department of Health and HM Treasury

Don’t outsource until you know precisely what you’re outsourcing

  • NHS England didn’t understand the diverse local processes Capita was supposed to standarise
  • False assumptions were made
  • NHS England didn’t benchmark existing data before outsourcing
“NHS England did not know enough about the services it inherited to set achievable service specifications and performance standards from the start of the contract. This was a complex first generation outsourcing. NHS England lacked adequate data on the volume and cost of the services before the contract was awarded, and there were no consistent measures of performance. It told us that it recognised that there was variation in how services were delivered across the country, but that it did not have a detailed understanding of how local processes were different. As a result, it made a number of assumptions about the volume, cost and performance of the services in order to set service specifications and performance standards. To mitigate the risk around the robustness of the activity data, the contract included a clause to ensure that volume data could be reviewed in the first few months and, if necessary, the contract starting volumes could be revised. Capita only requested one ‘allowable assumption’ that permitted future adjustments related to uncertainty in the number of staff to be transferred

**

“Because of gaps in its knowledge, NHS England had to make a number of assumptions about the volumes and costs of the services before awarding the contract. For example, it used data on the number of GP practices and the types of contract they held to estimate the number of GP payments that would be needed and the volume of orders for NHS supplies. NHS England told us, that to mitigate the risk around the robustness of the activity data, the contract included a clause to ensure that volume data could be reviewed in the first few months and if necessary the contract starting volumes could be revised. It also told us that it provided all the information and service access that bidders needed to develop their bids and as a result Capita only requested one allowable assumption that allows for future adjustments in cases of uncertainty. This related to the number of staff to be transferred.
“NHS England also made assumptions about current performance in order to set service specifications and measures for assessing PCSE’s performance. The contract set out 58 performance indicators – 24 key performance indicators and 34 standard service levels. NHS England considers that the key performance indicators are more important, as failure to deliver them would result in greater operational and reputational loss to NHS England.
**
“The mobilisation period did not give NHS England and Capita enough time to assess whether Capita was ready to start transforming the service. As a result, neither NHS England nor Capita knew enough about PCSE’s performance when Capita started making changes to the service in March 2016.
“It took longer than expected for Capita to develop consistent information about its performance. The contract allowed a three-month period to assess how performance at the start of the contract differed from expectations set out in the performance measures. Where performance measures were not being met, Capita could propose variations or alternative measures. If agreed, these would be applied for a period of two years (known as the transformation period). However, NHS England told us that it took Capita five months to start providing consistent information about its performance. NHS England considers that the quality of Capita’s data has improved but it still has concerns about its quality and reliability.”

Another repeated NPfIT blunder – contracting out and transforming at the same time

“NHS England’s decision to contract with Capita both to run existing services and also simultaneously to transform those services, was high risk. Capita was incentivised through the contract to close existing services to minimise its losses but the interaction between running, closing and transforming services was more complex than Capita or NHS England had anticipated. This was a high-risk strategy, particularly for a set of incompletely understood services being outsourced for the first time.”

Savings at a personal cost and risk to patients?

  • Despite the massive disruption for GPs, opticians and dentists, 87 women being notified incorrectly that they were no longer a part of the cervical screening programme, a backlog of 500,00 patient registration letters, some 64% of GP practices saying they had received incorrect patient records in the last three months, 1,000 GPs, dentists and opticians being unable to work and a loss of earnings and missed and inaccurate payments to practitioners, the savings Capita was contracted to deliver were delivered.
“In the first two years of the contract, NHS England achieved savings of £60 million compared to expected savings of £64 million. NHS England has reduced the cost of delivering the service by 30% from £87.8 million in 2014-15 to £62.7 million in 2016‑17. In 2016-17, NHS England’s costs included £41 million made in payments to Capita. It also spent £22 million on other related costs such as buying NHS forms, records archiving facilities and managing the PCSE contract.”

Don’t cut staff until you know for certain you don’t need them. The worst time to cut staff is before the IT-related changes have bedded in. Until then, you’ll need more people – not fewer. 

“Performance issues emerged shortly after Capita started closing primary care support offices and making other changes to the service. In March 2016, Capita introduced a new online portal for primary care providers to use to order supplies. In April 2016, it introduced a new courier arrangement and labelling system for moving medical records, which replaced different local arrangements. These changes were poorly implemented and providers struggled with the new systems. There were also problems caused by shortages of stock in the NHS supply chain. These issues resulted in a significant increase in the number of calls to Capita’s customer support centre, which could not cope with the increase. Between December 2015 and November 2016, Capita closed 35 of the 38 support offices it inherited and cut staff numbers from 1,300 to 660.
**
“Capita underestimated the scale and nature of the task and the impact of closing sites and losing local knowledge. Capita acknowledges that it took longer than anticipated to make changes to primary care support services. It underestimated the number of staff that would be needed to deliver the services, in part due to inaccurate assumptions about the volume of activity. It originally anticipated that it would only need around 314 staff by March 2018, but its actual headcount was 736. Capita also acknowledges that it made performance issues worse, by continuing to close support offices in summer 2016 even though it was aware the customer service centre was struggling to meet demand. The site closures resulted in the loss of local expertise. Procedures in place to retain local expertise did not work effectively as the staff who were retained did not always understand the systems being used in other regions.
**
“Capita Business Services Ltd (Capita) acknowledges that it underestimated the number of staff that it would need to deliver PCSE and the time it would take to implement changes. Capita’s bid involved reducing the number of staff from 1,390 at the start of the contract to 314 by March 2018, in order to minimise its losses over the first two years of the contract (Figure 10). As at March 2018, it had 736 staff working on PCSE, as the number it originally forecast was insufficient. Capita told us that contributing factors to this underestimation included higher service volumes than predicted and the significant variation in how services were delivered, including by NHS England area teams. It has also taken longer than it anticipated to make changes to the service, because it underestimated the extent of variation in the way local support offices operated and the time it would take primary care providers to adapt to new ways of working.”

NHS England took months to act against Capita

“NHS England formally intervened in Capita’s management of the contract in September 2016. It told us that by the end of summer 2016, it had become clear that Capita’s improvement plans were ineffectual in some key areas and that issues had become more widespread. NHS England served default notices, placing five of Capita’s nine services in a formal rectification process: the customer support centre; the medical records service; the patient registration service; the national performers lists service; and payments to opticians. It also embedded an ‘expert management team’ in Capita, to work alongside operational staff and provide additional oversight and support.”

An appalling contract?

“NHS England’s performance measures did not cover all the service areas Capita were required to deliver. Without comprehensive service indicators, NHS England cannot tell whether the services meet the needs of primary care providers. NHS England did include performance measures in the contract, although these did not cover all the activities that Capita was required to deliver. A review of the contract, carried out by NHS England in March 2016, found that of 78 key activities that Capita was contracted to carry out, some 23 were not captured by performance measures and were therefore ‘invisible’ to NHS England. It identified that 13 of the 23 activities without performance measures could affect patient safety if not delivered to standard. NHS England are in ongoing discussions around extending performance monitoring (paragraphs 3.8 and 3.13).
**
“Performance measures lack indicators on providing a high-quality service, as NHS England’s focus was on efficiency. For example, the performance measure for payments to GPs measured whether Capita is making payments on time but not whether the payments are accurate.

**

“Performance measures do not always cover the end-to-end performance of PCSE. For example, the contract measures Capita’s performance in delivering patient records only from when the records are picked up from GP surgeries. They ignore any delays picking up the records – a particularly acute problem for GPs.”

What’s the point of a few KPIs in an appalling contract?

“There were still gaps in the performance measures used to monitor Capita’s performance when it started to make changes to PCSE. NHS England’s review of the contract, in March 2016, found that of 78 key activities that Capita was contracted to carry out, some 23 were not captured by performance measures and were therefore ‘invisible’ to NHS England. It identified that 13 of the 23 activities without performance measures could affect patient safety if not delivered to standard.
“NHS England’s performance measures were not flagging issues when stakeholders started raising concerns in April 2016. At this time, Capita was reporting that it was meeting all but 4 of the 49 performance measures set by NHS England. The stakeholders we spoke to consider that there is still a mismatch between Capita’s reported performance that takes into account factors that Capita considers to be outside its control, and the issues that they are experiencing on the ground.
“NHS England told us that service specifications lack detail in some areas which leads to disagreements, as they are open to different interpretations. Areas of misunderstanding include:
  • Performance measures. The contract allowed Capita to use less onerous performance measures during the transformation period, from February 2016 to August 2017. However, as the transformation is not yet complete, it is unclear whether Capita should still be using these measures. The measures that were to be applied from August 2017 set a higher standard of performance.
  • By May 2018, NHS England and Capita had still not agreed how to calculate 11 performance measures.
  • The method of calculating the volumes of services and payments. NHS England does not agree with the approach that Capita has used to calculate the volumes of services. It considers this approach to be inconsistent with the methodology described in the contract. The volumes being reported by Capita are significantly different to the baselines set out in the contract for some services.”

What’s the point of a contractual “target”?

“Capita’s contract with NHS England gave a three-month period to agree final service volumes and performance targets with NHS England. At the end of this period, Capita reported that it had not been able to collect sufficient information to complete this exercise.”

Problems escalate – and further contractual measures make things worse

“In March 2016, it (Capita) opened an online portal for primary care providers to order NHS forms and some medical supplies. However, the number of orders far exceeded its expectations and there were not enough vehicles to fulfil the orders. This also affected the movement of medical records, as the service used the same vehicles. There was also a shortage of stock in the NHS supply chain which resulted in further delays in fulfilling orders. As a result of these issues, the number of calls to Capita’s customer support centre was higher than predicted, and the centre could not cope with the increase in demand.
“In April 2016, Capita implemented a contingency arrangement for moving medical records, following the decision to delay the full roll-out in March. This involved a single courier collecting records from GP practices and taking them all to Capita’s Darlington depot for sorting before being distributed. All legacy local couriers ceased to operate at this point. There was a further increase in the number of calls to the customer support centre as GP practices raised queries about the new process.”

Incompetent risk assessment?

The biggest risk was whether Capita would perform – but NHS England put the focus of its risk assessment on the threat of not meeting the financial savings targets.

“NHS England’s assessment of the contract risk focused on the likelihood of it failing to achieve its financial savings target and did not adequately assess the risk of Capita failing to provide the service to a good standard. Gaps in the data meant that NHS England could not challenge whether assumptions in the contract were reasonable. NHS England considered that Capita had access to existing service expertise that they had used to inform and test their transformation plans. It did not bring in staff with senior-level skills in transforming a service, as it expected this expertise to sit within Capita .
**
“NHS England also did little to assess whether Capita had the necessary skills to transform services successfully. Capita had partnered with an existing provider of primary care support services, Anglian Community Enterprise, which Capita was to contract services from. NHS England told us that it therefore considered that Capita had access to existing service expertise that they could use to inform and test their transformation plans. NHS England did not bring in staff with senior-level skills in transforming a service, as it expected this expertise to sit within Capita.”

 Capita acts against NHS England’s wishes

NHS England did not have the contractual mechanisms to intervene in some of Capita’s service changes. Capita expected to make a loss of £64 million in the first two years of the contract. Its bid involved reducing the number of staff by two‑thirds by January 2018. Capita therefore had an incentive to close support offices and cut back on staff as quickly as possible, in order to minimise its losses in the first two years of the contract. In May 2016, NHS England wrote to Capita expressing concerns about the closure of support offices, and asked Capita to reconsider its plans to reduce its number of staff. Although Capita’s site closure programme required NHS England’s engagement throughout the process, the contract did not require NHS England’s agreement to close offices, and between May and November 2016, Capita closed a further 20 offices.
**
“NHS England was unable to stop Capita’s aggressive office closure programme, without cancelling the contract, even though it was having a harmful impact on service delivery.
“The contract provided incentives for Capita to close primary care support offices and cut back on staff as quickly as possible, so that it could minimise its losses in the first two years. However, NHS England wrote to Capita on 6 May 2016, expressing concerns about Capita’s plans to significantly reduce its staff numbers at a time when there were significant issues with its performance. It also questioned whether Capita’s plans to deliver efficiency savings over a period of a few weeks, to compensate for the reduction in staff, were realistic. Although Capita’s site closure programme required NHS England’s engagement throughout the process, the contract did not require NHS England’s agreement for Capita to close offices or reduce staff.
“Between May and November 2016, Capita closed a further 20 offices and reduced its headcount from 820 to 660 employees. Both NHS England and Capita recognise that Capita made performance issues worse in spring 2016, by continuing to close support offices, as this resulted in the loss of local expertise.”

Basic contract principles still not agreed – 3 years into the contract

“Basic principles about the contract are still not agreed, which limits NHS England’s ability to hold Capita to account. NHS England and Capita have still not agreed how to calculate the volume of work carried out in some areas, and how these data should be used to calculate payments owed to Capita for delivering the services. By May 2018, two and a half years into the contract, they have not yet agreed on how to calculate 11 performance measures. There is a contractual mechanism for putting a service in rectification but none for exiting the rectification process. Capita provided NHS England with reports in August and September 2017 setting out why services should be taken out of rectification, but NHS England has not formally responded to three of these service reports. NHS England told us that it was waiting for further evidence from Capita on two services before it could consider if rectification was complete.”

NHS England claims maximum service credits from Capita – but these are contractually capped

“NHS England has largely secured the financial savings it expected. In the first two years of the contract, NHS England made savings of £60 million compared with expected savings of £64 million, as the financial risk of increased costs sits with Capita. To date, NHS England has deducted £5.3 million from payments to Capita as penalties for poor performance. The financial penalties are capped at £480,000 a month and were applied in full between July 2016 and April 2017. NHS England noted in its 2016-17 financial statements that it expected that it may have to pay up to £3 million in compensation to primary care providers. Contract penalties have yet to be applied from May 2017 because NHS England does not accept Capita’s reported performance data due to disagreements about the scope of some of the measures. This disagreement only emerged once Capita’s self-reported performance no longer triggered maximum service credits.
**
“The contract allows NHS England to apply financial deductions if Capita does not meet certain performance standards from January 2016. For example, if Capita processes fewer than 98.25% of GP payments on time, it is deemed a moderate failure and triggers a minimum penalty of £10,800 a month. The maximum penalty that can be applied for service failures was £480,000 a month in the first two years of the contract. From year three, it is set at 20% of payments to Capita, excluding fixed investment changes. Figure 9 on page 28 shows that, by April 2017, NHS England had deducted £5.3 million from payments, represented 7% of the total payable to that point. The maximum penalty was applied between July 2016 and April 2017. Contract penalties have yet to be applied from May 2017 because NHS England does not accept Capita’s reported performance data due to disagreements about the scope of some of the measures.
**
“No contract penalties have yet been applied for the period after April 2017. Negotiations are continuing on the penalties to be applied for the rest of year two and beyond.”

Capita’s losses?

“NHS England and Capita have reached a settlement on the first two years of the contract but commercial discussions about the future of the service are ongoing. Both parties have agreed a full and final settlement of all known commercial issues for the first two years of the contract, to 31 August 2017. NHS England paid Capita an additional £3.2 million. Capita has absorbed significant additional costs in excess of the £64 million losses it anticipated in the first two years, resulting in a £125 million loss over this period, including write-offs and service credits. Since September 2017, there has been no agreement on the full basis of charging. Capita stopped invoicing NHS England for services from September 2017, but resumed invoicing in February 2018 on the agreement that it would not prejudice the commercial discussions.”

NHS England to blame as well as Capita

“As well as Capita, a number of other organisations, including NHS England, have contributed to the underperformance of PCSE services. For example:
“For the market entry service, Capita is required to provide NHS England with a file, so that they can make a decision about applications for new pharmacies within 70 days of receipt of the initial application. In November 2017, only 41% of applications were processed on time – either because applicants and referees had not provided key information, or decisions had not yet been received from NHS England.
“The performance of the medical records service has been affected by difficulties retrieving medical records held in NHS England’s archives as well as from current GP practices. It was also affected by poor implementation by Capita of the new national courier arrangement for moving records, and difficulties that GP practices experienced complying with a new labelling system.
“The performance of the national performers lists service has been affected by the lack of timely decisions on removals and suspension requests by NHS England’s area teams.
“NHS England acknowledges that some of the issues with GP payments and pensions are a result of legacy issues predating the contract with Capita. In particular, there are a number of inaccuracies and missing documents affecting GP pension records, which can affect the accuracy of payments.”

Take some services back in-house?

NAO recommendation: “Determine whether all current services within the PCSE contract are best delivered through that contract or whether some should be taken in-house by NHS England. Experience has now highlighted which services can most easily be delivered by Capita and which have more complex dependencies. The current commercial discussions present an opportunity to revisit responsibilities.”

Get the buy-in of service users (also an NPfIT failure)

NAO recommendation: “Secure user engagement in advance of service changes. Primary care providers are a valuable source of practical feedback and can offer insights that will improve service delivery, especially where changes through transformation are significant.”

Pilot changes properly (also an NPfIT failure)

NAO recommendation: “Pilot significant transformation changes effectively. Several changes to services were not initially implemented effectively. NHS England could profitably discuss with Capita when pilots would offer the greatest benefit.”

Don’t under-estimate risks (also an NPfIT failure)

NAO recommendation: “Create a joint risk register which would more thoroughly set out dependencies, mitigations, responsibilities and required actions. NHS England did not adequately assess the risk of service failure and Capita failed to recognise the scale and nature of the task it was taking on. A joint risk register would allow delivery challenges and actions to surface at an earlier stage.”

Risk-assess bidders

NAO recommendation: “Risk assess the likelihood of bidders being able to deliver their promises and challenge the targets and assumptions of bidders. This should include benchmarking bidders on their capability to deliver their promises, such as by examining past performance. There should also be sufficient modelling to understand the contractor’s cost drivers and incentives.”

Disputes continue …

“Whether Capita has met the criteria for services to be removed from the formal rectification process. Capita considers that services should be taken out of formal rectification, but NHS England thinks there are still issues that need to be resolved. NHS England told us that the contract does not set out the process for removing services from rectification. Capita provided NHS England with a report for each service in August and September 2017, setting out why it should be taken out of formal rectification. However, NHS England has not formally responded to three of these reports. It told us that it was waiting for further evidence from Capita on two services before it could consider if rectification was complete.
**
“NHS England told us it considers that PCSE’s performance has improved. In February 2018, Capita Business Services Ltd (Capita) reported that it was meeting 41 out of 45 of its mitigated performance indicators, where information was available after taking into account factors Capita considered beyond its control. Capita was reporting one severe failure, which was for not notifying opticians that they had submitted an invalid payment claim within 30 calendar days. In November 2017, Capita reported it was meeting 40 out of 43 of its mitigated indicators, with one severe service failure. NHS England has not accepted Capita’s reported performance since May 2017 for 11 measures where there is a difference of view about how it should be calculated.
“The unadjusted underlying performance provides a better indicator of the performance that primary care providers are experiencing on the ground. In February 2018, unadjusted performance was more variable (32 out of 45 indicators being met) with seven severe service failures. In November 2017, only 28 out of 43 unadjusted performance indicators were being met, with 10 areas of severe service failure. Paragraph 2.13 describes how unmitigated performance is influenced not just by Capita, but by other organisations, including NHS England.
**
“For the period from 1 September 2017, NHS England and Capita are currently in unresolved commercial discussions. The main areas of disagreement are:
  • price bands – NHS England and Capita do not agree on the methodology for calculating the volumes of services
  • uncertainties about which performance measures should apply and the methodology for measuring performance against these measures
  • whether contract changes should be made for services that Capita considers are outside the scope of the original contract; and
  • the financial costs of delays in delivering transformation and the dependencies on NHS England and NHS Digital to support transformation.
“Because of the absence of an agreed basis for charging, Capita stopped invoicing NHS England for services from September 2017. Capita resumed invoicing in February 2018 on the agreement that it would not prejudice the commercial discussions.”

Comment

Today’s excellent National Audit Office report makes invaluable reading for anyone who is involved in implementing a major IT-related project or programme.

The depressing thing is that lessons from the 1997 book “Crash” – a collection of post mortems of the world’s worst IT disasters – have changed little in 20 years.

Capita has its accountabilities – in the share price and the jobs of senior people on the NHS England contract, some of whom have been replaced, including the PCSS managing director.

Who will be held responsible at NHS England for failures on the Capita contract? Nobody, as you’d expect in the public service. Decisions to outsource GP support services – against the firm advice of many GPs – were taken collectively. The responsibility is therefore diffuse and unidentifiable.

Clearly NHS England has repeated many of the classic mistakes; and in years to come NHS England, or its successor organisation, will probably do the same again because there’s no such thing as an institutional memory.

One possible answer may be for those involved in making big decisions on IT-related contracts in the public sector to be mandated to read – and assimilate – today’s National Audit Office report on GP support services, knowing that the report unwittingly identifies so many of the classic IT-related project and programme blunders.

National Audit Office report on Capita’s Primary Care Support Services contract 

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Are you happy paying to help with problem Capita contract?

By Tony Collins

This week, as Barnet residents go to the polls, how many will be influenced by the continuing national and local media coverage of the council’s mass outsourcing deal with Capita?

Barnet’s Capita contracts are a local election issue. The council’s conservatives and Capita say the outsourcing contracts have saved money and are performing as expected “in many areas”.

But a former local Tory councillor Sury Khatri , who has been deselected after criticising the Capita contract, described the deal as “disastrous”. Barnet has paid Capita £327m since the deals were signed in 2013. Capita runs council services that range from cemeteries to IT.

Councillor Khatri said,  “My time at the council has been overshadowed by the disastrous Capita contract that is falling apart at the seams. Four years on, issues still keep rolling out of the woodwork. This contract represents poor value for money, and the residents are being fleeced.”

Another critic of the Capita contracts is John Dix who blogs as “Mr Reasonable” and is one of several highly respected local bloggers. He has been studying the council’s accounts for some years. He runs a small business and is comfortable with accounts and balance sheets.

He writes,

“I have no problem with outsourcing so long as it is being done for the right reasons. Typically this is where it involves very specialist, non core activities where technical expertise may be difficult to secure and retain in house.

“In Barnet’s case this outsourcing programme covered so many services which were core to the running of the council and which in 2010 were rated as 4 star (good). Barnet has been an experiment in mass outsourcing and almost five years in, it appears to be a failure.

“Last night’s [19 April 2018] audit committee was a litany of service problems, system failures, lack of controls, under performance, a major fraud. Internal audit saying issues were a problem, Capita saying they weren’t.”

Shadow Chancellor John McDonnell has entered the debate. He has applauded Barnet’s Unison branch for its enduring, close scrutiny of the Capita contracts. Unison this week published a report on the deal.

Capita’s share price rises

Earlier this month the national press reported extensively on concerns that Capita would follow Carillion into liquidation.

Since the bad publicity, the company’s announcement of a pre-tax loss of £535m, up from £90m the previous year, £1.2bn of debt and a rights issue to raise £662m after fees by selling new shares at a discount, Capita’s share price has risen steadily, from a low a month ago of about 130p to about 191 yesterday.

Could it be that investors sense that Capita’s long-term future is secure: the company has a wide range of complex and impenetrable public sector contracts where history shows that public sector clients – ruling politicians and officials – will defend Capita more enthusiastically than Capita itself, whatever the facts?

A list of some of Capita’s problem contracts is below the comment.

Comment

Carillion, a facilities management and construction company, collapsed in part because the effects of its failures were usually obvious: it was desperately short of money and new roads and hospitals were left unfinished.

When IT-based outsourcing deals go wrong, the effects are usually more nuanced. Losses can be hidden in balance sheets that can be interpreted in different ways; and when clients’ employees go unpaid, or the army’s Defence Recruiting System has glitches or medical records are lost, the problems will almost always be officially described as teething even if, as in Capita’s NHS contracts, they last for years.

It is spin that rules and protects IT outsourcing contracts in the public sector. Spin hides what’s really going on. It is as integral as projected savings and key performance indicators.

When Somerset County Council signed a mass outsourcing deal with IBM, its ruling councillors boasted of huge savings. When the deal went wrong and was ended early after a legal dispute with IBM the council announced that bringing the deal in-house would bring large savings: savings either way. Liverpool council said the same thing when it outsourced to BT – setting up a joint venture called Liverpool Direct – and brought services back-in house: savings each time.

Barnet Council is still claiming savings while the council’s auditors are struggling to find them.

Spinmeisters know there is rarely any such thing as a failed public sector IT contract: the worst failures are simply in transition from failure to success. Barnet’s council taxpayers will never know the full truth, whoever is in power.

Even when a council goes bust, the truth is disputed. Critics of spending at Northamptonshire County Council, which has gone bust, blame secretive and dysfunctional management. Officials, ruling councillors and even the National Audit Office blame underfunding.

In March The Times reported that Northamptonshire had paid almost £1m to a consultancy owned by its former chief executive. It also reported that the council’s former director of people, transformation and transactions for services, was re-hired on a one-year contract that made her company £185,000 within days of being made redundant in 2016.  Her firm was awarded a £650-a-day IT contract that was not advertised.

In the same month, the National Audit Office put Northamptonshire’s difficulties down to underfunding. It conceded that the “precise causes of Northamptonshire’s financial difficulties are not as yet clear”.

Perhaps it’s only investors in Capita who will really know the truth: that the full truth on complex public sector contracts in which IT is central will rarely, if ever, emerge; and although Capita has internal accountability for failures – bonuses, the share price and jobs can be affected – there is no reason for anyone in the public sector to fear failure. No jobs are ever affected. Why not sign a few more big outsourcing deals, for good or ill?

Thank you to FOI campaigners David Orr and Andrew Rowson for information that helped me write this post.

Some of Capita’s problem contracts

There is no definitive list of Capita’s problem contracts. Indeed the Institute for Government’s Associate Director Nick Davies says that poor quality of contract data means the government “doesn’t have a clear picture of who it is buying from and what it is buying”. Here, nevertheless, is a list of some of Capita’s problem contracts in the public sector:

Barnet Council

A Capita spokesperson said: “The partnership between Capita and Barnet Council is performing as expected in many areas. We continue to work closely with the council to make service enhancements as required.”

Birmingham City Council

“The new deal will deliver a mix of services currently provided under the joint venture, plus project based work aimed at providing extra savings, with forecasts of £10 million of savings in the current financial year and £43 million by 2020-21.”

West Sussex County Council

A spokesman said, “Whatever your concerns and small hiccups along the way, I believe this contract has been and will continue to be of great benefit to this county council.”

Hounslow Council

A Capita spokesperson said: “We are working closely with the London Borough of Hounslow to ensure a smooth transition of the pensions administration service to a new provider.”

Breckland Council

“They concluded that planning officers, working for outsourcing company Capita, had misinterpreted a policy, known as DC11, which dictates the amount of outdoor playing space required for a development..”

Army

Mark Francois, a Conservative former defence minister,  said Capita was known “universally in the army as Crapita”. But Capita said in a statement,

“Capita is trusted by multiple private and public clients to deliver technology-led customer and business process services, as demonstrated by recent wins and contract extensions from clients including British Gas, Royal Mail, BBC, TfL Networks, M&S and VW.”

Electronic tagging

(but it’s alright now)

A Ministry of Justice spokeswoman said: “As the National Audit Office makes clear, there were challenges in the delivery of the electronic monitoring programme between 2010 and 2015…

“As a direct result, we fundamentally changed our approach in 2015, expanding and strengthening our commercial teams and bringing responsibility for oversight of the programme in-house.

“We are now in a strong position to continue improving confidence in the new service and providing better value for money for the taxpayer.”

Disability benefits

A spokesperson for the Department for Work and Pensions said, “Assessments work for the majority of people, with 83 per cent of ESA claimants and 76 per cent of PIP claimants telling us that they’re happy with their overall experience…”

Miners

A Capita spokesperson said: “This issue has been resolved and all members affected will shortly receive letters to advise that they do not need to take any action. We sincerely apologise for any concern and inconvenience this has caused.”

NHS

Opticians

Dentists

BBC licence fee

Windrush

Hundreds of IT-related deaths in the NHS every year? … why the full truth will never emerge

By Tony Collins

Two academics have given talks in London about the number of NHS patients who might have died because of IT-related problems.

Their comments come almost exactly five years after the Francis report into the “appalling suffering” of patients at Mid Staffordshire NHS Foundation Trust. The Francis report criticised an NHS culture that lacked candour and openness. Has that culture changed?

One of the academics was Martyn Thomas, a visiting professor in software engineering at Oxford, Aberystwyth and Bristol universities. The other academic was Harold Thimbleby, professor emeritus of geometry at Gresham College in London and professor of computer science at Swansea University.

IT is used in nearly every area of hospital activity, from storing and retrieving medical record to making appointments. Technology is also embedded in devices hat include MRI scanners and dialysis machines.

Speaking at a briefing before a lecture, Thimbleby said: “If you go into a hospital there isn’t a good word to describe how bad stuff in a hospital is and how unaware people are in hospitals of the low quality: they’re stuck with it. They’re over-worked, they’ve got a job to do and understanding the computer systems isn’t part of their job …”

He added that NHS computer-related deaths each year of between 100 and 900 people could be a big underestimate.

“Piper Alpha had 167 deaths and there was a public inquiry; Ladbroke Grove, the rail crash in Paddington had 31 deaths and there was a public inquiry; Grenfell, the fire last year had 71 years, and there is a public inquiry. Why don’t we have a public inquiry in the safety of hospital software?”

Thomas described how research in the USA has shown that 8% of all deaths are caused by errors in hospitals. In the UK, this could equate to tens of thousands of preventable adverse events in hospitals, he said.

He added that a significant proportion of clinical negligence claims in the NHS are due to poor and buggy computer systems that lead professionals into making mistakes – which are blamed on the professionals.

“That’s a lot of money going into liability claims; it’s a lot of trauma to patients and their families and it is a lot of trauma for staff because the staff get blamed and it really isn’t their fault.”

Thimbleby and Thomas called for better regulation of healthcare computers and more research into the implications of errors.

A Department of Health and Social Care spokeswoman told the Press Association,  “Patient safety is our priority, and our £4.2 billion investment in technology will help eliminate avoidable harm.”

But do hospitals generally report IT-related incidents that cause – or are suspected to have caused – harm?

Bath’s Royal United Hospital

Three year-old Samuel Starr died in the arms of his parents as his they read him his favourite stories at the local hospital.

At an inquest in 2014, his parents, and specialists, raised questions about whether long delays in arranging appointments on a new Cerner Millennium system at Bath’s Royal United Hospital, which replaced an old “TDS” patient administration system, was a factor in his death.

Ben Peregrine, the speciality manager for paediatrics at the RUH in Bath,  told the inquest:

“Samuel’s appointment request must have fallen through the cracks between the old and new system.”

After successful heart surgery at 9 months, Samuel should have had regular scans to see if his condition had worsened. But he didn’t have any scans for 20 months, in part because of difficulties in organising the appropriate appointments on Bath’s new Millennium systems.

Though there is no certainty, Samuel may be alive today if he’d had the scans.

“Success”

A year after the inquest, one of the supplier’s announcements on its website was about the success of its go-live at the Royal United Hospital, Bath.

“Royal United Hospitals Bath NHS Foundation Trust and Cerner have been working together to implement Cerner Millennium Maternity functionality in a RECORD TIME! It took only three months from the start of the project to its “go-live”! This is a first in the UK!

“The success of this implementation was mainly due to the very strong collaboration between Cerner and the Trust’s team…”

The success was in maternity – not paediatrics where Samuel Starr was being treated – but there was no reference to any Cerner-related implementation problems at the Royal United Hospital.

Has anything changed?

As the Francis report into Mid-Staffordshire trust’s failings found in 2013, the NHS has its own “house style” for how it handles the reporting of its not-so-good news – or suspected harm – to patients.

The Royal United Hospital Bath has a “normal” NHS way of reporting IT-related matters. It has an NHS-specific “good news” house style that hasn’t changed in decades.

One Royal United board paper reported that it had “only” 14 breaches that month [November 2017] of its target for treating patients with suspected cancer within 62 days of urgent referral by a GP.

And anyone looking in the hospital’s board papers for details of its recent IT-related problems would have no answer to any of these basic questions:

  •  how many patients were affected?
  •  in what way were they affected?
  • what was done about it?
  • why did it happen?

On 7 November 2017, Royal United Hospital implemented what it called the “Big 3”. The first of the Big 3 was the “Cerner Millennium EPMA”. There was no explanation in the board papers, at least for the benefit of non-executive directors, of what EPMA meant (electronic prescribing and medicines administration).

The second of the big three was “First Net”. Again no explanation that it is a Cerner product that helps to support triage and tracking, ordering tests and recording results, integrating documents into the patient’s electronic medical record, providing discharge plans along with GP follow-up instructions and prescriptions and management reporting.

The third of the Big 3 was “order comms” which, again, had no explanation. Order comms replaces paper by allowing doctors and nurses to order things electronically such as x-rays and receive updates on their systems.

More importantly, the Royal United Hospital’s board papers omit to give any context of the Big 3 go-live. What will it provide that numerous go-lives and past updates haven’t provided? No answer.

The RUH was one of the first computerised large hospitals in the UK. It bought into the controversial Regional Information System Plan of Wessex Regional Health Authority. The Plan wasted millions in the early 1990s.

Subsequently Tony Blair introduced the ill-fated NHS IT programme – the National Programme for IT [NPfIT] in the NHS. In  2002, the Royal United Hospital bought into that too. It replaced its Wessex “TDS” system with the Cerner electronic patient system from BT, one of the NPfIT suppliers.

The NPfIT was dismantled in 2011 with losses of billions of pounds, though some hospitals including Royal United, continue to use updated NPfIT systems.

The new Big 3 go-live went well, according to a report to the Royal United Hospital board. It said the “systems went live within the proposed project timescales” and the go-live “was successful overall”. But there’s no explanation of what didn’t go well, merely a brief mention that a “unified focus was required to complete the project”.

If you look carefully amid the graphs, bar charts, diagrams and statistics of the board papers, it’s possible to see that not everything went well. There’s a chart that shows a significant fall in emergency patients seen within the target of four hours when the Cerner systems went live. The fall is shown on a chart that looks at first as if it’s positive news: it reports the results of a “4-hour maximum wait in ED (Emergency Department) – improvement trajectory”:

And the last paragraph of text that accompanies an obscure chart in a different part of the board papers says that the trust’s four-hour wait remains the “trust’s most significant performance issue”.

But “normal” NHS house style still unofficially requires an obscure use of language when things go wrong, as if patients are not involved. Hence there’s no mention in the hospital’s board papers of any patients that might have been affected by problems with the Big 3 implementation.

These are some extracts from the Royal United Hospital’s board papers:

  • “Negative impact due to Big 3 go live on the 7th November 2017 specifically affecting early flow, time to assessment and time to treatment. Improvement plan in place.”
  •  “Due to the Big 3 Go Live on 7th November, the ED Clinical Quality timing indicators are under review pending ED clinical validation and a workflow investigation. Upon successful data quality review, the ED clinical quality indicators will be reinstated in the Performance Report.”
  • RTT incomplete pathways in 18 weeks at 88.2% below the Trusts Improvement Trajectory and the 92% national standard. This is slightly improved performance from October.
  • Overall 4 hour performance not achieved for Majors or Minors.
  • The Board are asked to discuss November performance, noting the impact on performance from the ‘Big 3’ go-live. Some performance metrics are not shown for November on the scorecard as data is being validated following the ‘Big 3’ go-live. IT and BIU are working to resolve this.”

Comment

Thimbleby and Thomas refer to an unknown number of deaths in the NHS because of a variety of IT-related problems. Nobody has any real idea of the numbers.

That the truth is obscured is not the fault of NHS IT people. They deserve much understanding, even sympathy. They often have poor work environments – sometimes in grim pre-fabricated huts or decaying buildings overlooking the car park – that have the usual hospital disinfectant smells and equipment that would be welcomed by IT museum curators. This post is not directed at them.

It’s directed at the NHS culture of  board reporting that turns up the volume on good news and buries in impenetrable NHS house style bad news.

Thimbleby and Thomas are to be applauded for drawing attention to NHS IT-related deaths. The circumstances of Samuel Starr’s death show that NHS administrative problems can have fatal consequences – yet the NHS generally categorises administrative IT systems as having no patient safety implications.

Earlier this month the National Audit Office reported that thousands of clinical notes went astray under an NHS outsourcing contract with Capita. We were told that nobody was harmed.

Despite the Francis report into unnecessary deaths and suffering at the Mid Staffordshire NHS Foundation Trust in 2013, the NHS trust board culture, at least when it comes to reporting on IT-related problems, has not changed. These were some of the Francis report’s findings that are relevant to IT reporting to NHS boards today:

  • A culture focused on doing the system’s business – not that of the patients;
  • An institutional culture which ascribed more weight to positive information about the service than to information capable of implying cause for concern;
  • Standards and methods of measuring compliance which did not focus on the effect of a service on patients;
  • A failure to tackle challenges to the building up of a positive culture.

One of the main recommendations of the Francis has certainly not been implemented.

“Ensure openness, transparency and candour throughout the system about matters of concern.”

Thank you to Zara Pradyer for alerting me to articles about the NHS and IT-related deaths. Thank you also to a local newspaper journalist who alerted me to the trust board papers.

A tragic outcome for Cerner Millennium implementation at Bath.

NHS computer problems could be responsible for hundreds of deaths, academics claim

Francis report into Mid Staffordshire’s failings – executive summary

Deaths and electronic medical records

Government Digital Service loses “genius” and “national treasure”. Is Sir Humphrey winning campaign to dismember GDS?

,By Tony Collins

The dismembering of the Government Digital Service is underway, says Andrew Greenway, a former programme manager working on digital projects for the Cabinet Office. He now works as an independent consultant.

His comments in Civil Service World came, coincidentally, as another top GDS official prepared to leave.

Paul Downey, GDS’s Technical Architect – who is described by former colleagues as a “legend” and “national treasure” – has left to join the Ministry of Housing, Communities and Local Government.

Downey is the latest in a long line of leading government technologists to leave GDS, which will confirm in the minds of many that Sir Humphrey has won the campaign to stop GDS interfering in the 100 year-old autonomy of individual government departments.

Cabinet Office minister Francis Maude and entrepreneur Martha Lane Fox set up GDS in 2011 to break down departmental silos and have a “single version of the truth” for everything that government touches.

Former prime minister David Cameron said the creation of GDS “is one of the great unsung triumphs of the last Parliament”

Downey helped departments to create new digital services. He represented GDS on the UK government Open Standards Board. Formerly he was BT’s Chief Web Services Architect.

In reply to Downey’s tweet announcing his departure, Stephen Foreshew-Cain, former Executive Director of GDS, tweeted, “When people talked about standing on the shoulders of giants, they were talking about you.”

Mike Bracken, Foreshew-Cain’s predecessor as head of GDS, tweeted about Downey’s departure, “You’re a legend, my friend”.

Tom Loosemore, founder of GDS who, in 2012, wrote the Government Digital Strategy for GDS, also tweeted praise for Downey.

Loosemore left GDS in 2015 for the Co-op group. In an interview shortly after leaving, Loosemore said, “The shape of government needs to change … Businesses don’t run on siloed departments any more and neither should government.”

Liam Maxwell, National Technology Adviser at HM Government who used to be the government’s chief technology officer and who ran teams at GDS, tweeted,”You have been total inspiration to me and hundreds of others”.

Dismembering

Greenway said GDS retains people, prestige and power.  “There is no question that the civil service is in a much stronger position on digital than it was six years ago. Some of the work going on in government, including the teams in GDS building digital platforms, remains world-leading”.

Despite bleeding skills elsewhere, GDS has not experienced a terminal brain drain, says Greenway. “Many of those who have stayed are doing a heroic job in trying circumstances.”

But he added that officials working on digital programmes in other departments describe the GDS team as well-meaning but increasingly peripheral.

 It now looks as if the Department of Digital, Culture, Media and Sport will take over from GDS. But Greenway warns against replacing a weakened centre with diffuse departmental effort.

“The point of GDS was to have a single team that could act as the voice of users for government as a whole. To do that well, it needed a mandate covering data as well as design, operations and technology. It also had to have a clear mission. Increasingly, it has neither of these.

“The departmental shape of government gives no incentive for any non-central department to step in. It is a great shame that the two most well-placed advocates for an effective centre — the Treasury and Sir Jeremy Heywood — have proved unable or unwilling to stop the rot …

“The dismembering of GDS is underway.”

Comment

GDS was a great idea. But Sir Humphries tend not to like great ideas if they mean internal change. Permanent secretaries are appointed on the basis that they are a safe pair of hands.  Safe in this context means three things:

  • not spilling the beans however rancid they may be
  • valuing  department’s unique heritage, administrative traditions, staff and procedures
  • talking daily of the need for large-scale “transformative” change while ensuring it doesn’t happen.

Thus, for the past few years, GDS professionals have found that top civil servants want central government departments to continue to be run as separate bureaucratic empires with their uniqueness and administrative traditions preserved.

GDS technologists, on the other hand, want to cut the costs of running Whitehall and the wider public sector while making it easier for the public to interact with government. This puts GDS at odds with Whitehall officials who believe that each departmental board knows best how to run its department.

In the long run GDS cannot win – because it was set up by politicians who wanted change but whose stewardship was temporary while the will to dismember GDS comes from the permanent secretariat who do not welcome change and have the power to resist it.

More’s the pity because taxpayers will continue to spend a fortune on preserving departmental silos and huge, unnecessarily-complex technology contracts.

Andrew Greenway on the dismembering of GDS – Civil Service World

GDS deserves credit for its successes – Government Computing

GDS to lose some policy control? – Computer Weekly

Government Digital Service blog

Government Digital Service being “dismembered”

Capita’s problems were “preventable” says Royal London

By Tony Collins

Royal London, a Capita investor, said yesterday it has been “raising concerns about Capita’s weak governance with the firm for a number of years, and voting against many resolutions on director re-elections and pay consistently since 2014.”

Royal London is the UK’s largest mutual life, pensions and investment company. It managed £113bn of funds as of 31 December 2017. It owns a 0.44% stake in Capita.

Ashley Hamilton Claxton, Royal London Asset Mananagement’s Head of Responsible Investment, said in a statement,

“We welcome the honesty and transparency with which Capita’s new CEO has accepted the company’s past failings, and put a plan in place to simplify and improve the business. However, we believe this was preventable and have been privately raising concerns about Capita’s weak governance with the firm for a number of years, and voting against many resolutions on director re-elections and pay consistently since 2014.

“Until recently, Capita’s board flouted one of the basic rules of the corporate governance code, with a small board primarily comprised of management insiders. The result was a board that lacked the independent spirit to rigorously assess whether the company was making the right long-term decisions.

“Our concerns about governance were compounded by the complexity of the underlying business and the company’s acquisition strategy. Capita’s approach to remuneration also left something to be desired, with major losses in 2013 being excluded from the profit figures used to assess the bonuses paid to executives at the firm.

“The sea change in the board over the past 18 months has been welcome and has addressed the key issue of independence. It will be up to the new Chairman and the Board to ensure that Capita does not repeat the mistakes of the past, and that its strategy is fit for purpose during a particularly turbulent time for the outsourcing sector.”

Last week Capita issued a profits warning and announced plans to raise £700m from investors to reduce debts.

With Capita seeking to raise money and cut costs, where will this leave local government customers that are reliant on the supplier to cut the costs of running local services?

Barnet Council has, controversially, contracted out a large chunk of its services to Capita – and also gives the company tens of millions in advance payments in return for a discount on the supplier’s fees.

By becoming a “commissioning council”, Barnet has made itself wholly reliant on Capita, say critics of the outsourcing deal. Among other responsibilities, Capita produced the council’s latest annual accounts – including a financial account of its own services to the council. The accounts were not produced on time which created extra chargeable work for the council’s auditors BDO.

Capita has run into problems on a number of its major outsourcing deals. The National Audit Office is investigating its work on GP support services.

Councillor Barry Rawlings, leader of the Labour group in Barnet, said the profits warning and Capita’s low share price raised questions about how it may respond to further troubles.

He told The Guardian that Capita may be looking to cut back services it supplies.

“Capita handles all of the back office, enforcement, planning, environmental health, trading standards, estates, payroll and so on. Will that be part of their core services? We might be one of the only places they do some things. If they narrow their scope, what is going to happen to these services?

Conservative leader of  Barnet council, Councillor Richard Cornelius, said,  “Capita currently runs approximately 10 per cent of our services by value. They do not run the entire council as some reports have suggested.

“The council regularly reviews the financial status of its major suppliers as part of its contract management and contingency planning arrangements. This is what any responsible local authority would do.”

Capita’s share price has more than halved in the last month – from about 400p to a low on 1 February 2018 of 158p – but today rose by about 10% to 196.

Comment

When an outsourcing giant is looking to cut its costs and raise money to cover debts, how does that square with local government customers that also want to cut costs – which is why they outsourced to Capita?

Outsourcing can make good sense – when for example a global company like BP wants to standardise IT services across the world. It doesn’t always make sense when an organisation wants a service transformation while also cutting costs. Something usually has to give which, perhaps, Barnet Council and its taxpayers are slowly finding out.

Ministers told of major problem on Capita NHS contract more than a year later

By Tony Collins

Today’s Financial Times and other newspapers cover a National Audit Office report into GP clinical notes and correspondence, some of it urgent, that was not directed to the patient’s GP.

The correspondence was archived by Capita under its contract to provide GP support services. But patient notes were still “live”. They included patient invitation letters, treatment/diagnosis notes, test results and documents/referrals marked ‘urgent’.

What isn’t well reported is that ministers were left in the dark about the problems for more than a year. The National Audit Office does not blame anyone – its remit does not include questioning policy decisions – but its report is impressive in setting out of the facts.

Before NHS England outsourced GP support services to Capita in 2015, GPs practices sent correspondence for patients that were not registered at their practice to local primary care services centres, which would attempt to redirect the mail.

By the time Capita took over GP support services on 1 September 2015, GPs were supposed to “return to sender” any correspondence that was sent to them incorrectly – and not send it to primary care services centres that were now run, in part, by Capita.

But some GPs continued to send incorrectly-addressed correspondence to the primary care services centres. Capita’s contract did not require it to redirect clinical correspondence.

An unknown number of GP practices continued to send mail to the centres, expecting the centre’s staff to redirect it. A further complication was that Capita had “transformation” plans to cut costs by closing the primary care services support centres.

Capita made an inventory of all records at each site and shared this with NHS England. The inventories made reference to ‘clinical notes’ but at this point no one identified these notes as live clinical correspondence. Capita stored the correspondence in its archive.

In line with its contract, Capita did not forward the mail. It was not until May 2016 – eight months after Capita took over the primary care services centres – that Capita told a member of NHS England’s primary care support team that there was a problem with an unquantified accumulation of clinical notes.

It was a further five months before Capita formally reported the incident to NHS England. At that time Capita estimated that there was an accumulation of hundreds of thousands of clinical notes. When the National Audit Office questioned Capita on the matter, it replied that, with hindsight, it believes it could have reported the backlog sooner.

In November 2016, Capita and NHS England carried out initial checks on the reported backlog of 580,000 clinical notes. It wasn’t until December 2016 that ministers were informed of problems – more than a year after Capita took over the contract.

Even in December 2016 ministers were not fully informed. Information about a backlog of live clinical notes was within in a number of items in the quarterly ministerial reports. NHS England did not report the matter to the Department of Health until April 2017 – about two years after the problems began.

Even then, officials told ministers that clinical notes had been sampled and were considered “low clinical and patient risk”. But a later study by NHS England’s National Incident Team identified a backlog of 1,811 high priority patient notes such as documents deemed to be related to screening or urgent test results.

The National Audit Office says, “NHS England expects to know by March 2018 whether there has been any harm to patients as a result of the delay in redirecting correspondence. NHS England will investigate further where GPs have identified that there could be potential harm to patients. The review will be led by NHS England’s national clinical directors, with consultant level input where required.”

Last month Richard Vautrey, chairman of British Medical Association’s General Practitioners Committee, wrote to the NHS Chief Executive Simon Stevens criticising a lack of substantial improvement on Capita’s contract to run primary care service centres.

In December, the GP Committee surveyed practices and individual GPs on the Capita contract. The results showed a little improvement across all service lines, when compared to its previous survey in October 2016, but a “significant deterioration” in some services. Vautrey’s letter said,

“While any new organisation takes time to take over services effectively, the situation has gone from bad to worse since Capita took over the PCSE [Primary Care Support England] service almost two and a half years ago …

“This situation is completely unacceptable. As a result of the lack of improvement in the service delivery of PCSE we are now left with no option but to support practices and individual doctors in taking legal routes to seek resolution. While this is taking place, we believe it is imperative that NHS England conducts a transparent and comprehensive review of all policy, procedures and processes used by PCSE across each service line.”

Comment:

It’ll be clear to some who read the NAO report that the problems with urgent patient notes going astray or being put mistakenly into storage, stems from NHS England’s decision to outsource a complex range of GP support services without fully considering – or caring about – what could go wrong.

It’s not yet known if patients have come to harm. It’s clear, though, that patients have been caught in the middle of a major administrative blunder that has complex causes and for which nobody in particular can be held responsible.

That ministers learned of a major failure on a public sector outsourcing deal over a year after live patient notes began to be archived is not surprising.

About four million civil and public servants have strict rules governing confidentiality. There are no requirements for civil and public service openness except when it comes to the Freedom of Information Act which many officials can – and do – easily circumvent.

Even today, the fourth year of Capita’s contract to run GP support services, the implications for patients of what has gone wrong are not yet fully known or understood.

It’s a familiar story: a public sector blunder for which nobody will take responsibility, for which nobody in particular seems to care about, and for which the preoccupation of officialdom will be to continue playing down the implications or not say anything at all.

Why would they be open when there is no effective requirement for it? It’s a truism that serious problems cannot be fixed until they are admitted. In the public sector, serious problems on large IT-related contracts are not usually fixed until the seriousness of the problems can no longer be denied.

For hundreds of years UK governments have struggled to reconcile a theoretical desire for openness with an instinctive and institutional need to hide mistakes. Nothing is likely to change now.

National Audit Office report – Investigation into clinical correspondence handling in the NHS.

Companies nervous over HMRC customs IT deadline?

By Tony Collins

This Computer Weekly article in 1994 was about the much-delayed customs system CHIEF. Will its CDS replacement that’s being built for the post-Brexit customs regime also be delayed by years?

The Financial Times  reported this week that UK companies are nervous over a deadline next year for the introduction of a new customs system three months before Brexit.

HMRC’s existing customs system CHIEF (Customs Handling of Import Export Freight) copes well with about 100 million transactions a year. It’s expected a £157m replacement system using software from IBM and European Dynamics will have to handle about 255 million transactions and with many more complexities and interdependencies than the existing system.

If the new system fails post-Brexit and CHIEF cannot be adapted to cope, it could be disastrous for companies that import and export freight. A post-Brexit failure could also have a serious impact on the UK economy and the collection of billions of pounds in VAT, according to the National Audit Office.

The FT quoted me on Monday as calling for an independent review of the new customs system by an outside body.

I told the FT of my concern that officials will, at times, tell ministers what they want to hear. Only a fully independent review of the new customs system (as opposed to a comfortable internal review conducted by the Infrastructure and Projects Authority) would stand a chance of revealing whether the new customs system was likely to work on time and whether smaller and medium-sized companies handling freight had been adequately consulted and would be able to integrate the new system into their own technology.

The National Audit Office reported last year that HMRC has a well-established forum for engaging with some stakeholders but has

“significant gaps in its knowledge of important groups. In particular it needs to know more about the number and needs of the smaller and less established traders who might be affected by the customs changes for the first time”.

The National Audit Office said that the new system will need to cope with 180,000 new traders who will use the system for the first time after Brexit, in addition to the 141,000 traders who currently make customs declarations for trade outside the EU.

The introduction in 1994 of CHIEF was labelled a disaster at the time by some traders,  in part because it was designed and developed without their close involvement. CHIEF  was eventually accepted and is now much liked – though it’s 24 years old.

Involve end-users – or risk failure

Lack of involvement of prospective end-users is a common factor in government IT disasters. It happened on the Universal Credit IT programme, which turned out to be a failure in its early years, and on the £10bn National Programme for IT which was dismantled in 2010. Billions of pounds were wasted.

The FT quoted me as saying that the chances of the new customs system CDS [Customs Declaration Service) doing all the things that traders need it to do from day one are almost nil.

The FT quotes one trader as saying,

“HMRC is introducing a massive new programme at what is already a critical time. It would be a complex undertaking at the best of times but proceeding with it at this very moment feels like a high stakes gamble.”

HMRC has been preparing to replace CHIEF with CDS since 2013. Its civil servants say that the use of the SAFe agile methodology when combined with the skills and capabilities of its staff mean that programme risks and issues will be effectively managed.

But, like other government departments, HMRC does not publish its reports on the state of major IT-related projects and programmes. One risk, then,  is that ministers may not know the full truth until a disaster is imminent.

In the meantime ministerial confidence is likely to remain high.

Learning from past mistakes?

HMRC has a mixed record on learning from past failures of big government IT-based projects.  Taking some of the lessons from “Crash”, these are the best  things about the new customs project:

  • It’s designed to be simple to use – a rarity for a government IT system. Last year HMRC reduced the number of system features it plans to implement from 968 to 519. It considered that there were many duplicated and redundant features listed in its programme backlog.
  • The SAFe agile methodology HMRC is using is supposed to help organisations implement large-scale, business-critical systems in the shortest possible time.
  • HMRC is directly managing the technical development and is carrying out this work using its own resources, independent contractors and the resources of its government technology company, RCDTS. Last year it had about 200 people working on the IT programme.

These are the potentially bad things:

  • It’s not HMRC’s fault but it doesn’t know how much work is going to be involved because talks over the post-Brexit customs regime are ongoing.
  • It’s accepted in IT project management that a big bang go-live is not a good idea. The new Customs Declaration Service is due to go live in January 2019, three months before Britain is due to leave the EU. CHIEF system was commissioned from BT in 1989 and its scheduled go-live was delayed by two years. Could CDS be delayed by two years as well? In pre-live trials CHIEF rejected hundreds of test customs declarations for no obvious reason.
  • The new service will use, at its core,  commercially available software (from IBM) to manage customs declarations and software (from European Dynamics) to calculate tariffs. The use of software packages is a good idea – but not if they need large-scale modification.  Tampering with proven packages is a much riskier strategy than developing software from scratch.  The new system will need to integrate with other HMRC systems and a range of third-party systems. It will need to provide information to 85 systems across 26 other government bodies.
  • If a software package works well in another country it almost certainly won’t work when deployed by the UK government. Core software in the new system uses a customs declaration management component that works well in the Netherlands but is not integrated with other systems, as it would be required to do in HMRC, and handles only 14 million declarations each year.
  • The IBM component has been tested in laboratory conditions to cope with 180 million declarations, but the UK may need to process 255 million declarations each year.
  • Testing software in laboratory conditions will give you little idea of whether it will work in the field. This was one of the costly lessons from the NHS IT programme NPfIT.
  • The National Audit Office said in a report last year that HMRC’s contingency plans were under-developed and that there were “significant gaps in staff resources”.

Comment

HMRC has an impressive new CIO Jackie Wright but whether she will have the freedom to work within Whitehall’s restrictive practices is uncertain. It seems that the more talented the CIO the more they’re made to feel like outsiders by senior civil servants who haven’t worked in the private sector.  It’s a pity that some of the best CIOs don’t usually last long in Whitehall.

Meanwhile HMRC’s top civil servants and IT specialists seem to be confident that CDS, the new customs system, will work on time.  Their confidence is not reassuring.  Ministers and civil servants publicly and repeatedly expressed confidence that Universal Credit would be fully rolled by the end of 2017. Now it’s running five years late.  The NHS IT programme NPfIT was to have been rolled out by 2015.  By 2010 it was dismantled as hopeless.

With some important exceptions, Whitehall’s track record on IT-related projects is poor – and that’s when what is needed is known. Brexit is still being negotiated. How can anyone build a new bridge when you’re not sure how long it’ll need to be and what the many and varied external stresses will be?

If the new or existing systems cannot cope with customs declarations after Brexit it may not be the fault of HMRC. But that’ll be little comfort for the hundreds of thousands of traders whose businesses rely, in part, on a speedy and efficient customs service.

FT article – UK companies nervous over deadline for new Customs system

Judge in Post Office Horizon case calls for a “change of attitude”

By Tony Collins

The Law Society Gazette reports that the High Court judge in the Post Office Horizon case has called for a “change of attitude”.

At a case management conference, the judge Sir Peter Fraser listed some of the problems already reported during the group litigation:

  • Failure to lodge required documents with the court
  • Refusing to disclose obviously relevant documents
  • Threatening ‘pointless’ interlocutory skirmishes.
  • Failure to respond to directions for two months
  • Failure to even consider e-disclosure questionnaires

The case involves a class action – called a Group Litigation Order – against the Post Office brought by more than 500 mostly sub-postmasters.

Justice for Subpostmasters Alliance seeks damages related to the introduction of the Horizon computer system about  17 years ago, which is alleged to have caused financial distress and in some cases bankruptcy.

According to the Law Society Gazette, the judge said the behaviour of legal advisers in the case “simply does not begin to qualify as either cost-effective, efficient, or being in accordance with the over-riding objective”. He added,

“A fundamental change of attitude by the legal advisers involved in this group litigation is required. A failure to heed this warning will result in draconian costs orders.”

The court has heard of problems trying to establish a timetable for the litigation. The claimants sought a substantive hearing for October 2018, while the Post Office argued the case could be managed for another entire year without any substantive hearing being fixed. Under this proposal, the hearing would not happen until at least 2019.

Fraser noted that to describe this approach as ‘leisurely, dilatory and unacceptable in the modern judicial system would be a considerable understatement’.

The day after a trial was ordered for November 2018, the Post Office asked for a change because its leading counsel already had a commitment at the Companies Court.

The judge suggested it was a ‘clear case of the tail wagging the dog’ if clerks were allowed to dictate hearing date. He said there was reasonable notice to arrange for a replacement counsel.

Fraser added: ‘Fixing hearings in this group litigation around the diaries of busy counsel, rather than their fixing their diaries around this case, is in my judgment fundamentally the wrong approach.’

Comment:

It appears that the judge did not single out the claimants or the Post Office as the main target for his irritation. He was impartial. But his no-nonsense approach might have surprised some at the Post Office.

The Post Office is familiar with control. When the Horizon system has shown a shortfall in the accounts of a local branch, the Post Office has required the sub-postmasters to pay whatever amount is shown, in order to return the balance to zero.

Even when paying the shown amount has led to bankruptcy and destruction of the family life of the sub-postmaster, the Post Office has pursued the case.

It has had control.

It supplied the contract that sub-postmasters signed; it supplied the Horizon branch accounting system; it required payment of what the system showed as a deficit; it investigated complaints by sub-postmasters that the shown deficits might have been incorrect;  it was able to decide what information to release or withhold – the “known errors” Horizon log being one piece of information not disclosed – and it was the prosecuting authority.

It has also been free to rebut public criticisms, as when BBC’s Panorama and forensic accountants Second Sight focused on the concerns of sub-postmasters.

Now it’s a High Court judge who is questioning, among other things, a failure to lodge required documents with the court and refusing a to disclose obviously relevant documents.

The judge’s comments are refreshing. Since 2009, when Computer Weekly first reported on the concerns of sub-postmasters, control has been one-sided.

Now at last it is on an even keel.

We hope the Post Office will reappraise whether it should be using public funds at all to fight the case.

If the case does drag on for years – postponing a judicial decision – who will benefit? Certainly not the sub-postmasters.

Law Society Gazette article

Has goodnewspeak gone too far when a mother whose allowance was blocked dies?

By Tony Collins

Yesterday’s post on goodnewspeak mentioned that officials at the Department for Work and Pensions had been celebrating the rollout of Universal Credit, not obviously mindful of the problems and delays in payments and the fact that some failed claimants had been on the brink of suicide.

Now Metro has reported that a 38 year-old mother of four who had mental health problems and an eating disorder died cold and alone after her benefits were cut because she was too ill to attend an Employment Support Allowance meeting.

Elaine Morrall was found dead in her home wearing a coat and scarf, her family said.  She’d had her benefits stopped because she failed to attend a meeting while in a hospital intensive care unit, they said.

Her family say wouldn’t put her heating on, because of the cost, until her children arrived home from school. The dead woman’s mother Linda Morrall blamed the Department of Work and Pensions for her death.

In an open letter on Facebook, Linda Morrall wrote: [My daughter] died on the afternoon of 2 November 2017 at home on her own … in the cold with her coat & scarf on…”

He daughter, she said, was in and out of intensive care but was “deemed not ill enough for ESA”. She had her benefits stopped numerous times, which in turn stopped her housing benefit. Being in intensive care was deemed insufficient reason for failing to attend a Universal Credit interview, said Linda Morrall.

“I went to the job centre to inform them that she couldn’t attend. But benefits stopped again.” Her daughter was due to go to court on Monday. “Is being dead now enough reason [not to attend court],” said Linda Morrall.  “How many people have got to die before this government realises they are killing vulnerable people?”

A spokesperson for the DWP told Metro, ‘Our thoughts are with Ms Morrall’s family at this difficult time. We understand that people can’t always attend appointments, which is why we will re-arrange alternative times.

“Assessment decisions are made with consideration of all the information provided, including supporting evidence from a GP or medical specialist.

“Anyone who disagrees with a decision can appeal.”

Metro article

Goodnewspeak and its Orwellian dark side

Goodnewspeak and its Orwellian dark side

By Tony Collins

Orwell made no mention of goodnewspeak. But maybe today it’s an increasingly popular descendant of  Newspeak – a language devised by Orwell to show how the State could use words and phrases to limit thought.

This week, as a statue of Orwell was unveiled outside the BBC, a local council in Sussex made an announcement that was a fine example of goodnewspeak.

This was Horsham District Council’s way of not saying that it was scrapping weekly rubbish collections.

This was the benign side of goodnewspeak. The dark side is a growing acceptance in Whitehall, local authorities and the wider public sector that nothing negative can be thought of let alone expressed at work.

This suppression of negative thoughts means that the rollout of Universal Credit can be said officially to be going well and can be speeded up  despite the clamour from outsiders, including a former Prime Minister (John Major), for a rethink to consider the problems and delays.

[Labour MP Frank Field said last month that the DWP was withholding bad news on Universal Credit.]

It means that the Department for Business, Energy and Industrial Strategy can continue to praise all aspects of its smart meters rollout while its officials keep silent on the fact that the obsolescent smart meters now being installed do not work properly when the householder switches supplier.

It means that council employees can think only good about their major IT suppliers – and trust them with the council’s finances as at Barnet council.

[Nobody at Barnet council has pointed out the potential for a conflict of interest in having outsourcing supplier Capita reporting on the council’s finances while having a financial interest in those finances. It took a local blogger Mr Reasonable to make the point.]

Goodnewspeak can also mean that public servants do their best, within the law, to avoid outside scrutiny that could otherwise lead to criticism, as at Lambeth council.

Last month Private Eye reported the results of a “People’s Audit” in which local residents asked questions and scrutinised the authority’s accounts. The audit found that:

 – The number of managers earning between £50,000 and £150,000 has increased by 88, at a cost of more than £5.5m year.
-Spending on Lambeth’s new town hall has gone from a projected £50m to £140m.
– The council “invested” a total of £57,000 on its public libraries last year – closing three of them – while spending £13m on corporate office accommodation.
-£10.3m was spent making people redundant.

These disclosures (and there are many more of them) raise the question of what Lambeth is doing to dispel the impression that it manages public money badly and that its decisions could be routine in the world of local authorities.

Lambeth council’s reaction to the audit was to denounce it and issue its own goodnewspeak statement; and it is considering a proposal to lobby the government to allow councils to ban such People’s Audits in future.

Lambeth’s website, incidentally, is entitled “Love Lambeth”. Which, perhaps, shows that its leaders have, at least, a deep sense of irony.

Whitehall

The following lists of announcements on the websites of the Department for Work and Pensions and the Department of Transport are examples of how goodnewspeak manifests itself in Whitehall:

And the Department of Transport’s website:

Ministry of Truth

Orwell wrote in Nineteen Eighty-Four of the Ministry of Truth whose expertise was lying, the Ministry of Peace which organised wars and the Ministry of Plenty which rationed food.

Some of the Party’s slogans were:

War is peace.
Freedom is slavery.
Ignorance is strength.

And Orwell, whose wife worked at the Ministry of Information at Senate House, London (Orwell’s model for the Ministry of Truth) said,

“If you want to keep a secret, you must also hide it from yourself.”

Comment

Of course goodnewspeak doesn’t exist as a policy anywhere. But its practice is all-pervasive in the public sector. And it seems to change the way people think when they’re at work.

It blocks out any view other than the official line.

In Nineteen Eight-four, Orwell created “Newspeak” as a language of the Party to coerce the public to shape their thoughts around the State’s beliefs. Its much-reduced vocabulary stopped people conceiving of any other point of view.

Not using Newspeak was a thoughtcrime. The Party advocated Duckspeak – to speak without thinking – literally quack like a duck.

Has this already happened in a minor way at Barnet? A council document on the benefits of its outsourcing policies was peppered with abstractions that could have been constructed by software-driven random-phrase generators:

“Ahead of the game”
“Top to bottom organisational restructure”
“Flexibility to meet future challenges whilst ensuring we provide excellent services to residents today.”
“Root of our success”
“New solutions to complex problems”
“Pioneering partnerships”
“Investing for the future”
“Protect what makes Barnet such a great place to live”
“Increasing resident satisfaction”
“Paying dividends”
“Prepared for the future”
“Great strides”
“A radical, ‘whole place’ approach to designing and providing services”
“We have not been backwards in coming forwards”
“Pursuing alternatives to the norm”
“Vision into reality”
“Frame our future strategic direction”
“Future Shape”
“Drivers for change”
“Genuine innovation in Local Government”
“Bold in its decision making”
“Forward looking change strategy”
“A new relationship with citizens”
“A one public sector approach”
“A relentless drive for efficiency”
“Focus on stimulating the market”
“Best in class’ range of tradable services to win and deliver work for other authorities.”
‘Form follows function’.
“Clear roles and responsibilities”
“An internal escalation model”
“Renewed focus on improving engagement”
“Increasing transparency, and developing trust”
“Connect with people and build relationships of trust”
“A steep demand line to climb”

Dark side

One worrying consequence is that Whitehall civil servants and public servants and ruling councillors at, say Barnet and Somerset councils (and even at Cornwall), made the assumption that their IT suppliers shared the public sector’s goodnewspeak philosophy.

But suppliers are commercially savvy. They don’t exist purely to serve the public. They have to make a profit or they risk insolvency.

For years, goodnewspeak at Somerset County Council led to officers and councillors regularly praising the successes of a joint venture with IBM while covering up the problems and losses, in part by routine refusals of FOI requests.

Goodnewspeak at Liverpool Council meant that its officials had nothing but praise for BT when they ended a joint venture in 2015. They said that ending the joint venture would save £30m. But the joint venture itself was supposed to have saved tens of millions.

Somerset County Council made a similar good news announcement when it terminated its joint venture Southwest One with IBM.

Such announcements are consistent with Newspeak’s “Doublethink” – the act of simultaneously accepting two mutually contradictory beliefs as correct.

DWP

Outsiders can find goodnewspeak shocking. The Daily Mirror reported on how the DWP celebrated the rollout of Universal Credit at Hove, Sussex, with a cake. Were managers mindful of the fact that some failed UC claimants have been driven to the brink of suicide?

Disillusioned

Francis Maude, when minister for the Cabinet Office, was almost universally disliked in the civil service. He was an outsider who did not accept the Whitehall culture.  Even though he believed the UK had the best civil service in the world, he did not always show it.

He tried to reduce Whitehall spending on IT projects and programmes that could not be justified. He spoke an IT supplier oligopoly.

Now he has left government, most of his civil service reforms (apart from the Government Digital Service) have settled back to how they were before he arrived in 2010.

In a speech last month, Maude spoke of a “distressing” disillusionment with the civil service culture. He said:

“Based on my experience as a Minister in the eighties and early nineties my expectations (of the civil service) were high. And the disillusionment was steep and distressing.

“It remains my view that we have some of the  very best civil servants in the world … But the Civil Service as an institution is deeply flawed, and in urgent need of radical reform.

” And it is civil servants themselves, especially the younger ones, who are most frustrated by the Service and its culture and practices.”

World’s best civil service

He added that, as the new minister responsible for the civil service, every draft speech or article presented to him started: ‘The British Civil Service is the best in the world.’

But complaints by ministers in all parties about the lack of institutional capability, inefficiency and failed implementation were legion, he said.

“When we queried the evidential basis for this assertion, it turned out that the only relevant assessment was a World Bank ranking for ‘government effectiveness’, in which the UK ranked number 16.”

Speaking the unsaid

Perhaps more than any former minister, Maude has expertly summarised the civil service culture but in a way that suggests it’s unredeemable.

“I and others have observed that all too often the first reaction of the Civil Service when something wrong is discovered is either to cover it up or to find a scapegoat, often someone who is not a career civil servant and who is considered dispensable.
“There seems to be an absolute determination to avoid any evidence that the permanent Civil Service is capable of failure.
“Another indicator is that if a Minister decides that a Civil Service leader is not equipped for his or her task, this has to be dressed up as “a breakdown in the relationship”, with the unspoken suggestion that this is at least as much the fault of the Minister as of the civil servant.
“It can never be admitted that the mandarin was inadequate in any way.
“When I suggested that there might be room for improvement, the distinguished former Civil Service Head, Lord Butler, accused me of a failure of leadership. Actually the leadership failure is to pretend that all is well when no one, even civil servants themselves, really believes that.

The good news

All is not lost – thanks to a vibrant and investigative local press in some areas and resident auditors such as Mr Reasonable, Mrs Angry, David Orr, Andrew Rowson and the people’s auditors in Lambeth.

Along with the National Audit Office and some MPs, these resident auditors are the only effective check on goodnewspeak. They are reminder to complacent officialdom that it cannot always hide behind its barrier of unaccountability.

Long may these dogged protectors of the public interest continue to highlight financial mismanagement, excess and self-indulgent,wasteful decisions.

Earlier this year Nineteen Eight-Four hit the No 1 spot in Amazon’s book sales chart.

Perhaps copies were being scooped up by shortlisted candidates for top public sector jobs as vital homework before falling in with the culture at their interviews.

**

Outside the BBC, Orwell’s new statute is inscribed with a quotation from a proposed preface to Animal Farm that was never used:

“If liberty means anything at all, it means the right to tell people what they do not want to hear.”

Thank you for David Orr, one of the dogged local resident auditors referred to above, for drawing my attention to some of the articles mentioned in this post.

DWP good news announcements

Newspeak

Whitewashing history in education

 

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