Category Archives: Deloitte

A classic “waterfall” IT project disaster – yet officials went by the book

By Tony Collins

Some of those who read “Crash – 10 easy ways to avoid a computer disaster” may remember a warning that buying an IT system on the basis that it works well in another country and can therefore be adapted to the UK’s needs, is flirting with disaster.

First published in 1999, Crash said,

“There are graveyards of computer projects that began life as a simple adaptation of a package used elsewhere in the world.”

One example at that time was the failure of the London Stock Exchange’s Taurus project.

Now a report published today by Audit Scotland on the “i6” project goes into forensic – but lucid – detail on what went wrong and the conflicting views of police and the supplier Accenture.

Says the report,

“The belief that most of the i6 system could be based on an existing IT system proved incorrect.”

It became clear well into project that

“a virtually fully bespoke system was required”.

The plan was for i6 to replace 130 paper-based processes and IT systems but on 1 July 2016, after many well-publicised difficulties and delays, the Scottish Police Authority and Accenture agreed to terminate the i6 contract.

Police in Scotland had chosen Accenture’s bid in 2013 largely because it had successfully implemented a system for Spain’s Guardia Civil police service.

To its credit Accenture refunded all the money the police in Scotland had paid for the i6 system, £11.06m, plus a further £13.56m – but Audit Scotland says the failure of the project …

“means that some of the benefits that should have arisen from implementing it, have been, at best, delayed. There was a need to modernise police ICT systems six years ago when the procurement of i6 began. That need has not been met. Police officers and staff continue to struggle with out-of-date, inefficient and poorly integrated systems.

“This also hinders how Police Scotland interacts and shares information and intelligence with the other parts of the justice system. There is an urgent need to determine what the next steps should be…”

The lessons are clear from the report:

  • Don’t buy an overseas system without realising that it’ll need to be built almost from scratch for the UK. The ideal is for the business processes to be greatly simplified and adapted to fit a tried and tested system, not the other way around. Audit Scotland says the police programme team and Accenture believed that the majority of the i6 system could be based on an existing IT system that Accenture had developed for Spain,  with the remainder being bespoke development work.  But there was an “over-reliance” on Accenture’s work for Guardia Civil”.
  • The “waterfall” systems development contributed to the fact that Police Scotland “only discovered the true extent of problems with the system when it was delivered for testing”.  Waterfall meant that Accenture produced the software in distinct phases, in a sequence resembling a waterfall. Once a phase was complete, the process moved to the next phase – and no turning back. “It meant that all of the design, coding and construction of i6 would be completed before Accenture released it to Police Scotland for testing. Police Scotland would pay for each phase when it was completed.” [Agile, on the other hand, is a “test and see” approach and is far more flexible. It can adapted according to what the end-user needs and wants, and changes in those needs and wants.]
  • Don’t trust the demonstration of a waterfall system. The demo may look great but rolling it out successfully across various regions may be a different story. Accenture had demonstrated i6 but much later, after a period of testing, the i6 programme team reported to the programme board in August 2015 that there were: critical errors in the technical coding, flaws that Accenture was unable to resolve as quickly as expected, serious concerns about the criminal justice module, which did not comply with the Integrated Scottish Criminal Justice Information System data standards, errors in the search and audit modules and “problems around the limited functionality in the administration module”.
  • External assurance reports may tell you that you have complied with good practice and they may give you detailed praise for your attention to detail but they probably haven’t looked at the big question: will the systems ever work? Audit Scotland said external assurance reports such as the Scottish Government’s “Gateway reviews” suggested improvements but “raised no major concerns”.  Throughout the course of the i6 programme, most of the external reviews suggested that delivery confidence was either amber or green.
  • If the plan is for a waterfall development, doing everything by the book before a contract is awarded will not guarantee success, or even make it more likely, if you haven’t asked the big question: Is this ever likely to work given the complexities we don’t yet understand? For officials in Scotland, everything went smoothly before the award of contract: there were even 18 months of pre-contract discussions. But within weeks of the contract’s start, Police Scotland and Accenture disagreed about whether the proposed system would deliver the requirements set out in the contract. Soon there was a “breakdown in relationships and a loss of trust between Police Scotland and Accenture that never fully recovered,” said Audit Scotland.
  • The supplier may be just as optimistic as you. “As the design and development of i6 progressed, it became apparent that Accenture would need to develop significantly more than had been originally anticipated. Despite delays and serious problems throughout the lifetime of the programme, Accenture provided regular assurance, in the face of strong challenge, about their confidence in delivering the i6 system. This assurance proved misplaced.”
  • When planning a waterfall system that has complexities and inter-dependencies that are not fully understood at the outset, expect ever-lengthening delays and projected costs to soar. At one point Police Scotland estimated that the level of effort Accenture would require to complete i6 was around eight times greater than the resources Accenture had estimated when signing the original contract. “The i6 programme team believed that the functionality of Accenture’s solution did not meet the requirements it had agreed in the contract. Accenture maintained that Police Scotland had not specified a detailed description of business requirements. This issue had not emerged during months of pre-award dialogue. Accenture also believed that it had set out clearly what its solution would do and maintained that Police Scotland, as part of procurement process, had accepted its qualified solution. A dispute followed about the interpretation of the contract requirements. Police Scotland argued that, after months of competitive dialogue, the requirements of the i6 system were well-defined, and that in line with the contract, these took precedence. Accenture argued its solution had precedence and that Police Scotland was trying to extend the scope of the programme. Accenture stated that, to meet Police Scotland’s interpretation of requirements, it would require more time and money.”
  • As soon as things start going badly awry, stop and have a re-think. Cancel all existing work if necessary rather than plough on simply because failure isn’t an option. Above all, take politics out of the equation. The Scottish Police Authority was anxious about i6 being seen to be a success after the failure of a previous police ICT project in 2012 – the Common Performance Management Platform. At the same time the i6 programme was “extremely important to Accenture at a global level. “This may have led to misplaced optimism about the prospects of success and unwillingness to consider terminating the programme,” says Audit Scotland.
  • When things start to go wrong, the truth is unlikely to emerge publicly. Even those accountable for the project may be kept in the dark. “Police Scotland were cautious of commercial sensitivities when providing assurances on i6 publicly. The Scottish Parliament’s Justice Sub-Committee on Policing held a number of evidence sessions with the Scottish Police Authority and Police Scotland to explore progress with the i6 programme. In March 2014, the Sub-Committee expressed frustration at the lack of information about the problems with the i6 programme that had been ongoing since August 2013. Police Scotland did not disclose the severity of the issues facing the programme, nor was it overly critical of Accenture. This may have reflected a desire to maintain relationships with Accenture to keep the programme on track or to maintain the commercial confidentiality of the contract.”

Accenture’s response

Accenture said,

“As the report acknowledges, the scope and the complexity of the solution for i6 increased significantly during the project.  This was driven by the client.  There were challenges and issues on both sides, but we worked closely with Police Scotland to review the programme and recommend revised plans to successfully deliver i6.

Despite our best efforts, it was not possible to agree the necessary changes and we mutually agreed to end the project.”

In May 2017 Audit Scotland is due to publish a report that summarises the lessons from a number of public sector ICT projects it has investigated.

Some of what i6 was intended to cover …

Comment

Tis a pity officials in Scotland hadn’t read Crash before they embarked on the i6 project – or if they had, taken more notice of the dangers of assuming a system that works overseas can be tweaked to work in the UK.

We commend Audit Scotland for its expert investigation and a fine report.

Clearly the failure of i6 is not entirely Accenture’s fault.  The project was commissioned on the basis of assumption and when things went wrong politics intervened to prevent a complete stop and a fundamental re-think.

Fatally, perhaps, there appears to have been no discussion about simplifying police administration to make the IT more straightforward. If police administration is so enshrined in law that it cannot be simplified, officials would have to accept before awarding the contract that they were buying an entirely new system.

The UK armed services simplified volumes of rules and practices before it introduced pay and personnel administration systems. It was hard, inglorious work. But simplifying ways of working first can make the difference between IT success and failure.

i6 – a review. Audit Scotland’s report. 

Waterfall approach damns £46m Scottish police system – Government Computing

Another public sector IT disaster – but useful if the lessons are learned.

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More IT-based megaprojects derail amid claims all is well

By Tony Collins

If one thing unites all failing IT-based megaprojects in the public sector it is the defensive shield of denial that suppliers and their clients hold up when confronted by bad news.

It has happened in the US and UK this week. On the Universal Credit  project, the minister in charge of the scheme, Lord Freud, accepted none of the criticisms in a National Audit Office report “Universal Credit: early progress”.   In a debate in the House of Lords Lord Freud quoted from two tiny parts of the NAO report that could be interpreted as positive comments.

“Spending so far is a small proportion of the total budget … and it is still entirely feasible that [universal credit] goes on to achieve considerable benefits for society,” said Lord Freud, quoting the NAO report.

But he mentioned none of the criticisms in the 55-page NAO report which concluded:

“At this early stage of the Universal Credit programme the Department has not achieved value for money. The Department has delayed rolling out Universal Credit to claimants, has had weak control of the programme, and has been unable to assess the value of the systems it spent over £300 million to develop.

“These problems represent a significant setback to Universal Credit and raise wider concerns about the Department’s ability to deal with weak programme management, over-optimistic timescales, and a lack of openness about progress.”

And a shield of denial went up in the US this week where newspapers on the east and west coast published stories on failing public sector IT-based megaprojects.  The LA [Los Angeles] Times said:

As many as 300,000 jobless affected by state software snags

“California lawmakers want to know why Deloitte’s unemployment benefits system arrived with major bugs and at almost double the cost estimate. The firm says the system is working.”

The LA Times continued:

“Problems are growing worse for the state’s Employment Development Department after a new computer system backfired, leaving some Californians without much-needed benefit cheques for weeks.”

The Department said the problems affected 80,000 claims but the LA Times obtained internal emails that showed the software glitches stopped payment to as many as 300,000 claimants.

Now lawmakers are setting up a hearing to determine what went wrong with a system that cost taxpayers $110m, almost double the original estimate.

Some blame the Department’s slow response to the problems. Others point the finger at a Deloitte Consulting.

The LA Times says that Deloitte has a “history of delivering projects over budget and with problematic results”. Deloitte also has been blamed, in part, for similar troubles with upgrades to unemployment software in Massachusetts, Pennsylvania and Florida, says the paper.

“We keep hiring the same company, and they keep having the same issues,” said Senator Anthony Cannella.  “At some point, it’s on us for hiring the same company. It’s faulty logic, and we’ve got to get better.”

In 2003 California planned to spend $58m upgrading its 30-year-old unemployment benefits system. By the time the state awarded Deloitte the contract in 2010  the cost estimate had grown by more than $30m.

The Department handed out $6.6bn to about 1 million unemployed Californians in 2012. The software was expected to ease the agency’s ability to verify who was eligible to receive benefits.

Problems began when the Department transferred old unemployment data to the new system. The software flagged claims for review — requiring state workers to manually process them.

The LA Times says that officials thought initially the workload would be manageable, but internal emails showed the agency was quickly overwhelmed. Phone lines were jammed. For weeks, the Department’s employees have been working overtime to clear the backlog.

A poor contract?

In a contract amendment signed two months ago California agreed to pay Deloitte $3.5m for five months of maintenance and operations costs. Those costs should have been anticipated in the contract said Michael Krigsman, a software consultant who is an expert on why big IT-based contracts go awry. He told the LA Times:

“It’s a striking oversight that maintenance was not anticipated at the beginning of the contract when the state was at a much stronger negotiation position.”

By the time the middle of a project is reached, the state has no choice but to stick with Deloitte to work out bugs that arise when the system goes live, he said.

System works

Loree Levy, a spokeswoman for the Department, said the system is working, processing 80% of claims on time. As for the troubles, she said, “There is a period of transition or adjustment with any large infrastructure upgrade like this one.”

Deloitte spokeswoman Courtney Flaherty said the new California system is working and that problems are not the result of a “breakdown or flaw in the software Deloitte developed”.

System not working?

While there seems to be no project disaster in the eyes of the Department and Deloitte Consulting, some of the unemployed see things differently. One wrote:

“I am a contract worker who had to fight for my unemployment benefits. I won my case and yet they still cannot pay me… It’s been more than 3 weeks since I won my appeal and as of this moment, I am owed 13 weeks of back payments. To add insult to injury, they cannot send me current weeks to certify and they refuse to even try to help me to get back into the online system.

“I blame Deloitte, but it is California that carries the heaviest burden of fault… We’re nearing November and they still haven’t fixed an issue that began over Labor Day? Nonsense!

“This is untenable for everyone affected …We are owed reparations as well as our money at this point. It’s a funny word, affected. That means families and individuals are going hungry but can’t get food stamps or welfare. It means evictions and repossessed cars. It means destroyed credit, late fees, years of turmoil and shame for people already dealing with unemployment. Shame on you California.”

Another wrote:

“ … Not communicating is NOT an answer. Unemployed individuals caught up in the nightmare were told to be patient.  Rents and other expenses were still accumulating.  But [when you] add on additional fees: late fees, restoral fees, interest fees, etc…….you get the picture.

“Dear Governor Brown,

“Please reimburse me for all additional fees I’ve had to absorb to survive this fiasco.  You are going to make me payback any overpayments, but ignore the cost to the unemployed taxpayer.  This is  appears to unfair.  Perhaps Deloitte should pay us back from their contracted funds before they receive their final payment.  I am saving all of my receipts to deduct from my 2013 tax return.

“BTW Gov Brown – I am still waiting on additional payments as of today and DMV registration for my vehicle was due on 10/20/13.  Are you going to waive the penalty for late payment? Am I the only one with this question?”

Scrutiny

California’s state Assembly has set a date of 6 November 2013 for a hearing into the Department’s system upgrade.

“We’re going to look at EDD, the contractors and others to see how the system broke down so we can avoid this in the future,” said Henry Perea, chair of the Assembly’s Insurance Committee, which has oversight over the jobless benefits program.

On its website Deloitte says:

“Deloitte continues to help EDD [Employment Development Department] transform the level of service it provides to unemployed workers and improve the quality of information collected by EDD. The next time unemployment spikes, California should be ready to meet the increased demand for services.”

Massachutsetts IT disaster?

On the opposite coast the Boston Globe reported on an entirely separate debacle (which also involved Deloitte):

          None admit fault on troubled jobless benefits system

“… even with the possibility that unemployed workers could face months more of difficulties and delays in getting benefits, officials from the Labor Department and contractor, Deloitte Consulting of New York, testified before the Senate Committee on Post Audit that the rollout of the computer system was largely a success.

“‘I am happy with the launch,’ said Joanne F. Goldstein, secretary of Labour and Workforce Development, noting that she would have liked some aspects to have gone better.

“Mark Price, a Deloitte principal in charge of the firm’s Massachusetts business, acknowledged that software has faced challenges during the rollout, but insisted, ‘We have a successful working system today. ‘’’

NPfIT shield

A shield of denial was up for years at the Department of Health whose CIOs and other spokespeople repeatedly claimed that the NPfIT was a success.

Comment

If you didn’t know that Universal Credit IT wasn’t working, or that thousands of people on the east and west coasts of the US hadn’t been paid unemployment benefits because of IT-related problems, and you had to rely on only the public comments of the IT suppliers and government spokespeople, you would have every reason to believe that Universal Credit and the jobless systems in Massachusetts and California were working well.

Why is it that after every failed IT-based megaproject those in charge can simply blow the truth gently away like soap bubbles?

When confronted by bad news, suppliers and their customers tend to join hands behind their defensive shields. On the other side are politicians, members of the public affected by the megaprojects and the press who have all, according to suppliers and officials, got it wrong.

Is this why lessons from public sector IT-based project disasters are not always learned? Because, in the eyes of suppliers and their clients, the disasters don’t really exist?

None admit fault on troubled jobless benefit system

State fired Deloitte

Complaints continue despite claims system is under control

As many as 300,000 affected by California’s software problems

California’s predictable fiasco?

Has DWP lost £400,000 worth of Universal Credit studies it commissioned?

By Tony Collins

On 12 March 2012, Chris Grayling, a minister at the Department for Work and Pensions, published a list of the DWP’s consultancy contracts.

Soon afterwards the question was asked: has the DWP published any of the consultants’ reports – nearly 50 of them commissioned from companies that included PricewaterCoopers, Atkins, Capgemini, IBM, Compass,  KPMG, Deloitte, Xantus, Gartner and Tribal?

No, said the DWP.

So I made an FOI request for two of the reports, on Universal Credit:

– Universal Credit Delivery Model Assessment Phase 1 and 2, and

– the Universal Credit End to End Technical Review.

The DWP could not find them. It didn’t even have a record of them.

Julie Kitchin, Senior Business Partner Operations at the DWP’s Financial Control Directorate, Risk Management Division at Leeds, said she requested a “thorough search of the Universal Credit Programme document library”.

And …

“Universal Credit Colleagues have confirmed that the Department does not hold documents with these titles or under these names.”

But Chris Grayling, a DWP minister, told the House of Commons that the reports exist. His written answer on 12 March 2012 referred to:

Universal Credit End to End Technical Review IBM £49,240
Universal Credit Delivery Model Assessment Phase 2 McKinsey and Partners £350,000

Julie Kitchin said she would check again and reply within 20 working days. “In the light of the additional information you have provided, I have asked the Universal Credit Programme to conduct a further search for the reports you have highlighted. ”

Comment:

Since the FOI Act came into force on 1 January 2005, the DWP has at no point granted any of my FOI requests or appeals. Its replies could be modelled on electronic birthday cards that play the same automated message every time you open them.

Perhaps the DWP could be the first department to use software to generate FOI replies without human involvement.

DWP hides already published Universal Credit report.

Chris Grayling’s written answer on DWP’s consultancy contracts

Millions of pounds of secret DWP reports

Cancer waits mix-up – how concerned is the Trust?

By Tony Collins

When a passenger jet crashes, if the airline’s next board meeting barely mentions it, and instead discusses a catering award and a staff survey, those booked on flights with the airline may have cause for concern.

So should patients at Imperial College Healthcare Trust be concerned that the trust has not mentioned in its latest published board papers a blunder that led to the Trust’s losing track, for nearly a year, of hundreds of patients with possible cancer?

The Department of Health requires that patients who go to their GP with symptoms that may indicate cancer are seen by a specialist within a maximum of two weeks.

Records incomplete

But Imperial has lost track of an unknown number of patients who went to their GPs with signs of possible cancer. It has been checking 900 hospital records which it found were incomplete.

For some of the patients the blunder won’t matter:  they will have been called by staff at GP practices, some of whom have systems that track patients under the two-week rule.

But some patients might have slipped through the net and not been alerted by Imperial to their urgent appointments. Imperial has no clear idea how many.

It has asked GP organisations for help in contacting patients, their carers or representatives, to‘ascertain whether the patient has received treatment or still requires treatment’”.

What detail has emerged on the problem has come not from Imperial but from NHS North West London which is a single management team that represents eight PCTs.  NWL  covers St Mary’s Hospital, Paddington, Hammersmith Hospital and Charing Cross Hospital, which are all managed by Imperial.

“Substantial concern”

NWL has what it calls “substantial concern” about the problems at Imperial. In addition to the problem reporting its two-week cancer waits, the Trust is trying to clear a backlog of patients who have waited more than 18 weeks from referral to consultant-led treatment.

“Systematic failings”

NWL executives report that Deloitte has carried out an external audit and “concerns remain about record keeping at Imperial”.  The executives say that “systematic failings” have been identified which will take time to resolve. This issue will be given close attention in the coming year, says NWL.

Patient safety an issue?

NWL also says that a “Clinical Review” is being carried out and a panel is being set up to look at the clinical issues that have arisen at Imperial. “The Director of Nursing confirmed that the clinical review would look at all patients affected by the problems at Imperial …”

In contrast to the concerns about Imperial’s performance among London PCTs, Imperial seems a little surprised that we are even investigating the problems.

“The problems are administrative and nothing to do with IT,” said a spokesperson.

The Trust is right. The problems are nothing to do with IT.  And yet the problems may be everything to do with IT. Appointments for patients with possible cancer have not been entered onto IT systems – and where they have, data has been incorrect, entered into duplicate records, or not followed up to check appointments were kept, or the patient seen for treatment and investigations.

Eye off the ball?

For nearly a year the problem was not spotted, which has left some North West London executives wondering how it could have happened. It is known the Trust has devoted time and attention of senior management to a replacement of existing systems with Cerner, under the National Programme for IT.  Has the Trust taken its eye off the ball while making plans for Cerner?

Some working in the NHS may ask whether it was more important for the Trust to have ensured that appointments for possible cancer were entered correctly onto existing systems, and routines written into software to provide alerts when cancer records were not closed off, or were incomplete.

**

Below are some of the comments of NWL PCTs about Imperial’s problems. Their concerns raise questions about whether the Trust’s processes and administration are stable enough for a transition from existing IT to new systems, which could cause further disruption.

These are some NWL statements in its board papers relating to Imperial:

“It was reported that at Imperial, the calculations of the backlog of referrals had been completed and work is underway to clear the backlog. However Deloitte has carried out an external audit and concerns remain about record keeping at Imperial. Systematic failings have been identified which will take time to resolve. This issue will be given close attention in the coming year.

“A Clinical Review is being carried out and a panel is being set up to look at the clinical issues that have arisen. The Director of Nursing confirmed that the clinical review would look at all patients affected by the problems at Imperial …”

Does NWL always trust what Imperial says?

Jeff Zitron [Chair, NHS NW London, Inner & Outer NWL Sub Clusters] said that the Board needs evidenced assurance that the issues that have arisen at Imperial and North West London Hospitals are being adequately addressed.

**

“Trish Longdon [Vice-chairman, NHS North West London Cluster Board] noted that although the Imperial targets were shown as ‘Green’  this does not reflect the true position. This was agreed and it was noted that they were in fact being treated as if they were Amber.”

“Urgent meeting”

“The Chairman asked for an update on the situation at Imperial College Healthcare Trust which had been the subject of substantial concern at the last INWL Inner North West London NHS] Board meeting. The INWL Board had agreed that an urgent meeting should be held with the Chairman and Chief Executive of Imperial, involving the CCG Chairs, the Tri-Borough Cabinet Members for Health, himself and Anne Rainsberry [Chief Executive North West London Cluster]. This was taking place later that day.”

Clinical harm?

“ Following investigation of Serious Incidents in May 2011, ICHT [Imperial College Healthcare NHS Trust] is unable to provide sufficient assurance of robust data quality in regard to reported performance for 18 weeks RTT [Referral To Treatment], cancer waiting times and the elective waiting list.

The Trust board have approved a reporting break until end of June 2012 which has been agreed by the Cluster in conjunction with NHS London. To ensure due diligence, an independent audit of waiting list management across all specialities has been undertaken and a set of recommendations made.

“ICHT continue to provide shadow reports to NHS NWL during this period with weekly reporting. Some evidence of improved performance management is observed. However this is not yet consistently embedded Trust- wide and clearance of the current backlog of patients is not at sufficient pace to meet the agreed trajectory…

“A clinical review will be undertaken to ensure that patients have not experienced harm due to an elongated wait.”

**

“Anne Rainsberry [Chief Executive North West London Cluster] referred to a range of discussions taking place on Imperial’s performance issues, focussing on the backlog of the Referral to Treatment waiting lists which had resulted in a reporting break being granted.

“Work was concluding at the end of April [2012] to reduce the original backlog of patient cases and enable reporting systems to get back on track in June. A clinical review had also started to determine if any risks to patients had arisen due to the delays. The review findings would be brought back to the Board…

“Anne Rainsberry referred to a meeting she had attended with the Department of Health to review Imperial‟s approach to resolving these issues.”

Big organisational challenge

“Simon Weldon [Director of Commissioning and Performance, North West London Cluster Board] … asked the NWL Board to be aware of the enormity of the organisational challenge facing Imperial and that remedial actions would take time to take effect.”

Imperial responds

Campaign4Change put it to Imperial College Healthcare NHS Trust that there is nothing in its latest published board papers to show the trust is concerned about the problems relating to cancer waits and lost appointments. We said that PCT papers referred to  “substantial concern” but there was nothing similar in Imperial’s latest published papers. We let Imperial know we would be asking the question: how concerned is Imperial about the confusion over cancer waits?

This was the reply of Imperial’s spokeswoman (in full)

“The safety of patients is our absolute priority. Our Trust is taking the issues involved in the current situation very seriously and at all times the well-being of the patients we serve is foremost in our minds.

“We acknowledge that some patients may have been caused additional pain and anxiety associated with a prolonged wait for diagnosis and treatment and worked to address the problem as robustly and quickly as possible.”

Separately, in May 2012, Imperial told us that it was in the process of validating 900 patient records that indicate that a patient might have been waiting longer than two weeks.

At that stage it had closed more than 400 of the 900 records “as the majority indicated that patients have either received or are receiving treatment, or that the patient did not attend their appointment and their GP had advised there was no need for further follow up”.

The spokeswoman said “To date our investigations have found no suggestion that any delay in treatment has caused a patient to come to serious harm.”

She said “This is not an IT issue, but an administrative issue related to the physical input and extraction of data from patient records. It is entirely unrelated to IT systems.”

Comment

It is extraordinary that Imperial is seeking to replace existing systems when it is organisationally in a questionable state. Simon Weldon, Director of Commissioning and Performance, North West London Cluster Board, referred to the “enormity of the organisational challenge facing Imperial”.

Under the NPfIT, a number of implementations of Cerner at several NHS sites have gone badly wrong – and they did not have Imperial’s problems before going live. It would be common sense for Imperial to get its data accurate and its management processes and checks reliably in place before attempting a major switch of IT systems.

Two other things are particularly worrying: Imperial appears not to concede in public it has any major problems, and it appears to separate IT from administration.

Having the best IT in the NHS is of limited value if important parts of the Trust are in a state of administrative disorder.  If data is unreliable, incomplete and inaccurate, and solid processes are not in place to ensure that the correct data is entered into systems when it needs to be entered, and routines are not in place to provide alerts and follow-ups, costly hardware and software may not compensate. Is this an IT issue or not? Does that matter?

We would not like to see a Cerner NPfIT debacle similar to the ones at Barts in London, Royal Free Hampstead, and at hospitals in Oxford, Milton Keynes, Weston-super-Mare, Morecambe Bay, Worthing and Bristol.

But is Imperial particularly concerned? Is it in denial over the seriousness of its problems? Why is it reporting its position at Green when North West London NHS regards its position as Amber? Why do its latest published board papers not mention its problems tracking patients under the two-week rule? Is the Trust so preoccupied with replacing its existing systems with Cerner that it is not doing the basics well?

One specialist in the NHS said: “If the Trust wasn’t spending so much time and effort doing the Cerner deployment then maybe they would have concentrated its scarce resources on performing the  job of managing patients.”

Accountability for failure in the NHS is poor to non-existent. So will Imperial be able to do what it wants regardless?

Troubled Cerner NPfIT go-lives, so far:

Barts and The London

Royal Free Hampstead

Weston Area Health Trust

Milton Keynes Hospital NHS Trust

Worthing and Southlands

Barnet and Chase Farm Hospitals NHS Trust

Nuffield Orthopaedic

North Bristol.

St George’s Healthcare NHS Trust

University Hospitals of Morecambe Bay NHS Foundation Trust

Birmingham Women’s Foundation Trust

NHS Bury

*We acknowledge Pulse which broke the story on Imperial’s cancer wait problems.

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

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

GPs kept in the dark over hospital cancer blunder – Pulse

Other links:

Halt NPfIT Cerner deployments says MP Richard Bacon

Bacon calls for halt on Millennium.

Millions of pounds of secret DWP reports

By Tony Collins

The Department for Work and Pensions is keeping secret – as a matter of course – millions of pounds worth of reports it has commissioned on a wide range of IT and other projects including Universal Credit.

A DWP spokesperson, confirming that all the reports (below) are not published, told Campaign4Change that the reports have limited distribution after commitments and assurances were given to their “authors”.

These authors include Deloitte, PricewaterhouseCoopers, Capgemini, KPMG, Gartner, McKinsey, Atkins, Tribal, Compass and IBM.

In the past, when the DWP has told the Information Commissioner that reports needed to be kept confidential because of commitments to suppliers, the Commissioner has found that the suppliers were content to have the reports published.

A spokesman for the DWP told us: “Consultants’ reports provide additional, often expert, information for the DWP to consider and have a limited distribution following commitments and assurances on disclosure with the authors.”

Lack of accountability

While the reports remain hidden the companies producing them will remain unaccountable for their contents. In our view the excessive and automatic secrecy brings a risk that taxpayers will end up paying millions of pounds for consultancy reports that tell the DWP what it wants to hear.

Would a consultancy be re-hired if its reports were sharply critical of the DWP and its projects?

And is the DWP’s instinctive secrecy appropriate in an era of so-called open government? The reports are not about Britain’s nuclear secrets. In the case of Universal Credit, reports on the progress or otherwise of the programme could be of interest to thousands of people whose benefits will be affected by the scheme.

We believe the DWP should be open by default, but will that ever happen? Epsom MP Chris Grayling is the current DWP minister responsible for the secret reports.

The reports

Below is a list of some of the unpublished consultancy reports produced for the DWP in 2010 and 2011:

Contract title Supplier Value (£)
Resource Management IT Healthcheck NSG 90,000
Jobcentre Plus Financial Information System Capability Review Capgemini 25,000
Olympic and Paralympic Legacy Plan Atkins 25,000
Undertake a Review of Data Centre Migration Approach PricewaterhouseCoopers 20,000
Organisational Design Project Deloitte 543,000
Developing a Business Intelligence Operating Model Deloitte 185,672
CIT Software Project Discovery Phase Deloitte 195,528
Support to CIT Improvement Programmes Tribal 760,000
Information Security Assurance Project Atkins 49,950
Assistance with Resource Management System Improvement Plan   Programme Phase 2 Atkins 72,690
Office for Disability Issues TrailBlazer Support—Housing Sitra 51,300
Office for Disability Issues—Trailblazer Resource Allocation for   Work Choice In-Control 11,750
Call Off Framework Agreement for Right to Control TrailBlazers PricewaterhouseCoopers 97,902
Commercial Assurance—Automated Delivery Service—Jobseekers   Allowance Atkins 47,300
Corporate Services Division Cost Optimisation Programme Network   and Telephony Xantus 94,370
National Registration Authority Audit (tScheme Audit) KPMG 10,727
Shingo Prize Pilot The Manufacturing   Institute—TMI Pract. Services 11,000
Business Control Strategic Improvements PricewaterhouseCoopers 750,000
A review of DWP Vendor Management Activities Procurement   Excellence 52,250
Assistance with Resource Management System Improvement Plan   Programme Phase 3 Atkins 94,050
Pension Reform Delivery Programme Closure Activity PricewaterhouseCoopers 100,000
Benchmarking Hosting Services Gartner 23,456
Application Delivery Centre (ADC) Validation Services Requests Atkins 97,500
Additional Modelling Support for Dynamic Benefits Oliver Wyman 19,500
Strategic Financial Consultancy Support to Help deliver Work   Programme KPMG 362,000
Shared Services Resource   Management Contract (RMOC) Benchmarking Compass 15,000
Final   assurance of DWP IT Strategy Capgemini 20,000
Research   into the Capacity of the Health Care Professional Market Deloitte 48,678
Commercial   support to the Work Programme Richard   Aitken-Davies 45,000
Support   to DWP Finance and Commercial Function (Organisation Design Review) PricewaterhouseCoopers 20,000
Support   to DWP CJT Cost Reduction Programme Bramble 1,065,000
DWP   Shared Services Delivery Model Options appraisal Deloitte 225,000
Benchmarking   of DWP Shared Services PricewaterhouseCoopers 19,000
Universal   Credit Delivery Model Assessment Phase 2 McKinsey and Partners 350,000
Universal   Credit Strategic Support Capgemini 505,000
Review   of Transforming Letters Project Deloitte 19,550
Application   Delivery Project Independent Market Assessment Compass 19,000
Universal   Credit End to End Technical Review IBM 49,240
Digital   Customer Total Experience Design Requirement Deloitte 16,667
Universal   Credit Supplier Workshop-Facilitation Xantus 11,399
Consultancy   Support to develop Flexible New Deal Exit Strategy KPMG 12,000
Support   of CIT Improvement Initiatives KPMG 250,000
Risk   Assurance Division Strategic Partner PricewaterhouseCoopers 1,000,000
Benchmarking   of the HPES Hosting Contract Compass 172,105
Compensating   People with Occupational Mesothelioma Deloitte 25,616
Specialist   tScheme Annual Audit of DWPs National Registration Authority KPMG 33,000