Category Archives: Government IT

Australian payroll IT project cost grows from $64m to over $400m

Posted on 10/05/2012 | Leave a comment

David Bicknell

In Australia, the state government in Queensland is coming to terms with a failing IT project whose cost has grown from $64.5m to $412m.

The payroll system for Queensland Health first went live in early 2010, prompting thousands of employees to be underpaid, overpaid or not paid at all, and triggering a subsequent critical report by the state’s Auditor General. 

Late in 2010, the Bligh government said $209m would need to be spent to fix the system in the following three financial years, on top of the original $64.5 million implementation cost.

Now, according to The Brisbane Times, the cost of the failed payroll system will reach an estimated $412 million by the end of June this year, with further costs likely to be incurred in the future.

Failure to prepare: Government slammed over health payroll bungle

Smart state’s technology spending up in the air

Leave a comment

Posted in Australia, Campaign4Change, Government IT, IT projects, IT-related failures

Tagged , , , ,

Are SIAMs the new SIs?

Posted on 10/05/2012 | 3 comments

In this guest blog, John Jones and John Pendlebury-Green, co-founders of strategic sales architects Landseer Partners, take a look at the development of a new generation of outsourcing in ICT and the creation of a new breed of integration and manageement specialists dubbed ‘SIAMs’. This article is also carried on Landseer Partners’ website.

We now live in an age of austerity where we have to live within our means and this includes the Government  which has just announced the need for Departments to find a further £16bn in savings. 

All Departments and Agencies are having to make real year-on-year cuts to their budgets – effectively having to do  the same for less money for some considerable time to come.  This is leading to new models for the delivery of services (third generation outsourcing) as Government becomes more about “policy and strategy” and leaves the delivery of public services to the private sector.

Industry has already played a major part in first and second generation of outsourcing including what is now more commonly called “outcome-based contracting”. 

The recent contract awards of new prison builds and operations similar to the likes of G4S and Interserve provide exemplars of outcome-based contracting. The Work Programme Initiative at the Department of Work and Pensions is another relatively recent example of second generation outsourcing with payment linked directly to outcomes.  Lessons learned are only now emerging as to the efficacy of these contracts.

What is interesting is that now we are starting to witness a new third-generation of outsourcing in ICT – Service Integration and Management (SIAM).  The consequences for the ICT Industry and the delivery of ICT within and to Government are likely to be profound. 

At Landseer Partners, we believe that the shape and players of the ICT market will change significantly in the next two to five years.  The net effect on the role of existing System Integrators (SI) is likely to be significant.

So what is SIAM all about and, importantly, what will make SIAM a success and its implications for the big SIs?

SIAMs are the ICT Managing Agent for the Customer

So, what are SIAMs – well, for starters, there is no agreed de facto industry definition of what a SIAM is. Rather, there are emerging trends in the private sector and in the current government procurements at the Ministry of Justice (MoJ) and the Foreign and Commonwealth Office (FCO) that identify key characteristics of what Service Integrators and Management Services may look like. 

For instance, the MoJ and FCO both plan to award contracts to SIAM providers that can successfully demonstrate the ability to integrate services and manage a number of Tower service providers that (typically) provide one or more commoditised services of: data hosting, LAN/WAN provision, Applications Management and Support and some Security related services.  Importantly, the SIAMs will be characterised by:

  • Taking the risks for “end to end” delivery of the services and their continuing operations
  • Creating new commercial constructs to balance risk versus delivery
  • Not necessarily holding direct contracts with the Tower service providers
  • Providing full 24/7 service desks to support national and global needs of the customer
  • Working hand-in-glove and be contract-managed by the retained Intelligent Client Function (or Informed Partner as they are sometimes known) of the Contracting Authority

In effect, the UK public sector is now requesting what has long happened in the construction industry; they are looking to award contracts to Managing Agents to help deliver and manage critical  ICT services back to Departments/Agencies.

Expected Benefits

So, with the advent of SIAMs  what are the expected benefits?  Reading the prospectuses of the government procurements we would expect the benefits to be large and varied and include:

  • Reduced cost of ICT services to the commissioning Department/Agency – this might come about by greater efficiencies in programme delivery; but significant cash savings are also expected as staff are transferred move to more cost-effective private sector pensions schemes
  • Better risk management with continuous incentives to improve service quality to users
  • Greater innovation by the SIAMs, possibly by the use of niche SMEs which will assist with more agile delivery and innovation methods

The Future

Given the real lack of experience and reliable data on the likely impact of the creation of SIAMs it is difficult to say at this particular time whether SIAMs will effective in the longer term]– will SIAMs be effective in the longer term?  Will they help to drive down cost of ICT services?  Will they help in the delivery of better public services?

Landseer Partners’s view is that, although it is early days, SIAMs are likely to be here to stay, at least in the foreseeable future. The status quo, keeping large in-house Intelligent Customer Functions and Service Desk provision, is  neither desirable nor efficient and future procurements will build on the lessons learned from the current MoJ and FCO procurements.

The key thing now is for System Integrators to recognise that change is in the air, that different business models are appearing and that, to be in the market, a change in attitude, behaviours and delivery will be needed in order to become Service Integrators and Managing Agents to Government.

3 Comments

Posted in Campaign4Change, change, change management, government, Government IT, managing change, managing outsourced services, outsourcing, procurement

Tagged , , , , , , , ,

The story behind India’s struggling Aakash IT project

Posted on 07/05/2012 | Leave a comment

By David Bicknell

The New York Times has carried a couple of excellent blog posts reporting on India’s struggling “Aakash” IT project.

The India Ink posts detail the story behind a plan to introduce a cheap computer built for Indian students. As the blog explains, last October, the Indian Ministry of Human Resources Development unveiled the new, $35 computer.

Now, more than six months later, with thousands of university students still waiting for the laptop, “the tale of the Aakash looks a bit like an Indian soap opera, complete with a convoluted storyline, multiple characters, and massive personality clashes.”

As India Ink says, the Aakash project, if successfully completed, could enable millions of students to connect with the larger digital world, and is being closely watched outside India as the national government tries to attract foreign investment in public-private partnerships for everything from infrastructure to vocational training.

“The original idea behind the Aakash seemed pleasantly simple. A cheap computer would benefit Indian university students by enabling them to watch lectures or get lecture notes and other class information online. In 2009, a team of government researchers developed the basic design for the low cost device.

“The job of putting the project out to bid fell to I.I.T. Rajasthan, which by spring of 2011 had received 477 million rupees — about $9.2 million — in government funds to pay for procuring and testing 100,000 low-cost tablets. In writing the tender, I.I.T. Rajasthan detailed the technical specifications for the tablet but did not specify the criteria for testing and approving the devices, according to a government source involved in the project. That omission was to prove disastrous.

Here is Part One of the tangled tale of the project, which involves issues with procurement, outsourcing, testing and governance.

And here is Part Two.

India’s $35 Aakash tablet comes apart
Aakash Tablet Problems: India’s $35 slate slammed by testers

Leave a comment

Posted in Campaign4Change, change management, governance, Government IT, India, outsourcing, procurement, project management, public-private partnerships

Tagged , , , , , , , , , ,

Whitehall defies NAO and Cameron on publishing status of big projects

Posted on 02/05/2012 | 1 comment

By Tony Collins

Government action to cut the number of failures of big projects including those with a major ICT component has made a difference, the National Audit Office reports today.

In its report “Assurance for major projects”  the NAO is largely supportive of actions by the Government, , the Cabinet Office’s Major Projects Authority and the Treasury in setting up reviews of major high-risk projects, including ICT-based programmes, to ensure that if they are failing they are put back on track or cancelled.

The NAO says the Government’s decision to “dismantle” the NPfIT was taken after the project was assessed by the Major Projects Authority.

But the report also shows how civil servants have managed to defy a mandate from the Prime Minister, and a separate NAO recommendation in 2010, for information on the status of big ICT and other high-risk projects to be published.

Says the NAO report

“The ambition to publish project information, as part of the government’s transparency agenda, has not been met.

“Our 2010 report recommended that the government should publicly report project status. We consider that public reporting of project information is key to providing greater accountability for projects and improving project outcomes… Regular transparent reporting of performance which highlights successes and non-compliance would also help to build an enduring assurance system.”

Separately in the report the NAO says

“There has been a lack of progress on transparency.  The [Cabinet Office’s Major Projects] Authority has not yet met its commitment to publish project information in line with government’s transparency agenda. The Authority cannot deliver this objective on its own. Senior level discussions are ongoing, between Cabinet Office, HM Treasury and departments, on the arrangements for public reporting.”

Should ministers intevene to force publication?

But the NAO report does not raise the question of why ministers have not intervened to force civil servants to publish the status information on high-risk projects.

Campaign4Changehas argued that publishing status reports on big ICT projects and programmes would be the most effective single action any government could take to reduce the number of failures. (see “Comment” below)

Prime Minister’s 2011 mandate

The NAO’s 2010 recommendation for status information on major projects to be published was backed by a mandate from the Prime Minister in January 2011 which included the undertaking to “require publication of project information consistent with the Coalition’s transparency agenda”.

The House of Commons’ Public Accounts Committee has recommended that departments publish information on the state of their major IT-based projects and programmes; and the Information Commissioner has rejected civil service arguments for not publishing such information.

In addition Francis Maude, the Cabinet Office minister, said, when in opposition, that the Conservatives, if they gained power,  would publish “Gateway” review reports soon after they are completed.  Gateway reports are similar to the assurance reviews carried out for the Major Projects Authority.

Yet none of this has happened.

The “rebel” civil servants

How is it that a group of civil servants who are opposed to publishing information on the status of large risky projects can defy the Prime Minister, Francis Maude, the National Audit Office, and the all-party Public Accounts Committee? Those recalcitrant civil servants argue that assurance reviewers would not tell the whole truth if they knew their assessments would be made public.

But how do we know they tell the whole truth when the reports are kept confidential? The Information Commissioner has pointed out in the past that civil servants have a public duty to be candid and honest. If they are not because their reports are to be published, they are failing in their public duty.

Today’s NAO report says there are differences of opinion among civil servants over whether to publish status information on projects.

Says the NAO

“There has been some support for greater transparency from departments who believe that tracking and publishing major milestones could create helpful tension in the system.

“However, concerns have been raised that increased transparency could limit the value of assurance, as it could inhibit assurance reviewers and project staff holding full and frank discussions.

“Some senior project staff also have concerns that public reporting could have a negative commercial impact, and would prefer delayed rather than real-time public reporting.”

The Cabinet Office told Campaign4Change in 2010 and 2011 that instead of publishing status reports on each major project, it will publish an annual report on the state of its programmes.

But that hasn’t happened either.

Says the NAO:

“As well as the objective to publish project information, the [Major Projects] Authority has not yet met its objective to publish an annual report on government’s major projects.

“The Authority initially expected to publish an annual report in December 2011 but is now expecting the report to be published in May or June 2012. The format of the annual report, and the information it will contain, has yet to be decided.”

Comment:

Many times over the last 20 years I have said that publishing status reports on major IT-based projects and programmes would be the most effective single action any government could take to deter departments from going ahead with overly ambitious schemes that are doomed to fail. If, against good sense, impractical schemes are approved, publishing status information will make all the difference.

Permanent secretaries will not lose sleep over a failing project, but they will not want information on it published – which is why that information should be published.

Publishing status information would give civil servants a good reason to tackle weaknesses as they developed.  Permanent secretaries may not mind losing public money on a failing project or programme. They will always fear embarrassment, however.

Who is really in control of Whitehall – civil servants or No 10? David Cameron’s office has issued a mandate that requires status information on projects to be published. The NAO has issued a similar recommendation. How long can the civil service hold out against the political will?

Links:

NAO report – Assurance for major projects

Firecontrol – same mistakes repeated on other projects

1 Comment

Posted in cost reduction, culture, excessive secrecy, Freedom of Information, Gateway reviews, Government IT, IT projects, IT-related failures, Major Projects Authority, openness and transparency, operational issues, private sector lessons for the public sector, project management, public sector

Tagged , , , ,

The debate over G-Cloud – have your say

Posted on 30/04/2012 | Leave a comment

By David Bicknell

A debate is running over the Government’s plans for G-Cloud. It follows Chris Chant’s Unacceptable IT is pervasive blog on his departure, a response to the comments received on Chant’s blog by his successor, Denise McDonagh, about Cloud Cynicism, and now, and this must break some new ground, a government-hosted ‘crowdsourcing’ opportunity for you to have your say and influence the debate.

Please add your thoughts here

Leave a comment

Posted in Campaign4Change, Cloud, G-Cloud, government, Government IT, IT projects, procurement

Tagged , , , , ,

Is DWP stance on Universal Credit reports mocking FOI?

Posted on 27/04/2012 | 1 comment

By Tony Collins

The Department for Work and Pensions, which has remained as secretive over the progress or otherwise of its IT-based projects as before the 2005 Freedom of Information Act, has, as expected, rejected our FOI request for reports on the state of the Universal Credit project.

We have appealed and the DWP has, as is customary, delayed its response. It appears that the Department works on the principle that the longer it delays FOI responses the more out of date will be its reports when the Information Commissioner eventually rules they must be published.

In its reply to us, the DWP gave reasons for hiding a report it has already put in the public domain: a “Starting Gate Review” of Universal Credit.

Hiding reports under its jumper

The review was carried out in February 2011. That the DWP is keeping under its jumper a public report suggests that its responses to the FOI Act owe more to instinct than proper consideration.

The DWP also refused to publish, under the FOI Act, a Universal Credit “Project Assessment Review in November 2011” by the Cabinet Office’s Major Projects Authority.

These are the reasons Ethna Harnett, Universal Credit Division, DWP,  gave for refusing our FOI request for Universal Credit project progress reports:

– “Further reviews, by the Major Project Authority and by the National Audit Office are planned.”

– “Elements of the information you requested is being withheld as it falls under the exemption in Section 36 (2) (b) and (c) of the Freedom of Information Act. This exemption requires the public interest for and against disclosure to be balanced.”

– “The information you have requested includes details of a sensitive nature whose publication would prejudice effective conduct of public affairs. There is a strong public interest in the Department maintaining an efficient and effective risk management and assurance process and in ensuring that this process is not undermined by premature disclosure particularly where risks are not yet fully mitigated.”

– “There is also a strong public interest in the Department being able to carry out and use frank assessments, including unrestrained and candid contributions from business areas. ”

– “The assurance reports produced by the Major Project Authority are not shared beyond the Senior Responsible Owner and interested parties within Government.”

– “DWP Ministers have, however, committed to update Parliament on the Universal Credit programme through written ministerial statements. These statements are available on the Parliamentary website – www.parliament.uk.”

– “The Major Projects Authority will publish information on the progress of the Government’s high-risk and high-value projects, referred to collectively as the government major projects portfolio, alongside the first annual report at the end of this financial year.”

Comment:

The DWP has never met any of our FOI requests and has, in every case, delayed its responses to our requests for internal appeals. The result of the appeals is always the same – the upholding of the original decision. We are in awe of the DWP’s ability to detach its IT operations from the FOI Act.

The DWP considers it is acting in the public interest: that assessments of its IT-based projects such as Universal Credit would not be candid if they were put in the public domain.

But if the DWP had got this right and that its assurance reports would be less effective if published, we’d expect to see successes with major DWP IT-based projects. We don’t see the evidence.

Indeed the signs are that Universal Credit, the DWP’s biggest project, is in trouble; and after 20 years the Department is still having trouble combining its various benefit systems.

The National Audit Office has qualified the DWP’s accounts every year for the last 23 years, largely because of the level of official error and fraud.

Is this a department that is getting IT right?  There is no evidence it is; and some evidence suggests it isn’t.

The DWP needs to change. It needs to see openness as an opportunity not a threat. Openness would show that officials are prepared to be measured publicly against the findings of their assessment reports. That needs self-confidence.

On the other hand secrecy permits an uneasy introspection, allows weaknesses to take hold, and gives officials comfort in not changing.

Somerset Maugham put it well in his excellent book Of human Bondage. He said: “Like all weak men he laid an exaggerated stress on not changing one’s mind.”

Time for truth on Universal Credit

Millions of pounds of secret DWP reports

Universal Credit latest

FOI blog

Trying to kill the FOI Act?

1 Comment

Posted in Campaign4Change, change, culture, DWP, excessive secrecy, Freedom of Information, Government IT, HMRC, Major Projects Authority, openness and transparency, Universal Credit

Tagged , ,

Government publishes data on £70 billion of future contracts

Posted on 27/04/2012 | Leave a comment

By David Bicknell

The Government has published data on £70 billion of potential future government contracts, with Cabinet Office minister Francis Maude arguing that the move marks a new era in openness about its long-term business needs.

“We have published details of £70 billion of potential Government business. Publishing data on what we plan to buy – whether it’s tunnels or computers – means we can identify skills gaps sooner and give industry a heads up so UK businesses are in a better position to compete,” he said.

The data published of potential future contracts over the next five years, covers 13 different sectors including construction, property, medical and police equipment. The publication of the data increases the potential opportunities for SMEs to bid for government business.

Information Age magazine has reported that the £70bn includes £2.5bn worth of IT projects.

Data on the contracts can be found at Contracts Finder

£70 billion of potential government business published to boost UK growth

Leave a comment

Posted in Campaign4Change, government, Government IT, procurement, SME

Tagged , ,

Cash-strapped council IT teams to get backing for innovation projects

Posted on 27/04/2012 | 2 comments

By David Bicknell

IT teams in cash-strapped councils are being given a helping hand to drive new IT projects where teams believe technology innovation could drive positive change in local communities.

It follows the launch of a Future Fund created by mobile telecomms company O2 to help forward-thinking councils get to grips with new methods of engaging their staff, citizens and communities.

Successful local authorities applying for the scheme will be awarded access to O2 consultancy time, services and technology to help them turn their project ideas into reality.

The Future Fund open for applications on 25th April with three grant funding packages available to the value of £125,000, £75,000 and £50,000.

60 councils attended the launch event with the scheme focused on authorities developing ideas and services against three broad themes: reducing cost and improving efficiencies; finding new ways of engaging with citizens; and empowering the community to do more for itself.

Each of the topics points to more effective service delivery, by empowering staff or by expanding the concept of ‘self-service’.

To support the Fund’s launch, O2 plans to showcase 17 different parts of its business, each with their own unique slant on the digital age, from established technologies such as wi-fi to ‘people’ skills, social media expertise, mobile advertising and location-based services, as well as business engagement and apps development. Councils will be able to pick which selection of services to use to build their idea and weave into their bid.

O2 says it has created the Future Fund through its Local Government Futures Forum, which aims to understand what the role of IT should be in modernising councils in challenging times.

It argues that as technology advances at a rapid pace, with people creating and consuming data in more diverse and immediate ways, councils face a challenge to use these channels to demonstrate communications nous and find new ways to engage with their communities.

A recent consultation exercise found that budget cuts across the public sector have resulted in an expected automatic squeeze on resources, with mounting pressure across all departments to operate more efficiently and do more with less. 

With ongoing pressure to reduce spending, council decision-makers are opting for solutions that make an immediate impact – cutting services, and in turn cost – rather than looking at ways of adapting them, with IT departments facing an uphill struggle to retain and control their destinies, often competing for de-centralised budgets across multiple teams with no place or input at a board level.

Ben Dowd, Director of Business at O2 says: “O2 believes that the right application of technology has the potential to drive real change. Our findings through our work with local government IT departments support this belief. What is different is that the Future Fund will give a glimpse of what is possible with a bit of imagination and we will support the winning bids by providing investment in their IT infrastructure coupled with resource and expertise.

“So it is up to the councils to determine how it can be applied to their own council, citizens or community, ultimately giving local government the ability to shape their own destiny in a project they are passionate about.”

Applications for the Fund will be judged by a panel of experts from O2 and independent parties. Councils will then have eight weeks to develop and deliver their ideas, before selection takes place later this year.

www.o2.co.uk/futurefund

2 Comments

Posted in change, cost reduction, efficiency savings, government, Government IT, innovation, local government, public sector, public services, SME

Tagged , , , , , , , , ,

Maude responds to fears over data-sharing between government agencies

Posted on 26/04/2012 | Leave a comment

By David Bicknell

Cabinet Office minister Francis Maude has responded to a Guardian story which reported that ministers are planning to shake up the law on using confidential personal data to make it easier for public-sector organisations to share confidential information supplied by the public.

The article had argued that “the proposals are similar to ‘database state’ legislation abandoned by the last Labour government in 2009 in the face of fierce opposition. That legislation was intended to reverse the basic data protection principle that sensitive personal information provided to one government agency should not normally be provided to another agency for a different purpose without explicit consent.”

Maude has responded to the Guardian piece, saying, “One of the guiding principles of this Government is the restoration of civil liberties and rolling back the intrusive state; that is why one of our first legislative acts was to scrap ID cards. So it is wrong to say our proposals are similar to the previous government’s abandoned “database state” legislation.

“We want people to be able to interact with government online, for example, in applying for benefits or a disabled parking permit, in a way that is quick, easy and secure. To do this we need to give them a way of proving their identity online, but only if they choose to. This would be done without a national, central scheme.

“This is all about putting the citizen in charge, not the state. But we are still taking great care to carefully consult on our plans. Throughout all our work in this area we have proactively engaged with privacy and consumer groups including NO2ID, Privacy International, Which?, London School of Economics, Oxford Internet Institute and Big Brother Watch.

“In June the Cabinet Office will publish, in a white paper, plans for improving data-linking across government. What will not be published in this white paper are any “fast-track” proposals that would require changes to the existing legislative landscape. Any such proposals will need careful consideration with the involvement of the public and interest groups with whom we will continue to engage.

“This is not a question of increasing the volume of data-sharing that takes place across government, but ensuring an appropriate framework is in place so that government can deliver more effective, joined-up and personalised public services, through effective data-linking.”

Leave a comment

Posted in data sharing, government, Government IT, openness and transparency

Tagged , , , , ,

Cerner project over budget by 100 times amount of local heart monitor donations

Posted on 25/04/2012 | Leave a comment

By Tony Collins

When the Lord Mayor of Bristol presented a cheque for £20,000 to buy 10 cardiac monitors for local hospitals he could not have known that NHS officials were quietly spending more than 100 times that amount on an over-budget Cerner project.

A charity, the Frenchay Cardiac Support Group, raised the £20,000 through a shop and fund-raising events. It was 100th the amount  of the overspent element on a project to install an NPfIT Cerner patient administration system at the North Bristol NHS Trust.

Officials at NHS Connecting for Health and the Trust may consider it unfair of Campaign4Change to compare a charity donation with the unplanned extra costs of an IT-enabled change programme. But whereas North Bristol is accountable to local patients and fund-raisers for the £20,000 donation, it has no duty to explain to its patients (or anyone) how or why it has spent £5m on a Cerner project that was expected to cost the Trust about £3m.

The figures are buried deep in the Trust’s latest board papers. There has been no discussion of the overspend during the public part of the Board’s March meeting. Nor was it mentioned on the Board’s agenda for the meeting.

What the Trust says

The Trust declined our invitation to explain the overspend saying that it has commissioned a review of the Cerner project by PWC. Its statement to us said:

“North Bristol NHS Trust has commissioned an independent review into the issues surrounding the implementation of its new electronic patient record system. This will be carried out by PricewaterhouseCoopers LLP.  The outcome of the review will be published in due course.  We do not feel it is appropriate to comment further until the conclusion of the review, which is expected to take several weeks.”

The Trust’s papers say that the majority of capital spending in January and February was on the Cerner project. The anticipated spending on the project will be more than £5m which would see the Trust considerably overspent because of the difficulties encountered, say the papers.

The same Board papers put the Trust’s IM&T overspending at about £2.3m. This is on top of the hundreds of millions of pounds that NHS Connecting for Health is paying BT to install Cerner at sites in the south of England, including north Bristol.

Comment:

NHS Trusts across London and the south of England are expected to install new Cerner systems in the coming years. London is in the midst of a major procurement, as is the south. If the disruption is as serious as in some earlier implementations thousands of patients will be affected. So what?

At North Bristol the NPfIT implementation of Cerner has gone seriously awry. Besides the duplication of medical records, disruption to appointments, and, for the first time, the missing of a two-week wait target for cancer patients, there have been at least 16 clinical incidents; and the Trust’s papers say there has been a “significant increase in DNA [Did Not Attend an appointment] rates since the implementation of Cerner”.

Time heals?

Does it matter? It will all settle down in time say NHS officials.

Indeed some in the NHS and the scientific community in general have a view that taking known risks are part and parcel of achieving Progress. If lives are lost pushing back frontiers of knowledge it is for the greater good. Hence the justification for risks taken in launches of the Space Shuttle and building new designs of bridges, tunnels and aircraft.

The greater good

It’s a philosophy not lost on officials at NHS Connecting for Health. Go-lives of electronic patient record systems will be disruptive and may even affect the care and treatment of patients. But it’s for the greater good and the damage won’t last too long. Besides, if the health of any individual patients is affected, this will be supposition: no official evidence will exist.

So should patients fear the implementation of new hospital-wide systems? It’s a little like the early flights of commercial aircraft. Most flights will go without incident but now and again a passenger jet will crash.

One difference between aircraft crashes and hospital IT implementations is that crashes are usually investigated by law, and lessons applied by regulatory authorities to make flying safer. The NHS has no duty to investigate or apply lessons from its IT-related mistakes. Which is one reason that the lessons from the Cerner implementation at Nuffield Orthopedic Centre in Oxford in 2005 have still not been learned. For example there were important differences in the way the Nuffield’s staff and doctors worked, and the way the system was designed to work.

Who would want to fly in an aircraft that hasn’t been certified as safe? So should patients experience an NHS that has uncertified patient record systems?

In aircraft crashes deaths are obvious. There is often a clear cause and effect. In the NHS there is no certification of IT systems. A hospital can go live with whatever systems it wants, whatever the effect on patients. Indeed the reporting of any damage to patients is down to the Trusts. That’s a clear conflict of interest – like relying on the builders of a supertanker to report the effects on wildlife and fish of an oil spillage.

It’s time for a change.

It’s time for the NHS – and the Department of Health and particularly NHS Connecting for Health – to get professional about hospital-wide IT implementations.

It’s time for regulation and certification, minimum standards of safety and independent reporting of disasters.

Links:

Does Hospital IT need airline-style certification?

Halt NPfIT Cerner projects says MP

NPfIT Cerner installation at Bristol as “more problems than anticipated”

Why is North Bristol Cerner project so expensive?

An ongoing IT crisis case study – North Bristol NHS Trust

Lessons from Cerner go-live at Nuffield in 2005.

Leave a comment

Posted in Campaign4Change, Government IT, managing change, managing outsourced services, NHS, npfit, openness and transparency, operational issues, oversight, Politics, private sector lessons for the public sector