Category Archives: improving communications

Campaign for electronic patient information centre

By Tony Collins

Shane Tickell, CEO of health IT supplier IMS Maxims, is leading a campaign for a national electronic patient information centre.

It would enable NHS staff, healthcare organisations and government suppliers to share details of, or learn about, innovative practices that work.

In a guest blog, Tickell argues that there are many examples of innovation in the NHS but information on the successes is scarce or not available in one place.

He advocates a physical and a virtual centre. Information, case studies, best practice and ideas from the NHS would be shared online. There are some websites that do this, but in isolation. The virtual site he proposes would be interactive and a way of collating information that exists in silos.

The physical centre, Tickell says, could be anywhere on the UK, potentially using some of the 2,000 acres of unused NHS estate. It would be a forum for education and sharing, where suppliers could showcase their systems, and NHS staff could speak openly about what they need from suppliers.

It would also be a place for policy to be explained by government officials, where quangos define their requirements, and NHS trusts share what they are doing and the lessons they have learned.

Shane Tickell writes:

“As an acceptance grows across the NHS that there is a crucial need for integration across health and social care, the extent to which our National Health Service is disjointed is becoming increasingly clear.

In many areas, although of course not all, there are so many examples of different approaches, poor collaboration and lack of joined thinking between organisations despite their attempts to achieve the same goals. On many occasions, I’ve seen examples where an NHS organisation has shared the results of a successful pilot with another organisation hundreds of miles away and yet the trust just a few miles down the road has no idea the initiative even exists.

In recent years, healthcare IT events such as EHI Live have helped suppliers of all sizes showcase their solutions, albeit just once a year.

However, despite best efforts, most often suppliers with the biggest marketing budgets often take the centre stage, while the smaller, more innovative companies huddle around the edges trying to grab the attention of the odd delegate who is less wowed by the exciting gizmos and freebies on the bigger stands.

Equally, these events have been valuable in enabling the NHS to share their experiences by allowing them to participate in best practice showcases. But while these shows are valuable in providing those once-a-year opportunities to network and see what is available, ideas and information gathered can soon be forgotten once back in the busy NHS setting, until the next time an event comes around.

There are more than 400 pilots across the NHS and 300 ‘examples of innovation’ alone, according to the BCS. On top of all of that, my team recently mapped more than 40 NHS organisations and bodies, who work virtually disparately to attempt to provide the NHS with direction, standards and protocols.

So where does this leave the NHS – confused? Disjointed? Not a clue where to start when they are told that they need to collaborate and innovate to improve patient safety and care while saving vast sums of money?

The NHS needs a place that provides an educational and innovation forum covering everything related to electronic health and wellbeing that is available all year round – an electronic patient information centre.

At present there are pockets of innovation across the country. Initiatives set up by the National Innovation Centre and its associated ‘innovation hubs’ are providing a useful mechanism to support and adopt healthcare technology across the regions.

But an all year round centre would provide a central location for healthcare organisations, bodies, government and suppliers to meet, discuss and understand policy. Equally important, the centre would provide a valuable place to educate on future challenges and where they are being driven from and an opportunity to work together to help to address them as soon as they start to emerge.

Although it would require investment, such a centre would provide trusts, CCGs, private and independent organisations and just about anyone with an interest in health and social care regardless of their budget, size, location or IT savviness with the opportunity to attend at a time that is convenient for them.

Meanwhile, suppliers of any shape or size would have a level playing field from which to be represented and educate their current and potential customers, rather than trawling up and down the country trying to find inroads to speak to those on the frontline. In addition, it would ensure that all is not lost from the National Programme for IT and that lessons learned are shared.

For too long the NHS has had to rely on word of mouth and second-guessing how surrounding organisations are achieving success. Now is the time to really work together to ensure true innovation is shared and for everyone to have a chance to be part of it.”

LinkedIn group – Electronic Patient Information Centre 

shane.tickell@imsmaxims.com.

Advertisements

Well done Eric Pickles – more open government to engulf councils

By Tony Collins

Few people have noticed but changes to the law next month could force councils to be much more open about big spending decisions including those that involve contracting out IT and other services.

It is a pity though that similar changes will not apply to the NHS.

The Local Government Association says that councils are already more open than Whitehall which is true.

Even so some councils are innately secretive about IT-related spending decisions, and discussions about projects that go wrong. Somerset County Council was notoriously secretive about its Southwest One joint venture with IBM in 2007. The deal has not made the expected savings and has consistently made losses. IBM claims the deal is a success.

Haringey Council’s “Tech refresh” project which went way over budget is another example. Evasive answers to opposition questions and meetings in secret were the norm.

Liverpool City Council was extraordinarily defensive and secretive about progress or otherwise on its Liverpool Direct Ltd joint venture with BT. The deal included giving BT control of IT.

Better public scrutiny

Now Local Government Secretary Eric Pickles has announced that changes to the law will mean that all decisions including those affecting budgets and local services will have to be taken in an open and public forum.

Ministers have put new regulations before Parliament that would come into force next month to extend the rights of people to attend all meetings of a council’s executive, its committees and subcommittees.

Pickles says the changes will result in greater public scrutiny. “The existing media definition will be broadened to cover organisations that provide internet news thereby opening up councils to local online news outlets. Individual councillors will also have stronger rights to scrutinise the actions of their council.

“Any executive decision that would result in the council incurring new spending or savings significantly affecting its budget or where it would affect the communities of two or more council wards will have to be taken in a more transparent way as a result.”

Councils will no longer be able to cite political advice as justification for closing a meeting to the public and press. Any intentional obstruction or refusal to supply certain documents could result in a fine for the individual concerned.

The changes clarify the limited circumstances where meetings can be closed, for example, where it is likely that a public meeting would result in the disclosure of confidential information. Where a meeting is due to be closed to the public, the council must now justify why that meeting is to be closed and give 28 days notice of such decision.

Chris Taggart, of OpenlyLocal.com, which has long championed the need to open council business up to public scrutiny, said

“In a world where hi-definition video cameras are under £100 and hyperlocal bloggers are doing some of the best council reporting in the country, it is crazy that councils are prohibiting members of the public from videoing, tweeting and live-blogging their meetings.”

These are the changes to be made by the  The Local Authorities (Executive Arrangements) (Meetings and Access to Information) (England) Regulations 2012 (the 2012 Regulations) which will come into force on 10 September 2012.

– Local authorities will have to provide reasonable facilities for members of the public to report council proceedings (regulation 4). This will make it easier for new ‘social media’ reporting of council executive meetings, opening proceedings to blogging, tweeting and hyper-local news/forum reporting.

– In the past council executives could hold meetings in private without giving public notice. From 10 September 2010 councils must give 28 days notice where a meeting is to be held in private, during which time people may make representations on why the meeting should be held in public. When the council wants to over-ride the notice period, it must publish a notice as soon as reasonably practicable explaining why the meeting is urgent and cannot be deferred (regulation 5).

– A document explaining the key decision to be made, the matter in respect of which a decision would be made, the documents to be considered before the decision is made, and the procedures for requesting details of those documents, has to be published (regulations 9).

– The new regulations create a presumption that all meetings of the executive, its committees and subcommittees are to be held in public (regulation 3) unless a narrowly-defined legal exception applies.

– Where the council has a document that contains materials relating to a business to be discussed at a public meeting, members of the local authority have additional rights to inspect such a document at least five days before the meeting (regulation 16). Previously no timescale existed.

– Where the council decides not to release the whole or part of a document to a member of an overview and scrutiny committee as requested by a councillor, it must provide a written statement to explain the reasons for not releasing such document (regulation 17).

– Documents relating to a key decision including background papers must be on the relevant local authority’s website (regulations 5, 6, 7, 9, 10, 14, 15, and 21).

Comment

Well done to Eric Pickles and the coalition. These are important and welcome changes. If council decision-makers know their discussions will be open to scrutiny they may give proper consideration to risks as well as the potential benefits of big IT-related investments. With inadequate scrutiny the potential benefits often drive decisions, which was the case with the flawed setting up of Southwest One. The press office at Liverpool City Council was so used to controlling information that its spokesman was outraged at questions we asked about its outsourcing venture with BT.

But what about the NHS?

It’s a pity the NHS is not subject to the new legal changes. Few trusts are open about their big IT-related investments; and when things go wrong, as has happened with some Cerner implementations, NHS trusts tend to lock all the doors, talk in whispers and instruct their press offices to issue statements that claim “teething troubles” have been largely addressed. The trust and everyone reading the statement know it is disingenuous but the facts to prove it are kept under wraps.

Organisations such as Imperial College Healthcare NHS Trust are taking decisions about major IT upgrades that could affect the safety, health and lives of patients without proper scrutiny. Pickles may want to mention his legal innovations to Andrew Lansley.

Eric Pickles announcement on opening up council discussions and decisions 

Ex Govt CIO speaks – having left the public sector

By Tony Collins

In November last year we asked “Where is the Government CIO?”

We said that the then Government CIO Joe Harley – amiable, straight-talking and influential – could be the civil service’s ambassador for change.

Like his predecessor John Suffolk he could have used conferences and public events to talk inspirationally about the dystopian costs of government IT and what to do about them.  Why hasn’t he, we asked.

“If the Government CIO has much to say, it is not for the public ear. While there has been talk in recent weeks of how five corporations control GovIT, and how it can cost up to £50,000 to change a line of code, Harley has been silent.

“Where does the Government CIO stand on the need for major reform of the machinery of government, on the sensible risks that could save billions? Is the top man in Government IT inspiring his colleagues and officials in other departments to do things differently?”

Now it’s good to hear Joe Harley has speaking publicly about government IT, and what needs to be done. He has left the public sector though.

He suggested to Computing that there needs to be less strategising and more action.

“The whole emphasis now needs to be on implementation and delivery. There has been enough strategising and there really needs to be execution… [The government must] deliver on the implementation plan that we created and grow the talent with capability for the future.

“When it starts to deliver, we’ll start to see government ICT getting a [better] reputation,” he said.

Comment

Who will do less strategising and focus more on delivery?

As Harley now says, there needs to be individual accountability for decisions rather than a generalised blaming of committees.

“I think we need to be more light-footed and make people more accountable for their decisions and actions rather than [blaming] committees and programme boards,” he said.

No individual in government is going to make the changes that Harley recommends. Any real changes will be effected by committees and programme boards. Which is probably why material change in government administration and IT will happen in geologic periods. Unless an individual with charisma and leadership abilities – and who doesn’t mind talking in public while still in the public sector – is prepared to make the difference.

NHS Trust has “major concern” over spend on Cerner

By Tony Collins

North Bristol NHS Trust reports in its latest board papers that  “overall the level of spending on Cerner continues to be a major concern and the IM&T Director is working to develop a plan to identify what will be needed in the current year”.

The trust went live with Cerner Millennium in December 2011 and had various problems which the Trust said had been “overcome” by 1 May 2012.

But the Trust’s board papers last month hint that some difficulties are continuing.

“There are also clearly still data issues from Cerner which are affecting these numbers which the team are working on,” says a North Bristol finance paper in June.

The overspend on Cerner is about £900,000 for a two-month period. The paper says the “costs of Cerner remain a risk as some of the forecast spend may need to be re-classified as revenue.

“The detail on this is currently being reviewed by the Director of IM&T and isn’t included in the month 2 position… There has been relatively little spend in capital with the exception of Cerner which has incurred £0.9m of cost for 2 months.”

The anticipated spending on the Cerner implementation for the Trust will be more than £5m.

Comment:

It’s not unusual for hospitals to run into trouble with a Cerner Millennium implementation.  When confronted with serious IT-related difficulties private sector organisations sometimes confront what has gone wrong with urgency, pragmatism and trying not to pretend things are better than they are.

Public sector organisations, when facing IT-related difficulties, can fall into the trap of concentrating on what has gone right, and talk as little as possible about the problems. Indeed North Bristol’s latest board papers hardly mention the Millennium difficulties.  There is not a mention in the Audit Committee report. Not a mention in the board agenda.  Only a finance report says that spending on Cerner is a major concern. Elsewhere in the board papers there are short, oblique references to data difficulties.

“With reference to the figures in Table 3, it was confirmed that all patients had been contacted but accuracy of the data could still not be guaranteed and reporting continued to be 2 months behind…  There were also a lot of duplicate referrals on the system.  This was being rectified but may affect billing,” says one board paper.

It would be wrong to suggest that a culture of accentuating the positive and hunching the shoulders at the negative has anything to do with IM&T. It’s one of the differences between the private and public sectors.

North Bristol’s board needs to be more open. If it cannot admit its difficulties how will it tackle them? And what is the point of taxpayers paying for internal auditors that simply assure the board they are doing a great job?

NPfIT Cerner go-live at North Bristol has more problems than anticipated.

Halt Cerner implementations after patient safety problems at five hospitals says MP

Richard Granger “ashamed” of some systems

North Bristol overspends £1m on Cerner

We operated on the wrong organ – but hey, it’s OK.

By Tony Collins

When a surgeon operates on the wrong organ the NHS calls it “wrong site surgery” (a euphemism which makes it sound like an official part of a medical student’s curriculum).

A surgical intervention on the wrong organ could never be a source of reassuring news unless it’s in the board papers of an NHS trust.  NHS board papers are, more often than not, the source of good news announcements, statistics and graphs. Bad news is between the lines.

This was North Bristol NHS Trust’s account of what it said was a “surgical intervention [that] was performed on the wrong organ in a patient”. The operation was complex due to distortion of the patient’s anatomy. “This incident has resulted in some long term harm for the patient although the patient has since fully recovered.” The trust reports more reassuring news:

–  the patient has been fully informed

–   and given an apology

–    a full investigation has been carried out and lessons learnt

–   the consultant surgeon was experienced, and was assisted by another specialist

–   the World Health Organisation Surgical Safety Checklist was used correctly and as such, could not have prevented this error.

–  the case was discussed at directorate clinical governance meetings and disseminated widely to raise awareness of distorted anatomy with clinical staff.

–  the Clinical Risk Committee, Commissioners and the National Patient Safety Agency are assured that human error is an acceptable reason for this incident and that all procedures were carried out correctly.

Comment:

It sounds reassuring that all procedures had been carried out correctly, and that the World Health Organisation Surgical Safety Checklist was used correctly. But if a sleeping driver injures someone, should his colleagues be assured that he’d just put the car through an MoT and was driving under the speed limit?

Trust board papers need to connect with everyday reality. I’d venture to suggest they are not the place for announcements on managerial successes.

The same trust reported the separate case of an  “Unintended retention of a foreign object post surgical intervention”. The retained object was a small microvascular clamp and this was removed during a subsequent operation,

“which resulted in a satisfactory outcome for the patient”.  Good news then.

We wonder how the trust will report the findings from its investigation of recent IT troubles.

NPfIT Cerner go-live at Bristol has “more problems than anticipated”

By Tony Collins

The BBC reports that there are “more problems than anticipated” with a patient-booking system at two Bristol hospitals run by North Bristol NHS Trust.

The trust describes the problems as “teething”.  Consultants say the problems are “potentially dangerous”.

Last month North Bristol went live with the Cerner Millennium system under an NPfIT contract with BT. The Trust says problems are due to software being used incorrectly. They have led to some patients missing their operations and the wrong patients being booked for operations, says the BBC.

Emails from executives at Frenchay and Southmead hospitals, seen by the BBC, said staff should be “vigilant” to check lists were “completely accurate”.

BBC Points West’s health correspondent Matthew Hill said emails sent by consultants to hospital bosses claimed operation lists printed by the system were “complete fiction” and “potentially dangerous”.

One consultant told the BBC he had been put down to operate on patients from a completely different speciality.

The trust said there had been “teething problems” and that there had been “more problems than anticipated”.

In an email to staff the trust said the change of system had been “a very big change” so there was “no surprise” there had been difficulties.

A trust spokesman said there were a series of problems around outpatients and the associated clinics and some of the data moved from old systems had not migrated as planned.

“We need to ensure that we rebuild and recreate the clinics to match what people expect them to be on the ground,” he said.

“In theatres we have had some issues but have absolutely ensured from the outset that clinical safety has been at the top and have ensured any risks and issues have been mitigated.”

Conservative MP Richard Bacon, a member of the Public Accounts Committee, has established through a Parliamentary question that the cost of the North Bristol Cerner implementation is much higher than for a non-NPfIT installation in the same city.

Health Minister Simon Burns told Bacon that the costs of a Cerner Millennium deployment at the North Bristol NHS Trust were £15.2m for deployment and an annual service charge of £2m.

This brought the total cost of the Cerner system over seven years to about £29m, which was more than three times the £8.2m price of a similar deployment outside of the NPfIT at University Hospitals Bristol Foundation Trust.

Comment

Several Cerner implementations under the NPfIT have gone awry but the problems have eventually been resolved. The question is whether patient care and treatment is affected in the meantime. The lack of openness over problems with patient care in the NHS mean that the answer will probably never be known, which underlines the need for better regulation of hospital IT implementations.

Does hospital IT need airline-style safety certification?

School report on Govt ICT Strategy – a good start

By Tony Collins

In a review of progress on the Government’s ICT Strategy after six months, the National Audit Office says that the Cabinet Office has made a “positive and productive start to implementing the Strategy”.

The NAO says that at least 70 people from the public sector have worked on the Strategy in the first six months though the public sector will need “at least another 84 people to deliver projects in the Plan”.

The UK Government’s ICT Strategy is more ambitious than the strategies in the US, Australia, Netherlands and Denmark, because it sets out three main aims:

– reducing waste and project failure

– building a common ICT infrastructure

– using ICT to enable and deliver change

The US Government’s ICT Strategy, in contrast, encompasses plans for a common infrastructure only – and these plans have not produced the expected savings, says the NAO.

In a paragraph that may be little noticed in the report, the NAO says that senior managers in central government have plans to award new ICT contracts (perhaps along the pre-coalition lines) in case the common solutions developed for the ICT Strategy are “not available in time”.

The NAO report also says that “suppliers were cautious about investing in new products and services because of government’s poor progress in implementing previous strategies”.

Of 17 actions in the Strategy that were due by September 2011, seven were delivered on time. Work on most of the other actions is underway and a “small number” are still behind schedule says the NAO.

The NAO calls on government to “broaden the focus to driving business change”.

Some successes of the UK’s ICT Strategy as identified by the NAO:

* The Cabinet Office has set up a small CIO Delivery Board led by the Government CIO Joe Harley to implement the ICT Strategy. The Board’s members include the Corporate IT Director at the DWP, CIOs at the Home Office, MoD, HMRC, Ministry of Justice and Department for Health, together with key officials at the Cabinet Office. The departmental CIOs on the Board are responsible directly to Francis Maude, Minister for the Cabinet Office, for implementing the ICT Strategy in their departments and are accountable to their own minister. No conflicts have arisen

* Senior managers in central government and the ICT industry are willing to align their strategies for ICT with new cross-government solutions and standards but need more detail.

*  Some suppliers have offered help to government to develop its thinking and help accelerate the pace of change in ICT in government.

* The Cabinet Office intended that delivering the Strategy would be resourced from existing budgets. Staff have been redirected from other tasks to work on implementing the Strategy. “We have found collaborative working across departmental boundaries. For example HMRC and the MoD have combined resources to develop a strategy for greener ICT. Teams producing the strategies for cloud computing and common desktops and mobile devices have worked together to reduce the risk of overlap and gaps.

* The BBC has shown the way in managing dozens of suppliers rather than relying on one big company. For BBC’s digital media initiative, the Corporation manages 47 separate suppliers, says the NAO.

* The Cabinet Office intends that departments will buy components of ICT infrastructure from a range of suppliers rather than signing a small number of long-term contracts; and to make sure different systems share data the Cabinet Office is agreeing a set of open technical standards.

* Some of the larger departments have already started to consolidate data centres, though the NAO said that the programme as a whole is moving slowly and no robust business case is yet in place.

* The Cabinet Office is starting to involve SMEs. It has established a baseline of current procurement spending with SMEs – 6.5% of total government spend – and hopes that the amount of work awarded to SMEs will increase to 25%. Government has started talking “directly to SMEs”, says the NAO.

Some problems identified in the NAO report:

* Cloud computing and agile skills are lacking. “Government also lacks key business skills. Although it has ouitsourced ICT systems development and services for many years, our reports have often stated that government is not good at managing commercial relationships and contracts or procurement.”

* Suppliers doubt real change will happen. The NAO says that suppliers doubted whether “government had the appropriate skills to move from using one major supplier to deliver ICT solutions and services, to managing many suppliers of different sizes providing different services”.

* The Government CIO Joe Harley, who promoted collaboration, is leaving in early 2012, as is his deputy Bill McCluggage. The NAO suggests their departures may “adversely affect” new ways of working.

* The NAO interviewed people from departments, agencies and ICT suppliers whose concern was that “short-term financial pressure conflicted with the need for the longer-term reform of public services”.

* The culture change required to implement the Strategy “may be a significant barrier”.

* The Cabinet Office acknowledges that the government does not have a definitive record of ICT spend in central government (which would make it difficult to have a baseline against which cuts could be shown).

* The Cabinet Office has not yet defined how reform and improved efficiency in public services will be measured across central government, as business outcomes against an agreed baseline.

**

Amyas Morse, head of the National Audit Office, said today: ” ICT is going to play an increasingly important role in changing how government works and how services are provided.

“The Government’s ICT Strategy is in its early days and initial signs are good. However, new ways of working are as dependent on developing the skills of people in the public sector as they are on changes to technology and processes; the big challenge is to ensure that the Strategy delivers value in each of these areas.”

NAO report:  Implementing the Government ICT Strategy: six-month review of progress.

Government’s new ICT plan – the good, bad and what’s needed

By Tony Collins

There is much to commend the 102-page Government’s ICT Strategy – Strategic Implementation Plan”.  Its chief assets are the touches of realism.

In the past Cabinet Office documents have referred to the billions that can be cut from the annual government IT spend of £15bn-£20bn. This document is different.

In promising a saving of just £460m – and not until 2014/15 – Cabinet Office officials are not being ambitious, but neither are they making impossibly unrealistic claims. [The press release refers to £1.4bn of savings but there’s no mention of that figure in the document itself.]

The Implementation Plan also points out that the oft-quoted annual government IT spend of £16bn-£17bn is not spending in central government IT alone but includes the wider public sector: local government, devolved administrations and the NHS. The Implementation Plan concedes that there is “no definitive or audited record of ICT spending in central government for 2009/10”, but it adds, “the best estimates suggest this to be around £6.5bn in central government…”

Now at last we have a figure for the cost of central government IT. But we’re also told that the Cabinet Office has no control or strong influence over most of the ICT-related spending in the public sector. The document says:

“Though implementation is not mandatory outside central government, Government will work with the wider public sector to identify and exploit further opportunities for savings through greater innovation, and sharing and re-use of solutions and services.”

That said the document has some laudable objectives for reducing ICT spending in central government. Some examples:

–         50% of central departments’ new ICT spending will be on public cloud computing services – by December 2015. [Note the word “new”. Most departmental IT spending is on old IT: support, maintenance and renewal of existing contracts.]

–         First annual timetable and plans from central government departments detailing how they will shift to public cloud computing services – by December 2011.

–         Cost of data centres reduced by 35% from 2011 baseline – by October 2016. [What is the baseline, how will the objective be measured, audited and reported?]

Drawbacks:

It is a pity the document to a large extent separates IT from the rest of government. If simplification and innovation is to be pervasive and long-lasting senior officials need to look first at ways-of-working and plan new IT in parallel with changes in working practices, or let the IT plans follow planned changes.

Not that this is a black-and-white rule. Universal Credit is an essentially IT-led change in working practices. The technology will cost hundreds of millions to develop – an up-front cost – but the simplification in benefit systems and payment regimes could save billions.

Another problem with the Implementation Plan is that it is in essence a public relations document. It is written for public consumption. It has little in common with a pragmatic set of instructions by a private sector board to line managers. Too much of the Cabinet Office’s Implementation Plan is given over to what has been achieved, such as the boast that “an informal consultation to crowd source feedback on Open Standards has taken place…” [who cares?] and much of the document is given over to what the civil service does best: the arty production of linked geometric shapes that present existing and future plans in an ostensibly professional and difficult-to-digest way.

And many of the targets in the Implementation Plan parody the civil service’s archetypal response to political initiatives; the Plan promises more documents and more targets. These are two of the many documents promised:

“Publication of cross-government information strategy principles – December 2011” …

“First draft of reference architecture published – December 2011.”

Platitudes abound: “Both goals are underpinned by the need to ensure that government maintains and builds the trust of citizens to assure them that the integrity and security of data will be appropriately safeguarded.”

There is also a lack of openness on the progress or otherwise of major projects. There is no mention in the Implementation Plan of the promise made by the Conservatives in opposition to publish “Gateway review” reports.

What’s needed

More is needed on specific measures to be taken by the Cabinet Office when departmental officials resist major reform. The promise below is an example of what is particularly welcome because it amounts to a Cabinet Office threat to withhold funding for non-compliant projects and programmes.

“Projects that have not demonstrated use of the Asset and Services Knowledgebase before proposing new spend will be declined.

“Departments, in order to obtain spend approval, will need to move to adopt mandatory common ICT infrastructure solutions and standards, and spending applications will be assessed for their synergy with the Strategy.”

But these threats stand out as unusually unambiguous. In much of the Implementation Plan the Cabinet Office is in danger of sounding and acting like PITO, the now-disbanded central police IT organisation that had good intentions but could not get autonomous police forces to do its will.

Unless Cabinet Office officials take on more power and control of largely autonomous departments – and overcome the uncertainties over who would take responsibility if all goes wrong – the Implementation Plan could turn out to be another government document that states good intentions and not the means to carry them through.

It’s as if the Cabinet Office has told departmental officials to drive at a maximum speed of 50mph when on official business to cut fuel costs. Will anyone take notice unless the speed limit is monitored? It’s the policing, monitoring and open objective reporting of the Implementation Plan’s intentions that will count.

Otherwise who cares about nameless officials making 100 pages of boasts and promises, even if the proof-reading is impressive and the diagrams look good if you don’t try to follow their meaning?

SMEs and agile to play key role as Government launches ICT plan.

Cabinet Office’s Government ICT Strategy – Strategic Implementation Plan.

Puffbox analysis of Implementation Plan.

Is there a useful job for the Cabinet Office?

Fiddling savings on shared services? Officialdom in need of reform

 By TonyCollins

An NAO report today suggests that some officials are fiddling projected savings figures from a shared services deal involving seven research councils.

It all began so well. A Fujitsu press release in 2008 said:

“UK Research Councils to implement shared services with Fujitsu. £40 million project will generate cost and efficiency savings across the organisations.”

An executive who representedFujitsu Services’ was quoted in the press release as saying at the time:

“Fujitsu is consistently proving that it can deliver effective shared services infrastructures and is playing a vital role in driving forward the transformational government agenda through shared services.

“Organisations that adopt a shared services approach can experience genuine economies of scale and reduction in costs which can be essential in their drive for continuous improvement.

Twenty-one months later Fujitsu and Research Councils UK parted company. The 10-year shared services contract began in August 2007. It was terminated by mutual consent in November 2009.

A revealing report, which is published today by the National Audit Office, shows how, despite the best intentions by the Cabinet Office to improve the management of IT-related projects and programmes, and decades of mistakes to learn from, some officials in departments are still making it up as they go along.

The worrying thing in the NAO report is not only what happened in the past – few will be surprised that the NAO report characterises the shared services deal as lacking professionalism. What’s worrying is officialdom’s more recent disregard for the truth when claiming savings for its shared services arrangements.

The NAO’s report”Shared Services in the Research Councils” suggests that officials manipulated – some could say fiddled – projected savings figures.

The NAO also found that officials awarded a £46m shared services contract to Fujitsu which came second in the bid evaluation. Exactly how the contract came to be awarded will be investigated soon by MPs on the Public Accounts Committee.

Origins of shared services contract  

In 2004 a review led by the Government adviser Peter Gershon suggested that the public sector should save money by sharing support services such as IT, HR and finance. In 2006 officials at the Department of Trade and Industry (now the Department for Business, Innovation and Skills) encouraged their colleagues at seven research councils to set up a shared service centre, which they did.

The UK Research Councils is an important organisation. In 2009/10 it spent £3.7bn, mostly on giving research grants to universities, the European Space Agency and other organisations. Its biggest recipient of grants is the Medical Research Council.

Fujitsu contract

Public servants appointed Fujitsu in August 2007 to put in place the ICT systems to underpin the shared service centre in a ten-year contract worth £46m. Fujitsu came second in the initial bid evaluations.

The NAO said that the bidding process produced a shortlist of three companies including Fujitsu. Said the NAO:

“The initial weightings applied by the [bid] panel had placed Fujitsu second: although the bid had scored well on quality, it was 19 per cent more expensive than the cheapest bid.”

An independent review commissioned by the project board backed the evaluations which put Fujitsu second. But the bid panel and the project board had concerns about the evaluation. The supplier chosen in the evaluation – which the NAO refuses to name – did not score well on quality requirements.

It appears that the bid panel and the project board preferred Fujitsu.

Mathematical error

Then officials happened to spot a mathematical error in the bid scoring. The corrected scoring left Fujitsu on top, as the new preferred bidder.

Said the NAO:

“… a mathematical error was identified by a member of the project team that changed the order of the preferred suppliers, leaving Fujitsu as the front runner

“The [bid] panel reconvened to discuss this but, rather than re-performing in full the quantitative and qualitative analysis and submitting this to independent review, it decided to appoint Fujitsu on the basis of a vote.

“In September 2007 the gateway review team concluded that the incident had weakened the value of the overall process and had left the project at risk of challenge.”

User requirements unclear

Full delivery was due in September 2008 but the project team and Fujitsu “quickly encountered difficulties, resulting in contract termination by mutual consent in November 2009”.

The NAO said there was “miscommunication between the parties about expectations and deliverables, primarily because design requirements had not been sufficiently defined before the contract started”.

Fujitsu consequently missed agreed milestones. “Fujitsu and the Centre told us that the fixed-rate contract awarded by the project proved to be unsuitable when the customers’ requirements were still unclear.”

Officials paid Fujitsu a total of £31.9 million, of which £546,000 related to termination costs. Despite the payments to Fujitsu, parts of the system were withdrawn and rebuilt in-house.

Overspend on Fujitsu contract

The NAO found there were “significant overspends on design and build activities and the contract with Fujitsu.”

At least £13m wasted on Fujitsu deal

Said the NAO:

“Had the Fujitsu contract worked as planned, we estimate that the additional £13.2m design and build costs … would not have been needed. In addition the project management overspend of £9.1m would have been lower, as, after termination of the Fujitsu contract, a significant overhead in managing contractors was incurred by the project.”

Fujitsu out – Oracle in

The breakdown in relations with Fujitsu led to the appointment of Oracle as supplier of the grants element of the project. “The contract with Oracle suggested that lessons had been learnt by the project following its experience with Fujitsu, with greater effort given to specifying the design upfront,” said the NAO.

Did officials know what they were doing?

In deciding how to share services the research councils came up with six options including setting up a centre run jointly by the councils or joining with another public sector agency such as one supplying the NHS.

But two of the options including the NHS one were dropped without proper analysis, said the NAO. The remaining four options were each given a score of one to three, against seven criteria. “The scores appear to be purely judgemental with no quantified analysis,” said the NAO.

Even if the six options had been properly appraised, the evaluation would have failed because it did not include a “do-minimum” option as recommended by HM Treasury.

“Overall, the quality of options appraisal was poor,” said the NAO.

Fiddling the figures?

 The NAO found that:

–         Initial estimates were of zero projected procurement savings from shared services. But by the time the first draft of the business case had been written the projected savings had soared to £693.9m.

–         When this project board queried this figure the research councils’ internal audit service scaled down the figure to £403.7m – but this included £159.3m of savings that internal audit had concluded were not soundly based.

–         Since the shared services centre began officials have recorded procurement savings of £35.2m against the business case and while of these are valid savings some are not. The NAO investigated 19 high-value savings that represented 40% of savings recorded to the end of 2010 and found that 35% “should not be claimed against the project investment”.

–         The research councils have been “unable to provide paperwork to substantiate the claimed saving”.

–         Savings claimed were indistinguishable from normal business practice such as disputing costs claimed by a supplier.

–         Clear evidence exists that the budget holder had no intention or need to pay the higher price against which the saving was calculated

–         Last month the research councils claimed that savings were £28m higher than they had reported previously owing to errors in the original numbers. But the NAO found that the councils were unable to reconcile fully the two sets of numbers; had not used a single method for calculating benefits or tracked these effectively; and had not included £7m of spending incurred by the councils. “Overall, this review has highlighted that Councils have not put in place proper processes to track benefits and forecast future operational savings,” said the NAO.

–         Further, investments needed to deliver projected savings have not been included in calculations.

–         Double counting. A revised target for projected procurement savings procurement “includes elements of double counting …”

Other NAO findings:

–        Four Gateway review reports of progress on setting up the shared services centre, including a review which put the project at “red – immediate action needed”, were not fully followed up. 

–         There was no evidence of intervention by the Department for Business, Innovation and Skills when it became clear the shared services project was likely to overspend.

–         The shared services centre has begun to match the pre-shared services payment performance of the research councils but a high number of invoices was on hold at the end of July 2011 because of problems with the end-to-end processes. About 5,900 invoices were on hold, awaiting payment, in July 2011, which was 21 per cent of all invoices due to be paid in that month. The reason for the delay was being investigated.

–         Despite the shared services arrangements, some research council staff were at times running parallel systems, or managing their businesses without adequate data.

–         In July 2011 the shared services centre had 53 key performance targets to meet but was only able to measure activity against 37 of them and of these met only 13..

–         Five of the seven research councils did not file annual accounts on time in 2011 in part because functions in the finance ICT system were not delivered by the project.

Some good news

Said the NAO:

“The grants function and its associated ICT system developed by the project has allowed the Councils to replace older systems that were increasingly at risk of failing. This is of critical importance, given that the processing of research grant applications lies at the heart of what the Councils do. The single grants system has the potential to make it easier for the Councils to collectively modify their processes in the future…”

Comment

The commendably thorough NAO investigation has shown once again how badly departments and their satellites are in need of independent Cabinet Office oversight when it comes to major IT-related projects. In that respect thank goodness for the Cabinet Office’s Major Projects Authority. But how much influence can it really have? How much influence is it having?

This NAO report suggests that some officials are fiddling the figures without a care for professional accounting practices. Double counting, not including full costs in projected savings calculations, not having paperwork to support figures and other such administrative misdemeanours indicates that some officials are making up savings figures as they go along.

What is to be done when some departments and their agencies are not to be trusted in managing major projects?

NAO report on shared services at seven research councils

FOI team hides already released Universal Credit report

By Tony Collins

Universal Credit is one the government’s most important IT-enabled programmes, along with HMRC’s “Real-time Information” scheme, Whitehall Shared Services and the MoD Change Programme.

If the Universal Credit programme goes wrong benefits claimants could have payments held up or receive incorrect amounts.

For this reason it is important that the coalition doesn’t repeat Labour’s mistake of wrapping IT-related projects and programmes in so much secrecy that the public, MPs and the media only discover problems when it is too late to effect a rescue.

Early warning of faltering projects

There is an early-warning of projects and programmes that are likely to falter or are actually faltering: “Starting” gate reviews and “Gateway” reviews, which are independent assessments of big or risky schemes.

The coalition in opposition promised to publish Gateway reviews if they came to power but civil servants have persuaded ministers to drop the proposal: does the minister want opponents and the media picking up authoritative internal information on projects that may be going wrong?

Our FOI request

Because of the continued suppression of the reports Campaign4Change, on 20 May 2011, made a request under the Freedom of Information for the Department for Work and Pensions to release a copy of Gateway reviews on the Universal Credit project.

The reply was nearly helpful. “There have been no Gateway reviews on the Universal Credit programme.  There has been one Starting Gate review on the Universal Credit programme.” The reply, by Jack Goodwin of the DWP’s Universal Credit Briefing Team, did not include a copy of the Starting Gate review report, so we sent a follow-up email.

We pointed that that Public Administration Committee had already requested a copy of the Universal Credit Gateway Zero Review and, in response, the DWP had sent the Committee a copy of the Stating Gate review, though the Committee decided not to publish it.

On 13 July the DWP said it needed extra time to consider our request. Gina Talbot at the DWP’s “Freedom of Information Focal Point” said: “I need to extend the time limit because the information requested must be considered under one of the exemptions to which the public interest test applies. This extra time is needed in order to make a determination as to the public interest. Accordingly, I hope to let you have a response by 10 August 2011.”

DWP wasting public money

This extra time and consideration was unnecessary and a waste of public money because the DWP had already given the report to the Public Administration Select Committee. Indeed the Universal Credit Starting Gate report had also been lodged in the House of Commons library after an MP asked the Cabinet Office’s Ian Watmore for a copy in May 2011.

So the DWP was considering at length whether to release a report that the Department had already released twice – to two separate committees of the House of Commons.

Grounds for appeal

In August the DWP formally refused Campaign4Change’s request, so we appealed. These were some of the reasons we gave:

i) Universal Credit is one of the government’s “mission-critical” projects and its success will be potentially important to tens of millions of benefit claimants.

ii) In the public interest, MPs, the media and public should understand the project’s feasibility risks and chances of success – in short whether it has got off to a good start. The Starting Gate report could help provide such an insight.

iii) The Public Accounts Committee has recommended that Starting Gates be published. The refusal of our request would appear to be a denial of the wishes of the Committee.

iv) Sometimes statements in published Gateway reviews have turned out to be too weak, sometimes too strong. There is no reason to believe that if the reviewers know their reports are for public consumption they will weaken their comments; and if they do weaken them the published reports will allow the quality of advice to be questioned or challenged by what the Cabinet Office minister Francis Maude calls armchair auditors.

v) The objection to publishing the reviews is that publication may inhibit candour. Starting Gate reviewers have a public duty to give the best advice they can (and indeed are paid for doing so). If they alter their advice to make it more acceptable to the public, media and Parliament they are failing in their public duty to give the best possible advice in all circumstances. Equally, if they give their advice in the expectation it will be kept confidential and therefore that they will not be held accountable for it, and alter their best advice on this basis, they could be failing in their public duty.

vi) There is no certain means for Parliament, the media or the public to know how large IT-based projects and programmes are progressing. Sometimes the National Audit Office reports on large IT-based projects, sometimes not.  The NAO cannot be relied on to produce the equivalent of a Starting Gate review on a large IT-based project or programme. Gateway reviews are not usually published contemporaneously.

vii) Coalition ministers have made it clear in numerous speeches that the public have a right to know how their money is being spent. Universal Credit is costing, as an IT-based  programme, several hundreds of millions of pounds. It is not in keeping with the spirit of ministerial statements on openness that the DWP keep confidential the Starting Gate review on Universal Credit. It is the only independent report on the feasibility of the project.

viii) Universal Credit is known to be a risky programme which senior civil servants have acknowledged. The Starting Gate review is likely to show whether or not those risks are understood.

ix) In refusing our request the DWP has not given any reasons for stating that it is satisfied that the “public interest in maintaining this exemption outweighs the public interest in disclosure”.

DWP rejects our appeal

Our appeal came to nothing. It was refused by the DWP’s David Hodgson Stakeholder Manager, who said in a letter:

“The case has been examined afresh, and guidance has been sought from domain experts to ensure all factors were taken fully into account. I have reviewed the original decision carefully and have decided to uphold the original decision withholding information for the following reason.

“While we recognise that publication of this information would provide an independent assessment of the key issues and risks, we have to balance this against the fact that the review document includes operational details of a sensitive nature whose publication would prejudice effective conduct of public affairs.

“The Department is satisfied that the public interest in maintaining this exemption outweighs the public interest in disclosure.”

The report was  released months ago

The DWP lodged the report in the House of Commons library months ago so it is in the public domain anyway. The department’s effort and time twice refusing the release of the report wasted public money.

Campaign4Change has now obtained a copy of the report via the House of Commons’ library.  We  will, separately, publish an article on the contents of the Starting Gate review report on Universal Credit.

Comment:

This episode suggests that officials at the DWP default to secrecy whatever the coalition says about openness and transparency. There are many superficially valid reasons officials can give to keep Gateway and Starting Gate reports secret. It is up to ministers to challenge that secrecy. If they don’t, the same mistakes and cycles will be repeated:

a) IT-related projects and programmes will continue to falter in secret, as they did under Labour

b) MPs and the media will try and find out the truth

c) Ministers will go on the defensive

d) The truth will eventually emerge and the coalition will be branded as inept when managing large IT-based projects and programmes – as inept as Labour.

If ministers publish Gateway progress reports now – as early warning reviews – we and others will applaud if early action is taken to stop or rescue a failing project. If ministers continue to pander to civil service secrecy the media and Parliamentarians will be right to criticise the coalition. Ministers have a chance to avoid the stigma of mismanagement of public funds. But will they take it?