Category Archives: IT and the Business

Capita adds 500 staff to boost recovery on “unacceptable” NHS contract

By Tony Collins

nicola-blackwoodNicola Blackwood, minister for public health and innovation at the Department of Health, yesterday described failings on Capita’s GP support services contract as “entirely unacceptable”.

Blackwood told MPs at an adjournment debate on failures relating to Capita’s £1bn Primary Care Support England contract,

“It was always clear that Capita’s services needed to be at least as good as those that they replaced… Capita put forward the most credible of any of the bids accepted on the short list, and at the time both the Department and NHS England had every confidence that the programme would be a success.

“However, it is evident that Capita was inadequately prepared for delivering this complex transition.”

Under its contract with NHS England, Capita is responsible for providing GP medical supplies such as needles and syringes, transferring medical records when patients switch GPs, payments to GPs and “performers list” applications.

Capita won the “Primary Care Support England” contract in 2015, amid unheeded warnings from some GPs that the private sector would be unable to successfully deliver the complexity of support services to GPs that were being provided by the NHS.

Blackwood said yesterday that MPs were “right to be concerned that the service provided by Capita under the primary care support services contract … has so far fallen well short of the standards that we expect, and GPs have borne the brunt of these failings, as we have heard today”.

She added,

“We need to make sure that GPs and their patients receive the service to which they are entitled.

“We want to restore acceptable services, and the contract contains sufficient financial incentives to ensure that Capita shares that goal, which is an important part of the contract and process.

“Let us be clear that the problems encountered with medical record transfers [in which thousands of records have gone missing, says the BBC] and overdue payments are entirely unacceptable. The Department shares that view.

“Both Capita and NHS England are co-operating fully with the Information Commissioner’s Office in order to address the implications for information governance, and I accept the need for urgent action in order to address the impact that this is having on patients and practitioners.

“That is why I have been holding regular meetings with Capita’s chief executive for integrated services, Joe Hemming, its new managing director for primary care support, Simon England, and NHS England’s national director for transformation and corporate operations, Karen Wheeler, and I will continue to hold such meetings.

“Both NHS England and Capita openly acknowledge that the service has not so far been good enough.

“NHS England has demanded and received rectification plans from Capita for the six most affected service lines, and has embedded a team of seven experts within Capita to support it as it resolves these issues…

“… it is also about having the right resources in the right place at the right time. Capita has informed me that it is adding around 500 more full-time equivalent staff to the service, at its cost, and that it is improving the training provided to ensure that new staff understand the importance of the service to both patients and practitioners.”

The minster denied that patients had been harmed (by GPs not having patient records).

“I know that these problems have caused great inconvenience and distress, but with reference to risk NHS England has assured me that it is not aware of any direct cases of patient harm that can be attributed to service issues.

“However, NHS England is working closely with regional and local medical directors so that we can be assured of patient safety. In particular, Dr Raj Patel, medical director of NHS England Greater Manchester, has joined the embedded team to ensure that clinical risks and concerns are appropriately addressed.

Backlogs

“The priority now is to deal with any backlogs, particularly with medical record requests, and to ensure that services are stabilised with the capacity to deal properly with new requests.

” There has been progress on that, which is encouraging. The backlog of medical record requests has reduced from 17,262 to 3,465 in the past two weeks. Capita assures me that it has an effective triage system in operation for new requests and is confident that the situate”ion will not recur. However, I will be monitoring the situation closely.”

Shortage of supplies

Blackwood continued,

“I am aware that some GPs were left short of basic supplies as a result, including syringes, and that they have had to source those from other suppliers at their own expense.

“NHS England tells me that it has reimbursed practices for any costs incurred from having to buy local supplies of needles and syringes.

Contact centre shortcomings

“I know that many of the members’ GP constituents have experienced frustration with Capita’s contact centre. I share those frustrations.

“Capita assures me that the contact centre has improved the way it responds to urgent queries by investing in more staff, improved processes and enhanced training. Capita is confident that these measures will deliver a quality service to customers. We will monitor its progress closely, including through meetings.

Late payments – compensation?

“I recognise that GPs, and ophthalmologists in particular, have suffered financial detriment as a result of late processing of payments.

“NHS England is working with Capita to explore what can be done to support affected stakeholders, and I have made it clear to Capita that I expect it to consider compensation as an option.”

Absence of medical records

Another Coventry MP Colleen Fletcher said that people who have requested a copy of a late relative’s medical records from the primary care support service have had to wait for more than twice the maximum 40 days that it should take to process such a request.

“It is utterly unacceptable to put anyone through that kind of delay, but it is inexcusable for it to happen to anyone who is already in an extremely vulnerable position following the death of a relative.”

New charges to the public for medical records

Geoffrey Robinson said,

“I have nothing against the private sector making profits—I am all for it—but the irony is that the companies cannot make a profit from a proper service, so they turn to such measures as imposing a £40 charge for access to a deceased relative’s records …

“They do not have to impose that charge. I think it used to be left to the GP’s discretion — but they now insist on it, and people have to pay postage and delivery charges on top, which is a disgraceful pursuit of short-term gain at the expense of the people they are meant to serve.”

Reinstate the old NHS support service?

Blackwood said,

“Some have suggested that the old model for provision of primary care support should be reinstated, but we must remember that it relied on localised services that did not connect with one another, with much duplication across processes.

“The quality of these services varied greatly—in some areas, it was outstanding; in others, it was quite poor. That was simply unsustainable.

“Furthermore, the system was unable to generate useful management information and so, honestly, issues such as the ones that we now face would be very unlikely to have surfaced. They would have gone unreported.

“A new model, with efficient and modernised processes, is the right approach to deliver to our primary care providers the service that they deserve.

“The Department and I will continue to closely scrutinise Capita and NHS England as they work to resolve current problems and build a quality service that is sustainable.”

A long way to go

“I acknowledge fully that there is a long way to go before the service can be considered acceptable and that Capita has much to do to earn the trust of practitioners and patients.

“This is clearly a live issue. I want to be clear today: I am listening. The issue is at the top of my priority list and will remain there until I am satisfied that an efficient and effective service is being delivered that meets the needs of patients and providers.”

Lessons

Coventry Labour MP Geoffrey Robinson, who secured the adjournment debate, told the minister,

“These contracts are gaily handed out to companies that do not have the skills, preparation or sheer commitment necessary to provide the service.”

He questioned whether the contract would make the intended 40% savings.

“… the irony is that we have ended up with a terrible service that is costing more than the previous service ever would, because the company was not properly prepared, did not have a commitment to providing the service, and was unable to do so, and because of the competing and irreconcilable claims about short-term gains in the form of profits and illusory savings for the health service…

“We should not have badly planned impositions from the private sector, which does not know what it is going to do or how to do it.”

He said that minsters and civil servants pride themselves on awarding a contract that they have won a hard-nosed negotiation.

 “We got them down from Y to X and we saved all this. It is great. We really screwed the private sector, didn’t we? That is all a total illusion.”

Labour MP Kate Green said that NHS England trialled the new system in west Yorkshire and it provided unsatisfactory. “Yet the contract was rolled out regardless.”

Savings?

Robinson said,

“How can the Minister talk of savings? How can any savings have been made when 9,000 patients records have been missing for more than two months, without which they cannot attend doctors surgeries? It is illusory to speak of savings.”

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How well is new passport IT coping with high demand?

By T0ny Collins

In 1989 when the Passport Agency introduced new systems avoidable chaos ensued. A decade later, in 1999, officials introduced a new passport system and avoidable chaos ensued. Jack Straw, the then Home Secretary, apologised to the House of Commons.

Last year HM Passport Office introduced, after delays,  a replacement passport system, the Application Management System. It was built with the help of the Passport Office’s main IT supplier CSC under a 10-year £385m contract awarded in 2009.

The Passport Office said at the time the new system was designed “to be easier to use and enable cases to be examined more efficiently”. So how well is the system coping with unusually high demand, given that an objective was to help passport staff deal with applications more efficiently?

The answer is that we don’t know: open government has yet to reach HM Passport Office. It publishes no regular updates on how well it is performing, how many passports it is processing each month or how long it is taking on average to process them. It has published no information on the performance of the Application Management System or how much it has cost.

All we know is that the system was due to be rolled out in 2012 but concerns about how well it would perform after go-live led to the roll-out being delayed a year. In the past 18 months it has been fully rolled out.

Comment

Has there been a repeat of the IT problems that seriously delayed the processing of applications in 1989 and 1999? In both years, passport officials had inadequate contingency arrangements to cope with a surge in demand, according to National Audit Office reports.

Clearly the same thing has happened for a third time: there have been inadequate contingency arrangements to cope with an unexpectedly high surge in demand.

How is it the passport office can repeatedly build up excessive backlogs without telling anyone? One answer is that there is a structural secrecy about internal performance.

Despite attempts by Francis Maude and the Cabinet Office to make departments and agencies more open about their performance, the Passport Office is more secretive than ever.

It appears that even the Home Secretary Theresa May was kept in the dark about the latest backlogs.  She gave reassuring statistics to the House of Commons about passport applications being processed on time – and only days later conceded there were backlogs.

It’s a familiar story: administrative problems in a government agency are denied until the truth can be hidden no longer because of the number of constituents who are contacting their MPs.

David Cameron said this week that up to 30,000 passport applications may be delayed.

One man who contacted the BBC said he had applied for a passport 7 weeks before he was due to travel. The passport office website said he should get a new passport in 3 weeks. When it had not arrived after 6 weeks he called the passport office and was told he’d be called back within 48 hours. He wasn’t, so he called again and was told the same thing. In the end he lost his holiday.

In 1989 the IT-related disaster was avoidable because managers continued a roll-out even though tests at the Glasgow office had shown it was taking longer to process passport applications on computers than clerically. Backlogs built up and deteriorating relations with staff culminated in industrial action

In 1999 electronic scanning of passport applications and added security checks imposed by the new systems caused delays and lowered productivity.  Even so a national roll-out continued. Contingency plans were inadequate, said the National Audit Office.

Does the “new” Application Management System show down processing of applications? We don’t know. The Passport Office is keeping its 2014 statistics to itself.

Decades of observing failures in government administration have taught me that chaos always seems to take officialdom by surprise.

If departments and agencies had to account publicly for their performance on a monthly and not just an annual basis, the public, MPs, ministers and officials themselves, would know when chaos is looming. But openness won’t happen unless the culture of the Passport Office changes.

For the time being its preoccupation seems to be finding whoever published photos of masses of files of passport applications seemingly awaiting processing.

The taking and publication of the photos seems to be regarded as a greater crime than the backlogs themselves.  To discourage such leaks the Passport Office has sent a threatening letter to staff.

But innocuous leaks are an essential part of the democratic process. They help ministers find out what’s going on in their departments and agencies.  Has government administration really come to this?

 

Survive a Public Accounts Committee hearing – a lesson for ministers and top civil servants?

By Tony Collins

Mark Thompson was Director General of the BBC for eight years from 2004 to 2012. He was one of the highest paid in the public sector, earning more than £800,000.  He’s now CEO of the New York Times Company.

When he went before the Public Accounts Committee in February 2014 he faced accusations he had mislead MPs over the BBC’s Digital Media Initiative which was cancelled in 2013. The BBC wrote off £98.4m on the project.

Thompson has emerged from the affair unscathed although he had presided over the project.  Indeed he seems to have impressed the committee’s MPs who are notoriously hard to please.

In today’s PAC report on the failure of DMI, MPs appear to have preferred Thompson’s evidence over that of other witnesses. So how is it possible to come to a PAC to answer accusations of misleading Parliament and end up winning over your accusers?

Today’s PAC report on DMI criticises the BBC for:

–  complacency in taking a “very high-risk” project in-house from Siemens

–  spending years working on a system that did not meet users’ needs

–  not knowing enough about progress which led to Parliament being   misinformed that all was well when it wasn’t

– ending up with a system that costs £3m a year to run, compared to £780,000 a year for the 40 year-old “Infax” system it was designed to replace. And Infax works 10 times faster.

In February 2014 Committee chairman Margaret Hodge began her questioning of Thompson over DMI by pointing out that, three years earlier, in 2011, he had assured the PAC that all was well with the project when it wasn’t.

Thompson told Hodge in February 2011 that DMI was “out in the business” and “there are many programmes that are already being made with DMI”. In reality, the DMI had been used to make only one programme, called ‘Bang Goes the Theory’ – and problems on the project at that time were deepening but, as in many public sector IT-based projects that go wrong, such as Universal Credit, bad news from the project team was not being escalated to top management (or the BBC Trust).

How Thompson won over PAC MPs

At the PAC hearing in February 2014 Hodge asked Thompson if he had misled the Committee when he spoke positively about DMI in 2011.

Thompson’s reply was so free of reserve that it appears to have taken the wind out of Hodge.

Thompson replied: “I don’t believe that I have misled you on any other matter, and I do not believe that I knowingly misled you on this one.

“I will answer your question directly, but can I just make one broad point about DMI before then? In my time at the BBC, we had very many successful technology projects—very large projects, some of them much larger than DMI. I believe that the team, including John Linwood [then the BBC’s Chief Technology Officer], who were in the middle of DMI, had many successes—for example, digital switchover, West One, Salford and BBC iPlayer.

“I just wanted to say … everything I have heard and seen makes me feel that DMI was not a success. It failed as a project. It failed in a way that also meant the loss of a lot of public money. As the director-general who was at the helm when DMI was created and developed and who, in the end, oversaw much of the governance system that, as we will no doubt discuss, did not perform perfectly in this project, I just want to say sorry.

“I want to apologise to you and to the public for the failure of this project. That is the broad point.”

Hodge (who would normally, at a point such as this, launch her main offensive) said simply:

“Thank you.”

Usually civil servants will deny that a big IT-based project has actually failed. Many times the archetypal civil servant Sir David Nicholson, when Chief Executive of the NHS, defended the failed NPfIT at PAC hearings.

But Thompson told PAC MPs:  “Here we are in the beginning of 2014—I am not going to debate with you whether or not this project [DMI] failed. I am sure we can talk about how, why, where and so forth, but it definitely failed.

“When I came to see you in February 2011, I believed that the project was in very good shape indeed. Why did I believe that? I had seen a number of programmes myself—I had been and seen parts of DMI working on ‘Bang Goes the Theory’; I knew that ‘The One Show’ had started to use elements of DMI a few weeks earlier; and I knew that a kind of prototype version of the technology had been used in the very, very successful ‘Frozen Planet’ natural history series.

“I have gone back and asked the BBC to look at all the briefing materials—I had a voluminous amount of briefing from the BBC—and there is a real consistency between the briefing I got – .”

Richard Bacon: Sorry, a real inconsistency?

Thompson: No, a real consistency between the briefing I got and the evidence that I gave. To be honest, some of this is going to go very much to the point Mr Bacon was making earlier on (about what is or is not a deployment).

Stephen Barclay: Just a second…So it was consistent, but consistently wrong, wasn’t it, because just the following month, after the consistent briefing, you were then aware that it was going to miss the key milestone? From March 2011 you knew it [DMI] was not going to hit the deadline.

Thompson: If I may say so, what I am trying to focus on at the moment is the question—I understand, given subsequent events, the perfectly reasonable question—about whether the testimony I gave in February 2011 misled you or not… My belief is that my testimony gave a faithful and accurate account of my understanding of the project at this point.

Hodge: But were you misled, then?

Thompson: Let me give you just a sense of my briefing. To be honest, there were echoes of this in John Linwood’s testimony a few minutes ago, and Mr Bacon has helped me to understand this by putting his finger on the use of one word in particular, which is ‘deployment’. This is the timeline …”

Thompson then did something civil servants rarely do, if ever, when they appear before the committee. He read from the internal briefings he had received on the project in 2010 and 2011 . Those briefings indicated all was well.

He was not even shown a draft Accenture report in December 2010 that said the elements of the DMI examined (by Accenture) were not robust enough for programme-making and that significant remedial work was required.

Thompson said that the day before he gave evidence to the PAC in February 2011 he was given an internal note which said:

“Our next release [of DMI], Enhanced Production Tools, entered into user acceptance testing this week. This release builds on the production tool we previously delivered in 2010, Fabric Workspace, and desktop editing and logging.

“We will deploy its release to pilot users in Bristol, the ‘Blue Peter’ production team, ‘The One Show’ current affairs team, ‘Bang Goes the theory’ — again — ‘Generation Earth’, weather and ‘Pavlopetri’ inside London Factual.”

Thompson had the firm impression that DMI was challenging but that the BBC was starting to deliver the system and users had been positive about the elements delivered.

Thompson said in February 2014, “Mr Bacon is right about the very bullish use of the world “deployed”, meaning, perhaps, elements that have been loaded on to a desktop but not really extensively used: that was the background to the remarks I made to you in February 2011. I am absolutely clear that at the time that was what I knew and believed about the project.”

Hodge: So you were misled?

Thompson replied, in essence, that the BBC’s business users tried to make DMI work but most of them gave up. There were tensions between the project team who were enthusiastic about DMI and the business users who, mostly, weren’t.

These were complicated, difficult issues, said Thompson. “There was a pronounced and, it would appear, growing difference of opinion between the team making DMI and the business users on how effective and how real the technology was.

“You will understand that I have been involved in a lot of projects at the BBC and in other organisations, and I can smell business obstinacy. I can smell when a business is unready, is not prepared to play ball or is constantly moving the goalposts.

“I absolutely understand John Linwood’s particular perspective, given what he was doing. He was a very passionate advocate of the project, and I understand all of that.

“In my time, which ended when I left in September 2012, I saw great efforts being made by the business—in other words, by colleagues inside BBC Vision, BBC North and elsewhere—to get DMI to work. Although there were tensions, I do not believe that those tensions, which frankly were more or less inevitable, were themselves a central and critical part of the project’s failure.”

Richard Bacon: … It sounds to me as if the people getting the business case through the main governance processes were technology and finance people. I want to be clear on what you are saying. It sounds to me as if the technology people were very gung-ho and the experience of the business people on the ground was that it was not necessarily working as well as they had been led to believe, so they probably lost faith in it. Is that a fair summary?

Thompson: “I believe that that was definitely what started to happen, certainly by the end of 2011 and through 2012. It happened for understandable reasons. This has been a troubled project…

“I thought great efforts were made in BBC Vision and in BBC North both by senior people and by some front-line programme makers to help us to get the thing to work.

“Where my perspective perhaps differs from John’s perspective – it is very easy for me to sit here and say that this project failed because some difficult programme makers refused to use it, although there may have been an element of that somewhere – is that I thought that, overall, this was a project on which there was a lot of work and effort to try to get it to work on the business side…”

Hodge asked again if Thompson had been misled when he assured the PAC in February 2011 that DMI was being used at the BBC.

Thompson: I believed it.

Hodge: You believed it?

Thompson: Yes.

Hodge:  You believed it, but were you being misled?

Thompson: “I think that the language that the team was using, combined to some extent with the fact that I had seen what looked like a very positive demonstration of it … I had heard that “The One Show” had also started using it, and I saw a list of other programmes that were also using it. That combined with the language in the briefing led me to believe that it was being more extensively used.”

PAC conclusion

The PAC could have concluded in its report today that the BBC had misled Parliament in February 2011. But MPs used the word “misinformed” instead.

“Neither the [BBC’s] Executive Board nor the [BBC] Trust knew enough about the DMI’s progress, which led to Parliament being misinformed. While [Thompson] assures us that he gave a faithful and accurate account of his understanding of the project at that point in early 2011, he was mistaken and there was confusion within the BBC about what had actually been deployed and used.

“In its reporting on major projects, the BBC needs to use clear milestones that give the Executive and the Trust an unambiguous and accurate account of progress and any problems.”

Comment

The PAC had every right to be angry.  So credible were the BBC’s assurances about DMI in February 2011 that the Committee published a report in April 2011 that reflected those assurances. It was wrong.

But there is a positive element in the failure of DMI – and that is the completely open and honest testimony of Mark Thompson.

MPs on the PAC are used to be being misled – usually by the sin of omission – when civil servants and ministers come before them. But when Thompson read from his internal briefings it was easy to see how he came to the view that DMI in February 2011 was showing signs of a success.

It was clear to MPs that Thompson had not set out to mislead.

Perhaps the moral of the story is that you can go far with honesty and openness. That’s not an easy lesson for the ministers and civil servants who have to appear before the PAC, but it has certainly served Thompson well.

BBC Digital Media Initiative – Public Accounts Committee report

 

Natwest/RBS – what went wrong?

By Tony Collins

Outsourcing to India and losing IBM mainframe skills in the process? The failure of CA-7 batch scheduling software which had a knock-on effect on multiple feeder systems?

As RBS continues to try and clear the backlog from last week’s crash during a software upgrade, many in the IT industry are asking how it could have happened.

Stephen Hester, RBS’s boss, told the BBC today:

“In simple terms there was a software change which didn’t go right. Although that was put right quickly there then was a big backlog of things that had to be reprocessed in sequence. That got on top of our technical teams … it is like the landing path at Heathrow. Once you get out of sequence it takes a time to get back into sequence even if the original fault is put right.

“Our people are working incredibly hard … I am pleased to report that as of today RBS and Natwest systems are operating normally.

“We need to make sure they stay normal for the next few days. There is still some significant catch-up today, much less tomorrow and so on as we go through the week.”

The immediate technical cause of the problems might not have been too difficult for those inside the bank to establish – but finding out how and why it happened, why processes were not in place to stop a backlog of work building up, and why testing of the upgrade did not pre-empt the failure may take weeks and possibly months to establish.

Attributing blame could take many years. After BSkyB appointed EDS to supply a CRM system in 2000, and the project failed, it was ten years later before a court reached a judgment on blame. The cause of the failed project was never definitively established.

Official cause of system crash

The official cause of RBS/Natwest’s problems was given at the weekend by Susan Allen, Director of Customer Services, RBS Group which includes Natwest and Ulster Bank. She told Paul Lewis of BBC’s Moneybox programme:

“Earlier this week we had a problem in our overnight backup. So a piece of software failed that started all the updates that happened to our systems overnight.

“What that has meant practically is that information on customers’ accounts has not been updated… It is horrendous.

“The underlying problem has been fixed, so the computer software that failed has been replaced. That is in and working. The challenge we now have is bringing all the systems back up and working through all the data that should have been gone through over the last three nights …

“We have 12 million customers in Natwest and RBS and just over 100,000 in Ulster Bank. So it is affecting a serious number of people. It is having a terrible impact.

“We are encouraging all of our customers to call us, come and see us in our branches … we have branches open late .. and have doubled the number of people on the phone. Call centres are open 24 hours a day.”

Call centres use 0845 numbers which are chargeable for some. Lewis asked, Why are you making people pay to fix a problem that’s your fault?

“Customers should not be having to pay for those calls,”replied Allen. “If that is a problem for people we will take a look at that.”

Lewis: Will you re-imburse people for their calls?

“Absolutely. We recognise there will be lots of different expenses as a result of this. We apologise and want to make sure they are not out of pocket. If people have got claims they should put them through to us…we will need the information to deal with the claims.”

Lewis: Will you refund charges by credit card companies for late payments?

“We will. We will… we will make sure nobody is out of pocket… in one instance we got cash in a cab to a customer’s home… clearly we trust our customers so if we can see that somebody has a certain amount coming in every week we will give them money against that. So we ask people to come in and bring identification with them such as their bank card, we will do what we can to help.

“We will look after our customers. We realise this has had a huge impact on people. We are not underestimating it … clearly there are things that have gone wrong and we cannot put everything right.”

Lewis: How much damage has this done to the reputation of the bank?

“Time will tell. For us it is pretty devastating. We pride ourselves on being a bank that really cares about our customers and wants to deliver great service. We absolutely mean it.”

Lewis: Should you get a bonus?

“We only get performance bonuses when we perform and this has not been a good performance.”

Comment:

Her explanation of the cause of the IT crash is unclear but otherwise Susan Allen’s answers to Paul Lewis’s questions were exemplary. Her openness and unaffected humility is surely the best way to handle a PR crisis. Small comfort for the millions affected though.

Technical cause of the crash?

Some of those commenting to The Register appear to have a good knowledge of RBS systems. There are suggestions RBS has lost some important IBM mainframe software skills in outsourcing.

One or two have suggested that the crash was caused by a failure of the bank’s CA-7 batch scheduling software. In February RBS had an “urgent requirement” in Hyderabad, India, for people with four to seven years experience of CA7.

One comment on The Register said that RBS runs updates on customer accounts overnight on an IBM mainframe, via a number of feeder systems that include BACS. “The actual definitive customer account updates were carried out by a number of programs written in assembly language dating back to about 1969-70, and updated since then. These were also choc-full of obscure business rules … and I do not believe anyone there really knew how it all worked anymore, even back in 2001…

“Of course the moral is complex mainframe systems require staff with the skills, and in this case, the specific system knowledge to keep things smooth. The fewer of these you have, the more difficult it is to recover from problems like this.”

Robert Peston, the BBC’s Business Editor, asks whether outsourcing was to blame.

“In my conversations with RBS bankers, there is an implication that outsourcing contributed to the problems – though they won’t say whether this is an issue of basic competence or of the complexities of co-ordinating a rescue when a variety of parties are involved.”

An RBS spokesperson told The Register that the software error occurred on a UK-based piece of software.

Some lessons from the crisis – Bank of England Governor.

How London IT director saves millions by buying patient record system.

By Tony Collins

An NHS organisation in London has bought an electronic patient record system for less than a third of the cost of similar technology that is being supplied by BT to other trusts in the capital and the south of England.

The £7.1m purchase by Whittington Health – a trust that incorporates Whittington Hospital near Archway tube station – raises further questions about why the Department of Health is paying BT between £31m and £36m for each installation of the Cerner Millennium electronic patient record [EPR] system under the NPfIT.

Whittington Health is buying the Medway EPR system from System C which is owned by McKesson. The plan is for the EPR to operate across GP, hospital and social care boundaries.

It will include a patient portal. The idea is that patients will use the portal to log on to their Whittington Health accounts, see and save test results and letters, and manage outpatient appointments on-line.

In a board paper, Whittington Health’s IT Director Glenn Winteringham puts the case for spending £7.1m on a single integrated EPR.  Winteringham puts the average cost of  System C’s Medway at £8m. This cost, he says, represents “significant value for money” against the average deployment costs for the NHS Connecting for Health solution (Cerner Millennium) for London of £31m. In the south of England the average cost of Cerner Millennium is £36m, says Winteringham in his paper.

He also points out that the new EPR will avoid costs for using “Rio” community systems. The NPfIT contract with BT for Rio runs out mid 2015. “From this date onwards the Trust will incur an annual maintenance and support cost. Implementing the EPR will enable cost avoidance to the [organisation] of £4m per year to use RIO (indicative quotes from BT are £2m instance of RIO and the [organisation] has 2 – Islington and Haringey).

BT’s quote to Whittington for Rio is several times higher than the cost of Rio when supplied directly by its supplier CSE Healthcare Systems. A CSE competitor Maracis has said that, during a debrief, it was told that its prices were similar to those offered by CSE Healthcare for a Rio deployment – then less than £600,000 for installation and five years of support.

In comparison BT’s quote to Whittington for Rio, as supplied under the NPfIT, puts the cost of the system at more than fifteen times the cost of buying Rio directly.

In short Whittington and Winteringham will save taxpayers many millions by buying Medway rather than acquiring Cerner and Rio from BT.

Why such a price difference?

The difference between the £31m and £36m paid to BT for Cerner Millennium and the £8m on average paid to System C could be partly explained by the fact that Whittington (and University Hospitals Bristol) bought directly from the supplier, not through an NPfIT local service provider contract between the Department of Health and BT. Under the NPfIT contract BT is, in essence, an intermediary.

But why should an EPR system cost several times more under the NHS IT scheme than bought outside it?

Comment:

Did officials who agreed to payments to BT for Cerner and Rio mistakenly add some digits?

Whittington’s purchase of System C’s Medway again raises the question – which has gone unanswered despite the best efforts of dogged MP Richard Bacon – of why the Department of Health has intervened in the NHS to pay prices for Rio and Cerner that caricature profligacy.

Perhaps the DH should give BT £8m for each installation of Cerner Millennium and donate the remaining £21m to a charity of BT’s choice. The voluntary sector would gain hundreds of millions of pounds and the DH could at last be praised for spending its IT money wisely.

Whittington buys Medway and scraps Rio – E-Health Insider

NHS IT supplier “corrects” Health CIO’s statements

MP seeks inquiry into BT’s £546m NHS deal

NPfIT go-live at Bristol – trust issues apology

How many organisations are failing to deliver on their Agile developments?

By David Bicknell

How many organisations are struggling to see real value and business benefits from their Agile IT projects?

This blog, looking back at some of the predictions for Agile in 2012, argues that a number of organisations that have adopted Agile have an inability to understand its why and how, while others are inadaquately prepared for adoption, resulting in a failure to address management impact across teams and engineering practices in teams.

The piece cites the Cutter Consortium blog which, in looking ahead to 2012, argued that “many organisations worldwide will continue to adopt Agile. Most of them will do so with no expert guidance, with ho-hum results, and with little understanding of why they got those results.

It suggestted that, “People will continue to get their Agile skills certified while others rail against the value and implication of those certificates. Companies will still rely on head hunters to hire Agile coaches, and wonder why those coaches can’t seem to straighten out their Agile implementation.

“Organisations will continue to agonise over micro-estimation of detailed backlogs. They will continue to spend a pretty penny on “adding bodies” to projects riddled with technical debt, while not investing in the skills and habits their developers need to reduce or avoid increasing such debt. Managers will continue to use language like, “We just hired a resource in development” without investing proper attention in the hired person. And downsizings will continue until morale improves.”

Another blog predicted that, “Everyone will claim they are Agile, but that 50% of them will be wrong, and half of the rest won’t get any value from it. There are too many bad development practices at organisations that have too few people, with too little coaching, and hardly any tooling.”

Meanwhile, this survey suggests that Agile development has a higher priority in the private sector (in the US) than in the public sector.

So what is the true picture for Agile? Is it delivering project success, as JP Morgan and John Deere, have found? Or are some organisations adopting Agile almost as a fashion accessory, without really understanding where they’re going?

Related reading

Agile skills gain ground

JP Morgan adopts Agile in Australia

As Agile as a John Deere tractor

Are your IT projects ‘drivers’ or ‘supporters’?

By David Bicknell

An article by Art Langer in the Wall St Journal argues that IT projects are either ‘drivers’ or ‘supporters’.

Drivers are those projects and activities that affect the relationship with an organisation’s clients i.e. projects that drive revenue directly or indirectly. Supporters, on the other hand, are those everyday activities that are more operational in nature.

Langer cites the work that Dana Deasy has done firstly at Siemens  and more recently at BP.

He writes: “We all know that executives are more interested in implementing technologies to drive the business, than they are in using cutting-edge technology for its own sake. For Deasy, the biggest challenge was mostly building internal consensus about  how the technology would help  customers–and how Siemens could be more competitive in the marketplace.

“Deasy also had to show his executives that the evaluation of investments in these projects would be different than evaluations of other kinds of IT work. With e-business, the market reaction to different product and service offerings can be less certain.

“So Deasy established the concept of “revalidation.” Approved technology projects were reviewed every 90 days to determine whether they were indeed providing the planned outcomes, whether new outcomes needed to be established, or whether the technology was no longer useful.

“Siemens was moving from a traditional process of analyse-develop-deliver to a new process of sensing what a customer might want, and then responding to it more dynamically.”

Langer concludes by saying that, “The idea that all IT projects must succeed is outdated and unrealistic in true “driver” initiatives. CIOs must learn from Deasy’s lesson: If you are engaging in true “driver” initiatives, you cannot evaluate them on the “supporter” method of simple success rates.”

Interesting piece – worth a read.

How to Develop and Evaluate Strategic IT Projects

Why ignoring the human factor can lead to failed IT projects

By David Bicknell

In a column for the Wall St Journal, Frank Wander, a former CIO of the Guardian Life Insurance Company, has warned that ignoring the human factor is a sure route to the failure of IT projects.

He points out that, “Sixty years into the information economy, information technology projects, especially large ones, still fail, or under-perform, at disheartening rates. Trillions of dollars of collective project experience, and, what long ago, should have become a predictable undertaking, remains an area of dissatisfaction. Yet, the performance of our technology infrastructure (devices, networks, storage) has made quantum leaps forward over that same time period.”

He argues that workers are the most expensive, but least understood tool. In the insurance industry, for example, talent represents 63% of IT cost, according to a 2011 Gartner report.

He concludes: “As an industry, we must remove this blind spot, recruit the best talent, nurture it and unlock the full productivity potential by designing social environments where the chemistry enables IT to flourish. Companies that understand this, and embrace it, will win; the rest will compete in a race to the bottom.”

IT is from Venus, the Business is from Mars

By David Bicknell

Monday morning and another week for IT and the business to work together in the best interests of the organisation – though if you were to read this article from the Wall St Journal, you might think otherwise.

The  piece, “IT is from Venus, non-IT is from Mars”, by research scientist George Westerman from the MIT Centre for Digital Business, suggests  that in many companies, the relationship between IT and business leaders is a very troubled marriage. Miscommunication is rife, leaving executives struggling to figure out what’s working for the company, what’s not, and how to improve the situation.

The article argues that ‘the marriage’ can be saved, provided IT and business executives have a clearer understanding of the needs of both sides, how they work and the challenges they face. That means business leaders and IT executives must talk with each other about their operations and about how IT can help the company fulfill its goals, instead of talking past each other about how one side or the other is preventing that from happening.

The article cites four separate studies by researchers at MIT that show that transparency—clear communication about IT performance and decision processes—is the best predictor of the business value of IT. These studies all show that transparency creates an environment that improves both IT performance and the IT/Business relationship.

The article discusses four areas where IT and non-IT executives fail to understand each other clearly, and how transparency can help bridge the gap between two completely different interpretations.

On IT Cost and Performance:

The Business says: “IT costs too much; we’re not getting the service we’re paying for.”

IT says: “Given our budget constraints, we’re doing really well.”

On Risk Management:

Business says: “I want it this way.”

IT says: “We can’t do it that way.”

On Prioritisation:

Business says: “I need this right away.”

IT says: “Sure, but three other executives just told me the same thing.”

On Accountability:

Business says: “Why do you make me go through all of this bureaucracy?”

IT says: “Our methodologies are how we make sure everyone does the right thing.”

The article concludes that “creating transparency takes extra time and effort on everyone’s part, especially IT’s. But this is one project that definitely pays. Transparency around performance and decision processes improves the business value of IT and builds trust between business and IT people. As everyone learns to work better together, IT becomes part of the company’s business-level decisions and initiatives, not its own world. When that happens, the marriage of IT and the business side is really working.”