Category Archives: operational issues

Well done Eric Pickles – more open government to engulf councils

Posted on 29/08/2012 | 2 comments

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 

2 Comments

Posted in BT Health, Campaign4Change, Cerner, decision-making, e-health, excessive secrecy, health, health records, improving communications, IT-related failures, local government, managing outsourced services, NHS, npfit, openness and transparency, operational issues, outsourcing, Politics, public sector, public services, public-private partnerships, shared services

Tagged ,

How to identify a high-risk supplier – Cabinet Office works out details

Posted on 25/07/2012 | 5 comments

By Tony Collins

Francis Maude, the Cabinet Office minister, has agreed mechanisms for officials to identify high-risk suppliers where “material and substantial underperformance is evident”.

On his blog Spend Matters, Peter Smith has published parts of a letter from Maude.

Where under-performing suppliers are identified “departments will be asked to engage with the Cabinet Office at each stage of any procurement process involving the affected supplier to ensure that performance concerns are taken fully into account before proceeding”.

The implication is that the Cabinet Office will draw up a blacklist of bad suppliers which departments will take account of when buying. Smith says that two suppliers are already on the blacklist.

Comment: 

For more than 20 years the trade press has identified the same suppliers in a succession of failed or failing IT-based projects but poor performance has never been taken seriously into account.

This is usually because the suppliers argue that the media and/or Parliament has got it all wrong.  Departments, it appears, will always prefer a potential supplier’s version to whatever is said in the media or in Parliament.

The Office of Government Commerce, now part of the Cabinet Office, kept intelligence information on suppliers but it seems to have made no difference in procurements.

It is unlikely the Cabinet Office’s blacklist will rule out any suppliers from a shortlist. As Smith says, suppliers will claim that any problem was all the fault of ministers or civil servants who kept changing their minds, were not around to make key decisions, or didn’t understand the nature of the work.

But still the blacklist is a worthwhile innovation. At least one big IT supplier has made a habit of threatening to withdraw from existing assignments when officials have refused to revise terms, prices or length of contract. The blacklist will strengthen the negotiating hand of officials.

The challenge for Maude will be persuading departments to take the blacklist idea seriously.

Peter Smith, Spend Matters.

5 Comments

Posted in Campaign4Change, EU procurement, Government IT, innovation, IT-related failures, legal disputes, managing outsourced services, operational issues, private sector lessons for the public sector, supplier relationships

Tagged , , ,

Lessons from an IT disaster

Posted on 23/07/2012 | Leave a comment

By Tony Collins

Only rarely is an independent report on an IT-related disaster published.  So North Bristol NHS Trust deserves credit for publishing a report  by Pricewaterhousecoopers into the problematic go-live of Cerner Millennium in December 2011.  PwC calls the Cerner system a “business-critical patient record system”.

The implementation, says PwC,  resulted in significant continuing  operational difficulty. PwC was asked to review the implementation, identify what went wrong and make recommendations.

What is clear from PWC’s report is that North Bristol NHS Trust repeated the known mistakes of other trusts that had gone live with Cerner Millennium:

–          A lack of independent challenge

–          Not enough testing of the system and new business processes

–          Inadequate contingency arrangements

–          Not enough time for data migration

–          Training systems not the same as those to be used

–          Preparations treated as an IT project, not a change programme.

–          Differences between legacy and Cerner systems not fully understood before go live

–          Staff did not always understand new or changed business processes

In 2007 the National Audit Office reported in detail on the lessons from the go-live of Cerner Millennium at Nuffield Orthopaedic Centre, Oxford in December 2005.

One of those lessons was that the Trust did not learn lessons from earlier NPfIT Cerner Millennium go-lives. This happened again at North Bristol, suggests the PwC report:

“There were not dissimilar Cerner implementations within the Greenfield [other ex-Fujitsu and now BT-managed Cerner Millennium implementations under the NPfIT] systems running a few months before NBT’s [North Bristol Trust] implementation. Similar difficulties were experienced there, but they were more successfully addressed.”

Below are extracts from PwC’s report “Independent review of Cerner Millennium implementation North Bristol NHS Trust”.

“The success of an implementation of this scale, complexity and timing depends on substantial, robust and enduring programme management focusing on:

–          The IT implementation. Incorporating configuration of Cerner Millennium, infrastructure, security, interfaces and testing;

–          The migration of data from the two legacy PAS systems into Cerner Millennium;

–          Change management to engage and train stakeholders, embed change in the organisation and ensure that processes and procedures are aligned to the new system;

–          Continuous communication with users about changes to business processes as a result of the implementation; and

–          Quality control criteria and the association governance to ensure that go-live went ahead in a safe and sustainable manner.

–          The Trust needed stringent programme management with programme and project managers of the highest quality, to ensure that effective governance and project planning procedures were followed.

–          The go-live decision and assurances needed to pass strict criteria with sufficient evidence to provide assurance to the board that all necessary activities were completed prior to go-live.

The implementation in both the wards and the Emergency Department (ED) went well. Staff in ED were well engaged in the project and as a result were fully aware of the changes to their business processes at go live. There were some minor system issues initially but these were resolved quickly and ED was fully operational with Cerner Millennium soon after go live. One of the underlying factors in the success of the deployment to ED was that there was no data migration required as the historical data remains in the old system.

The launch in the wards went as expected; the functionality was tested well and the data was loaded manually, although there now appear to be issues with staff engaging and using the system as intended.

The majority of problems encountered at go live related to the theatre and outpatient clinic builds.

Outpatients had the most disruption immediately after go live. The Trust’s back office team had not finished building the outpatient clinics in Cerner Millennium, so the new and old systems did not mirror each other and data could not successfully migrate. Changes continued to be made to clinics in the old PAS systems, and these were not all reflected in Cerner Millennium.

Ad hoc clinics were used in the old PAS system to allow overbooking to maximise activity. These were not separated from real clinics at go live and migrated to Cerner Millennium as real clinics. The ad hoc clinics in PAS had deliberately abnormal timings so they could be excluded from time-based reports, for example 12:30am and 5:30am. The system generated letters for these ad hoc out- of-hours clinics, and many were sent to patients.

In the old system, clinics for a number of consultants could be pooled to facilitate patients seeing the next available consultant.  All clinics in Cerner Millennium are specific to a consultant and this caused significant confusion to administration staff using the new system.

PAS [the legacy patient administration system] treats “weeks” differently to Cerner Millennium. On migration, weeks were misaligned and the dates for clinics and theatres was incorrect. This created huge confusion as patient notes did not agree with Cerner Millennium , despite exhaustive work before go live to ensure that all patient notes were ready for the clinics that should have been on the system.  This also affected information in letters, with patients advised to attend their appointment on the wrong date.

There was a further issue in theatres relating to theatre procedure codes. The Trust did not map the old procedure codes to the new to ensure that all the required procedures would be available in Cerner Millennium for the data to migrate successfully. The Trust identified this issue soon after go live and has run a parallel manual process to ensure patients received the correct procedures.

The training provided to staff by the Trust did not equip them to be able to use Cerner Millennium at go live. The training environment did not mirror the system the Trust implemented as certain elements of the system were not complete when the training domain was created. Theatre staff and outpatient appointments could not train on a system with theatre schedules and outpatient clinics built in.

The Trust is now beginning to move out of the crisis and return to normal operations.

Lack of effective quality controls

There was insufficient rigour over the controls criteria and sign off of the gateway reviews.

There was inadequate operational control over the go live process, such as clinic freeze and updates pre-, during, and post go-live. Evidence from the interviews suggests that:

  • There was little challenge to confirm that the gateway criteria had in fact been met.
  • There was no evidence presented to the Cerner Programme Board or the Trust Board to demonstrate that the gateway criteria had been met.
  • There was not enough focus on or monitoring of risks and issues and their impact on go live.
  • The cleansing of old and out-of-date data from the legacy PAS systems was inadequate; as a result, erroneous data became live data in the Cerner system.
  • Data Migration issues were not all resolved and their impact on go live was not considered.
  • The outpatient and theatre builds were neither complete nor accurate, and there were no controls which could have detected this before go live.
  • There were inadequate controls over clinic freeze and clinic changes prior to go live.

Lack of effective programme planning

Programme plans were not rigorously updated as the programme progressed and planning around training, testing and data migration and build was not robust. The Trust failed to recognise this programme as a change programme and did not effectively manage the engagement and feedback from their stakeholders. Evidence from the interviews suggests that:

  • The Trust did not factor contingency into its programme plan to account for changes to the go live date.
  • The Cerner Programme Management Office was not effective because of inadequate resource and programme tools.
  • The Trust had a lack of sufficiently skilled resources for a project on this scale.
  • The Trust’s operational staff were not fully engaged in the Cerner project.
  • The Cerner project was treated as an IT project and not a business change programme.
  • The training was inadequate and did not provide users with the skills they needed to be able to use the system at go live.
  • The testing focused on the functionality of the system and not end-user testing of the outpatient and theatre builds.
  • There was no end-user testing of the final outpatient clinic and theatre builds prior to go live.
  • There was lack of understanding of roles within the wider programme team.
  • External parties offered NBT help and advice. They felt that the advice was not taken and the help was refused.

Lack of effective programme governance

Programme governance processes were not reviewed and updated regularly to ensure that they were adequate and there was inappropriate accountability for key decision making. During the implementation, the Trust established new overarching change management arrangements for the Building our Future programme. Evidence from the interviews suggests that:

  • The Cerner Project team failed to comply with the Trust’s Building our Future governance processes
  • The information presented to the Cerner Programme Board and the Trust board by the Cerner Project team was inadequate for them to make informed decisions;
  • The Cerner Programme Board was not effective; and
  • Significant issues relating to the theatre and outpatient clinic build were not escalated to the Cerner Programme Board or the Trust board.

PwC’s Conclusions

For a programme of this scale and complexity, the management arrangements were not sufficiently extensive or robust. There were many issues with the software and data migration, the training of users and operational go live planning. The Trust Board and the Cerner Programme Board did not plan to have, and did not receive, independent assurance that the state of the programme supported a decision to go-live.

Complex IT implementations are never without risks and issues that need to be managed, even at the point of go live. The scale of the issues in this implementation was not properly understood by those with responsibility, and as a result they were not in a position to make sound decisions.

Many of the problems are associated with poor data and process migration. Staff found that a significant proportion of migrated data was incorrect in the new system, and this had rapid and substantial operational impact which has taken a considerable time to rectify with manual processes. Staff needed to be more directly involved in migration and process testing.

The implementation was manifestly a complex change programme. But IT took the lead, and there was no intelligent customer with sufficient distance from IT to ensure products and progress were properly challenged.

There were not dissimilar Cerner implementations within the Greenfield running a few months before NBT implementation. Similar difficulties were experienced there, but they were more successfully addressed.”

PwC recommends that:

–  the Trust “stop and take stock”. It says  “The Trust needs to take stock of its position and develop a coherent and detailed plan for the remainder of the recovery stage. The Trust then needs to ensure that effective cross programme planning and governance arrangements are enforced for all current projects, especially those under the Building Our Future programme.”

PwC also recommends that the Trust carry out a:

–  Governance review

– Capability/capacity review

– Cross programme plan review

– Operational assessment

– Review of process and controls

– Review of information requirement

– Technical resilience/infrastructure review

– Review of access controls

Comment:

To me the PwC report throws up at least six points:

1) Are NPfIT go-lives more political than pragmatic?

In the 1990s Barclays Bank went live with new systems for all its branches. During the night (I was invited to watch the go-live at head office) the most striking element was a check list that asked questions on progress so far. The answers determined whether the go-live would happen. The check-list was completed repeatedly – seemingly endlessly – during the night.

Many  different types of mishaps could have stopped the go-live.  None did.  Go-lives of Cerner Millennium are different. They seem unstoppable, whatever the circumstances, whatever the problems.  There was nothing political about the Barclays go-live. But NPfIT go-lives are intensely political.

Would North Bristol’s board have accepted with equanimity a last-minute cancellation, especially after go-lives had been postponed at least twice before?

2)  Are NHS boards too focused on “good news” to oversee an NPfIT go live?

North Bristol NHS Trust deserves praise for publishing the PwC report.  But it’s not the whole story.  The report says little about any potentially serious impact on patients. Also it mentions (almost in passing) that the Trust board discussed in November 2011 the readiness of Cerner Millennium to go live. That discussion was probably positive because Millennium went live a month later. But there is no mention of that discussion in the Trust’s board papers for November 2011.

Why did the Trust discuss its readiness to go live in secret? And why did it keep secret its November 2011 report on its readiness to go live?

If North Bristol, like so many NHS trusts, is congenitally beset with a good news culture at board level, can the full truth ever be properly discussed?

3) Isn’t it time Cerner lessons were learnt?

After seven years of Cerner implementations in the NHS, several of them notorious failures, isn’t it time Trusts learnt the lessons?

4)  What’s the current position?

PwC’s report is succinct and professional. It’s also diplomatically-worded. There is little in the report that points to how the Trust is coping with the operational difficulties. Indeed it suggests the Trust is returning to normal. “The Trust is now beginning to move out of the crisis and return to normal operations,” says the PwC report. But that is, in essence, what the Trust has been saying publicly since January 2012.  PwC says nothing about whether the safety of patients has been jeopardized by the go-live.

5) Where were the Trust’s Audit Committee – and internal auditors?

Every NHS Trust has an audit committee and internal auditors to warn about things that are going wrong, or may go wrong. It appears that they were out to lunch when it came to North Bristol’s Cerner Millennium project and its consequences.  The Audit Committee seems hardly to have mentioned the project. Should North Bristol’s board hold the Audit Committee and internal auditors to account?

6) Is the Trust board to blame?

Perhaps rightly PwC does not seek to apportion blame. But did the Trust board ask the right questions often enough?  The tacit criticism in the PwC report is of the IT department and layers of management below board level. But is that criticism misdirected? If the board’s culture of encouraging good news – of “bring me solutions not problems” –  has not changed, perhaps little or nothing will have been learned from North Bristol’s IT-related disaster.

PWC report Independent review of Cerner Millennium implementation North Bristol NHS Trust.

Lessons from Nuffield Orthopaedic’s Cerner Millennium implementation in 2005.

North Bristol apologises over Cerner go-live.

New hospital system caused chaos.

MP asks why two Cerner systems cost vastly different prices.

Leave a comment

Posted in Campaign4Change, culture, e-health, Gateway reviews, governance, Government IT, health, health records, IT projects, IT-related failures, NHS, npfit, openness and transparency, operational issues, project management, public sector, public services

Tagged ,

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

Posted on 05/07/2012 | 2 comments

By Tony Collins

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

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

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

Records incomplete

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

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

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

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

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

“Substantial concern”

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

“Systematic failings”

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

Patient safety an issue?

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

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

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

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

Eye off the ball?

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

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

**

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

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

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

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

Does NWL always trust what Imperial says?

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

**

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

“Urgent meeting”

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

Clinical harm?

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

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

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

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

**

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

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

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

Big organisational challenge

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

Imperial responds

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

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

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

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

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

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

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

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

Comment

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

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

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

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

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

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

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

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

Troubled Cerner NPfIT go-lives, so far:

Barts and The London

Royal Free Hampstead

Weston Area Health Trust

Milton Keynes Hospital NHS Trust

Worthing and Southlands

Barnet and Chase Farm Hospitals NHS Trust

Nuffield Orthopaedic

North Bristol.

St George’s Healthcare NHS Trust

University Hospitals of Morecambe Bay NHS Foundation Trust

Birmingham Women’s Foundation Trust

NHS Bury

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

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

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

GPs kept in the dark over hospital cancer blunder – Pulse

Other links:

Halt NPfIT Cerner deployments says MP Richard Bacon

Bacon calls for halt on Millennium.

2 Comments

Posted in Campaign4Change, Cerner, Deloitte, e-health, health, health records, NHS, npfit, openness and transparency, operational issues, oversight, private sector lessons for the public sector, public sector

Tagged

Poor IT suppliers to face ban from contracts?

Posted on 28/06/2012 | Leave a comment

By Tony Collins

The Cabinet Office minister Francis Maude is due to meet representatives of suppliers today, including  Accenture BT,Capgemini, Capita, HP, IBM, Interserve, Logica, Serco, and Steria.

They will be warned that suppliers with poor performance may find it more difficult to secure new work with the Government. The Cabinet Office says that formal information on a supplier’s performance will be available and will be taken into consideration at the start of and during the procurement process (pre-contract).

Maude will tell them that the Government is strengthening its supplier management by monitoring suppliers’ performance for the Crown as a whole.

“I want Whitehall procurement to become as sharp as the best businesses”, says Maude. “Today I will tell companies that we won’t tolerate poor performance and that to work with us you will have to offer the best value for money.”

The suppliers at today’s meeting represent around £15bn worth of central government contract spend.

The representatives will also be:

– asked their reactions on the government’s approach to business over the past two years

– briefed on the expanded Cabinet Office team of negotiators (Crown Representatives) from the private and public sectors. Maude says these negotiators aim to maximise the Government’s bulk buying power to obtain strategic discounts for taxpayers and end the days of lengthy and inflexible contracts.

Spending controls made permanent

Maude is announcing today that cross-Whitehall spending controls will be a permanent way of life. The Government introduced in 2010 temporary controls on spending in areas such as ICT  and consultancy. It claims £3.75bn of cash savings in 2010/11, and efficiency savings for 2011/12, which it says are being audited.

The Cabinet Office says: “By creating an overall picture of where the money is going, the controls allow government to act strategically in a way it never could before. For example, strict controls on ICT expenditure do not just reduce costs but also reveal the software, hardware and services that departments are buying and whether there is a competitive mix of suppliers and software standards across government.”

Maude said: “Our cross-Whitehall controls on spending have made billions of cash savings for the taxpayer – something that has never been done before. That’s why I’m pleased to confirm that our controls will be a permanent feature, helping to change fundamentally the way government operates.”

Leave a comment

Posted in cost reduction, efficiency savings, Government IT, IT-related failures, operational issues, outsourcing, oversight, Politics, private sector lessons for the public sector, procurement, project management, public sector, software quality, supplier relationships

Tagged , ,

RBS/Natwest: Some lessons from the IT crash – Bank of England Governor.

Posted on 26/06/2012 | 1 comment

By Tony Collins

Sir Mervyn King, Governor Bank of England, promised today that there would be a “very detailed inquiry” once problems at RBS/Natwest are back to normal.

Such a report would be unusual because the cause or causes of IT-related crashes in the public and private sectors are usually kept secret unless in rare cases a legal action comes to court.

Mervyn King told the Treasury Committee today:

“Once the current difficulties are over then we will need the FSA to go in and carry out a very detailed investigation to find out first of all what went wrong but even more importantly why it took so long to recover.

“Computer systems will always go wrong from time to time. The important things are your back-up systems and the time it takes to implement recovery. As of now we have kept in very close touch. My office was in touch with senior RBS management right through the weekend. Our banking director was in touch with RBA and FSA on this right since this problem began … It is still going to take time to catch up, to get back to normal.

“The important thing now is that we provide whatever support is needed to let them put it right. Once it is back to normal then we must carry out a very detailed inquiry.

“To my mind, one of the big lessons from this is that it shows everyone is how important the basic functions of banking actually are: what can go wrong when the system of payments from person to another is interrupted. Fortunately it has been one bank, albeit a very big bank, and customers of that bank have been affected, and of course customers of other banks have been affected, and payments have not gone through.

“I hope this is a reminder, a demonstration, to everyone, for example, of what might have happened if we had not rescued RBS in the autumn of 2008. The whole payment system would have collapsed. [It is] why it is so important to ensure you have a banking system where the people running it are completely focused on this essential service function of banking to provide … customers with a functioning payment system.

Learning from supermarkets.

“I have been driven by the belief that the nature of banking and providing these kinds of services is very different from investment banking operations. Those are important but they are very different. When you go out and see how supermarkets operate, the senior management is utterly focused on ensuring that the IT systems, the ordering systems, the delivery system, works hour by hour. That is very important to ensure that that is true of the banking system as well…”

Comment:

History  is, to some extent, the story of the unforeseen, in which case a published report on the cause of the problems at RBS/Natwest could be helpful to other banks and major organisations whose ageing systems are vulnerable to an unforeseen failure of huge proportions.

A published report on the crisis may show systemic management failures. The mere fear of such a report would be an added deterrent – additional to potential losses and payments of compensation – to any bank that does not give the attention it should to operational systems, even when those systems support a retail banking operation that may represent a small part, perhaps only 2% of a bank’s balance sheet.

It is ironic that RBS is publicly owned. Will the IT disaster now be added to the list of other public sector failures? Did RBS, now in the public sector, drop its IT-related standards and caution in part because the commercial imperative was absent?

Natwest/RBS – what went wrong?

1 Comment

Posted in Government IT, IBM, IT projects, IT-related failures, managing outsourced services, operational issues, software quality, supplier relationships

Natwest/RBS – what went wrong?

Posted on 25/06/2012 | 4 comments

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.

4 Comments

Posted in Campaign4Change, India, IT and the Business, IT projects, IT-related failures, M&A, managing outsourced services, operational issues, outsourcing, supplier relationships

Tagged

Cabinet Office promises unprecedented openness on risky projects

Posted on 13/06/2012 | 2 comments

By Tony Collins

The Cabinet Office has defended its decision not to publish “Gateway” review reports on the progress or otherwise of large and risky IT and construction projects.

Gateway reviews are regular, short and independent audits on the state of medium and high-risk projects. Their publication would allow  MPs and the public to have an early warning of a major project in trouble – rather than know of a project failure only after it has happened.

Campaigners have sought for a decade to have the review reports published; and the  Information Commissioner, in requiring the publishing of ID Card gateway reviews under FOI,  dismissed the generalised arguments put forward by officials for Gateway reviews to remain confidential.

The Conservatives, when in opposition, promised to publish Gateway review reports if they came to power. But departmental heads and senior officials have stopped this happening.

Now the Cabinet Office, in a statement to The Guardian, has suggested that the first annual report of the Major Projects Authority will more than compensate for the non-publication of Gateway review reports.

The statement says that the Authority’s ( delayed)  first annual report will “bring unprecedented scrutiny and transparency to our most expensive and highest risk programmes, changing forever the culture of secrecy that has allowed failure to be swept under the carpet”.

The statement continues:

“Historically, fewer than a third of government major projects have delivered to original estimates of time, cost and quality. Since April 2011 the Major Projects Authority has enforced a tough new assurance regime and begun raising leadership standards within the Civil Service.”

The Guardian asked the Cabinet Office whether the traffic light red/amber/green status of Gateway reviews will be published.  The spokesman replied:

“The annual report will contain details of the status of major projects.“

Comment:

We applaud the Major Projects Authority in scrutinising, and in rare cases helping to stop,  departmental projects that don’t have adequate business cases. The Authority’s work is vital in pre-empting ridiculous schemes such as the NPfIT.

But project  disasters that rely on  IT continue, at the Ministry of Justice for example.  Like the National Audit Office, the  Major Projects Authority has limited resources and cannot scrutinise everything. Even if it could, the system of government is not set up in such a way as to allow the Authority to have final say over whether a project is stopped, curbed or re-negotiated.

Preventing failure

Gateway review reports are a critical component in preventing IT-related project failures. If officials know the whistle is going to be authoritatively blown on their failing schemes they are likely to do all they can to avoid failure in the first place. If they know that nobody will be aware of doomed schemes until those involved have left or moved, they will have less incentive to make projects a success.

An annual report is no substitute for the contemporaneous publishing of Gateway review reports. Each Gateway review is several pages and puts into context the traffic light red/amber/green status of the project. An annual report will not contain every Gateway review report. If just the traffic light status is published that will be a start, but without the context of the report what will it mean?

[And it’s worth bearing in mind that the first annual report of the Major Projects Authority is already six months late.]

The non-publication of Gateway review reports is  a victory by senior officials over ministerial promises.  How can we believe that the coalition is committed to unprecedented openness when the final say remains with Sir Humphrey?

Cabinet Office promises to challenge culture of secrecy on IT projects.

Whitehall to relent on secrecy over mega projects?

2 Comments

Posted in change, change management, cost avoidance, cost reduction, excessive secrecy, Freedom of Information, Gateway reviews, government, Government IT, IT projects, IT-related failures, openness and transparency, operational issues, Politics, reducing cost strategically

Tagged , , , ,

The real reason NHS Risk Register is a State secret?

Posted on 16/05/2012 | 2 comments

By Tony Collins

Yesterday  (15 May 2012) the Information Commissioner Christopher Graham issued a finely-crafted report to Parliament on his concerns about the Government’s use of a ministerial veto to stop publication of the Transition Risk Register relating to health service reforms.

Graham’s concern is that the veto represents a new and worrying approach to Freedom of Information.

Graham cannot do anything about the veto but he can warn MPs when he feels the Government has gone too far. This he has done in his report which says that the previous three occasions on which the ministerial veto has been exercised related to the disclosure of Cabinet material under FOIA. Now the Government has applied the veto to information held by the Department of Health.

Says yesterday’s report: “ The Commissioner would wish to record his concern that the exercise of the veto in this case extends its use into other areas of the policy process. It represents a departure from the position adopted in the Statement of Policy and therefore marks a significant step in the Government’s approach to freedom of information.”

The Government’s decision to ban publication of the health service risk register is particularly relevant to IT-related projects. This is because the government uses exactly the same arguments to ban contemporaneous publication of Gateway reviews and other independent assessments of IT-related projects and programmes.

Risk registers and Gateway reviews of IT-enabled change projects are similar. They are designed to identify all the main risks associated with the project or programme and have a red/amber/green system of rating the risks.

The Government’s argues that risk registers (and Gateway reviews) are researched and written in a “safe space” that allows civil servants to give advice and recommendations in a frank way. This candour would be compromised if the civil servants thought their advice would be published, says the Government.

In issuing a veto on the health risk register Andrew Lansley, the Health Secretary said, in essence, that he could not trust civil servants to be entirely honest if they knew their reports would be made public.

Said Lansley:  “If risk registers are routinely or regularly disclosed at highly sensitive times in relation to highly sensitive issues, or there is legitimate concern that they could be, it is highly likely that the form and content will change: to make the content more anodyne; to strip out controversial issues or downplay them; to include argument as to why risks might be worth taking; to water down the RAG [red,amber, green] system.

“They would be drafted as public facing documents designed to manage the public perception of risk; not as frank internal working tools. These consequences (many of them insidious) would be to the detriment of good government.”

Lansley also wanted to ban publication to pre-empt sensational media coverage.  In this he was repeating the arguments made by civil servants under Labour who refused, under the FOI Act, to publish risk registers and Gateway reviews.  Said Lansley “I consider that the form and the frankness of the content of TRR [health service Transition Risk Register] would have been liable to create sensationalised reporting and debate.

“The content would also have been inherently highly open to misinterpretation by both the press seeking a headline and/or for political reasons. The likelihood of this occurring is particularly acute where the subject matter is, as with the Transition programme, controversial and the proposals at a highly sensitive stage.”

But the Commissioner did not accept that disclosure of the Transition Risk Register would affect the frankness and candour of future risk registers. The Commissioner also said that a ministerial veto should, by law, be made only in exceptional circumstances.  But the Government has failed to explain why there are exceptional circumstances in this case.  Said the Commissioner:

“The Commissioner does not consider that sufficient reasons have been given as to why this case is considered to be exceptional, particularly in light of the [Information] Tribunal’s decision dismissing the Department’s [Department of Health’s] appeal.

“The Commissioner notes that much of the argument advanced as to why the case is considered to be exceptional merely repeats the arguments previously made to Commissioner and the Tribunal and which were in part dismissed by the Tribunal.”

Graham concludes:

“In light of previous commitments he has made, and the interest shown by past Select Committees in the use of the ministerial veto, the Commissioner intends to lay a report before Parliament under section 49(2) FOIA on each occasion that the veto is exercised. This document fulfils that commitment.

“ Laying this report is an indication of the Commissioner’s concern to ensure that the exercise of the veto does not go unnoticed by Parliament and, it is hoped, will serve to underline the Commissioner’s view that the exercise of the ministerial veto in any future case should be genuinely exceptional…

“The arguments employed by the Department at the Tribunal and by the Secretary of State in explanation of the subsequent veto, both in the Statement of Reasons and in exchanges in the House of Commons around the Ministerial Statement, certainly use the language of ‘exceptional circumstances’ and ‘matter of principle’. But the arguments are deployed in support of what is in fact the direct opposite of the exceptional – a generally less qualified, and therefore more predictable, ‘safe space’.

“As such, the Government’s approach in this matter appears to have most to do with how the law might be changed to apply differently in future. This question falls naturally to consideration by the Justice Committee who have been undertaking post-legislative scrutiny of the Act.”

Comment:

The reason for the veto in the case of the health service risk register has little to do with protecting a safe space for frank discussion.

Civil servants already compile risk registers, Gateway reviews and similar reports on the basis that they may, at some point, be published. Officials are no more likely to be frank if they know their reports will be confidential than more guarded if they know the documents will be published. They will do what their job entails. Their job requires honesty. They will do that job whether or not reports are published.

The real reason for the veto – and the refusal of departments to publish all contemporaneous internal reports on large and complex programmes, particularly those with a large IT element – is that some new schemes within Government operate at a shambolic level.

Any new government, whatever its hue, soon learns to keep secret the fact that such programmes are sometimes characterised by near anarchy.

One outsider to the UK government, Australian David Pitchford, discovered the truth when he became Executive Director of Major Projects within the Efficiency and Reform Group which is part of the Cabinet Office. Pitchford may not have realised his comments would be reported when he told a project management conference in 2010 that “nobody in the UK Government seems to know how many projects they have on the books, nor how much these are likely to cost”.

He found that projects were launched, and continued, without agreed budgets or business cases.  Today, there is better scrutiny of major projects, by the Cabinet Office’s Major Projects Authority. But the MPA is limited in what it can do or scrutinise. Which leaves government in a general mess when it comes to implementing anything new.

Evidence for this mess comes from the National Audit Office. Its auditors tend to investigate departments as a whole more than they do specific projects but when they do the careful reader can see that projects such as the Rural Payments Agency’s Single Payment Scheme (a scant regard for public funds, said the NAO) and the C-NOMIS project for the prison service (kindergarten mistakes, said chair of Public Accounts Committee) were without a structure. Chaos prevailed – and ministers were among the last to know.

Publication of project reports encourages professionalism. Departmental heads can be held to account if Parliament knows what has gone wrong. That’s precisely the reason departmental heads don’t want risk registers and other project reports published. It’s why all internal reports on Universal Credit, the government’s biggest IT-related project, are kept secret in spite of FOI requests.

The ministerial veto in the case of the NHS risk register is the government and civil service colluding in keeping the public and Parliament in ignorance of internal management’s inability to run complex new projects and programmes in a professional way.

Ministers and permanent secretaries don’t especially mind media criticisms that are based on speculation. They don’t want their critics having authoritative internal reports. That’s why the Cabinet agreed the health service veto – and it’s one reason the government has a not-very-hidden aversion to the FOI Act.

The coalition cannot justly claim to cherish open government while it is refusing so many requests under FOI to publish contemporaneous taxpayer-funded reports on its major schemes.

We agree with the Information Commissioner that use of the ministerial veto is a step too far. No number of announcements by the Cabinet Office on open government will gloss over the fact that the coalition is even more secretive about mega-projects than Labour. That’s saying something.

2 Comments

Posted in Campaign4Change, Freedom of Information, Gateway reviews, Government IT, IT projects, IT-related failures, Major Projects Authority, NHS, operational issues, Politics, private sector lessons for the public sector, project management, public sector, public services, Universal Credit

Tagged , ,

Whitehall defies NAO and Cameron on publishing status of big projects

Posted on 02/05/2012 | 1 comment

By Tony Collins

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

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

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

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

Says the NAO report

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

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

Separately in the report the NAO says

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

Should ministers intevene to force publication?

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

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

Prime Minister’s 2011 mandate

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

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

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

Yet none of this has happened.

The “rebel” civil servants

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

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

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

Says the NAO

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

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

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

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

But that hasn’t happened either.

Says the NAO:

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

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

Comment:

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

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

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

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

Links:

NAO report – Assurance for major projects

Firecontrol – same mistakes repeated on other projects

1 Comment

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

Tagged , , , ,