Category Archives: oversight

Universal Credit – good for its IT suppliers?

By Tony Collins

The DWP is conceding in its own tangential way that the IT for Universal Credit is not up to scratch; and an article in the Daily Telegraph suggests that Universal Credit this year (and perhaps well beyond) will handle so few claimants that the calculations for the time being could be done by hand, or on a spreadsheet, and not automatically by IT systems. The Register, through anonymous sources, has confirmation of this.

The FT says there will be a progressive national rollout of the coalition’s welfare reform in just six additional jobcentres which it said was the “latest sign the project is falling behind schedule”. It added that a significant shake-up of the IT underpinning universal credit is under way. 

The DWP said David Pitchford, the Whitehall troubleshooter who took over the running of Universal Credit for three months, had been asked to “review” the IT and ministers had “accepted his recommendation that they should explore enhancing the IT for universal credit working with the government digital service”.

“Advancements in technology since the current system was developed have meant that a more responsive system that is more flexible and secure could potentially be built,” said the DWP.

The FT quoted Howard Shiplee, who has led the Universal Credit  project since May, as denying claims from MPs that the original IT had been dumped because it had not delivered. “The existing systems that we have are working, and working effectively,” he said.

He added that he had set aside 100 days not to stop the programme, but to reflect on where it has got to and start to look at the entire total plan.

Iain Duncan Smith, the work and pensions secretary, doesn’t concede that the  timetable for the implementation of Universal Credit has changed. He told the work and pensions committee on Wednesday that numbers of claimants would ramp up during 2014 and he insisted that all claimants would be on the system by 2017, as originally planned.

“We get fixated on things like IT; the reality is it’s about a cultural shift,” Duncan Smith told MPs.

Comment

Iain Duncan Smith makes it clear that his DWP staff and suppliers, with the help of HMRC, are implementing Universal Credit with extreme care. Labour’s  work and pensions spokesman Liam Byrne says the Universal Credit project is a shambles. The truth is hard to fathom.

For years the DWP has rejected press reports that the IT for Universal Credit was in trouble. It is able to do without fear of authoritative contradiction because it keeps secret all its consultancy reports on the state of the Universal Credit project, despite FOI requests.

The Cabinet Office minister Francis Maude and his officials talk much about the need for openness and transparency. Isn’t it time they persuaded DWP officials to release their internal and external reports on the detailed challenges faced by suppliers and civil servants on Universal Credit and other major government IT projects?

All big government IT projects are characterised by secrecy and defensiveness, although a little information about them is in the vague and subjectively-worded Major Projects Authority annual report.

One by-product of departmental defensiveness and secrecy is that the IT suppliers – in Universal Credit’s case HP, IBM and Accenture – are likely to continue to be paid even if the project is halted and redesigned. It’s probable the suppliers would argue that they have successfully done what they were asked to do in the contract. Who knows what the truth is?

The DWP is in effect protecting its suppliers from public and parliamentary scrutiny. It has been this way for decades and nothing has changed.

When Whitehall shuns statutory scrutiny

By Tony Collins

In some ways central departments are deeply accountable.

They provide volumes of statistics and reports to the centre of government (Cabinet Office and Treasury) – as far as their limited management information systems will let them – and senior officers will sometimes answer questions from MPs on Parliamentary committees. Their permanent secretaries will meet colleagues in other departments every week.

At the same time, on things that really matter, some central departments – and councils – can be infinitely unaccountable. 

A report by the National Audit Office – which it says was researched and written unusually quickly, partly in response to parliamentary concern – gives a glimpse of how unaccountable central departments (and councils) can be.

When they don’t want to provide information they simply don’t – and nothing it seems can be done to force disclosure.

Power to ignore

With explicit and written approval from David Cameron the Cabinet Office has the power to mandate change in central departments. But senior officials can, if they wish, when faced with central requests for information, ignore, reject, deliberately misunderstand, confuse or minimise answers, or delay until the request no longer need be answered.

This ability of central departments to evade democratic and even statutory scrutiny surfaces in the NAO report Confidentiality clauses and special severance payments.

The report is into the gagging of public servants when they receive payments for ending their employments early. Rightly, the media’s coverage of the report focuses on the NAO’s concerns over gagging clauses that stop officials becoming whistleblowers. The FT said on Friday (21 June 2013)

“More than a thousand civil servants have signed gagging clauses that could stop them speaking out about problems, a system the [NAO] condemned as “unacceptable”.

What the national media apparently did not notice was that the NAO was unable to obtain all the information it had requested of departments.

“Despite the NAO’s statutory access rights, it received only 60 per cent of the compromise agreements requested from departments,” says the NAO.

The NAO has statutory rights of access to information held by departments. Indeed its Comptroller and Auditor General Amyas Morse certifies the accounts of all government departments and many other public sector bodies. The NAO says he has “statutory authority to examine and report to Parliament on whether departments and the bodies they fund have used their resources efficiently, effectively, and with economy”.

Avoiding NAO scrutiny

But some departments have not complied with the NAO’s requests, and one, the Department of Culture, Media & Sport, formally requested not to be involved in the NAO’s investigation.

Says the NAO report

“Unfortunately, some departments did not respond promptly to our requests, and were delayed by their legal teams’ questioning of our access rights.

The NAO adds

“The Department for Culture, Media & Sport requested not to be involved in this piece of work, a position which could not be resolved until after our fieldwork window had closed.

“We found it challenging to gain a complete picture of the use of confidentiality clauses as, by their nature, they are not openly discussed. Our work was also hampered by incomplete records, and access to data as outlined above.

“It took several attempts to identify the appropriate individuals within departments responsible for compromise agreements and the associated payments. We experienced delays in receiving data, and what departments provided was frequently incomplete or in a format that was difficult to collate and analyse.”

So what can the NAO do now it has been snubbed or, to put it in Whitehall-speak, has encountered departmental non-compliance with statutory access requests?

Little or nothing. The NAO has no power to punish. Through MPs on the Public Accounts Committee it can admonish. That is all.

Says the NAO:

“Given the innovative nature of this work, some initial difficulties were anticipated. We will continue to work with departments, the Treasury and Cabinet Office to explore ways in which we can obtain the evidence on a timelier basis. It is important that departments are able to respond more quickly to these investigations in the future.”

Councils too can evade democratic accountability. The NAO has no access rights to local authorities but councils are, in theory, subject to the Freedom of Information Act. In practice they can all but ignore the FOI legislation if they wish.

In March 2010, the Audit Commission published a report on severance payments to council chief executives. The study found that:

• agreed severance packages for 37 council chief executives totalled £9.5 million, 40 per cent of which were in pension benefits;

• three in every ten outgoing council chief executives received a pay-off;

• the average cost to councils of each severance package was almost double the annual basic salary, but in four cases was more than triple; and

• 79 per cent of mutually-agreed severance payments had a confidentiality clause.

But the NAO found that, in a recent survey of councils by a member of the public under the FoI Act, 52 councils refused to disclose information on their use of compromise agreements.

The good news

The NAO says: “Some organisations have chosen to be transparent about severance packages, such as NHS National Services Scotland, who agreed to the disclosure of a director’s remuneration package, despite a confidentiality agreement being in place, following consultation with legal advisers.”

Comment:

How is Francis Maude to reform central government, particularly IT, if officials in central departments can apparently do what they wish?

The NAO found cases of payments that were higher than contractual entitlement, where there was the apparent reward for failure, and no attempt to seek Treasury’s approval.  Is all this lawful? 

On top of this there are departmental officials who avoided the NAO’s statutory requests for information.

If they can circumvent the law they can probably resist any central demands for change. Resistance seems to be regarded within departments as honourable.

One irony is that bureaucrats in Russia probably have little choice but to respond to central demands – whereas officials in Whitehall departments don’t have to.

Radical reform to change Whitehall’s outdated and costly ways is unlikely to happen while senior officers in departments run the system and have the final say.

NAO report “Confidentiality clauses and special severance payments

Does a Mid Staffs culture still pervade the NHS?

By Tony Collins

The Francis report on Mid Staffordshire NHS Foundation Trust highlighted appalling record-keeping among other problems.

One of the case studies in the report was that of an insulin-dependent diabetic, Gillian Astbury,  who entered Cannock Hospital for a urinary tract infection, had a fall in the hospital, was discharged, and later admitted to Stafford Hospital on 1 April 2007 because of bones she damaged in the fall. She died ten days later, probably after not being given insulin.

Francis highlights the lack of records on her need for insulin. There was a “failure to keep nursing records adequately or at all … there was a failure to comply with professional guidelines on note taking …”

Astbury’s partner Ron Street told hospital staff that she was diabetic, a point which went into her medical notes – initially.  But, said Francis,  nursing records for Astbury were almost non-existent.

“There is no evidence of what care took place … during interview nursing staff admitted that they did not check or read the notes regularly (if at all) and there was no linkage with notes from other wards …” 

Francis’s recommendations included a call for trust staff and managers to be open and accountable when things that go wrong.

This isn’t happening.

Campaign4Change picked an NHS trust to test whether the pre-Francis culture still prevails: whether there is the same old secrecy and defensiveness over standards of record-keeping, and whether positive news suffocates real and potential problems in trust board reports.

North Bristol NHS Trust

North Bristol NHS Trust has a chronic problem with record-keeping. It installed the Cerner Millennium electronic patient record system in December 2011, prompting a “crisis”.

Later the trust’s PR officer said in response to an FOI request that there had been 16 clinical incidents in two months relating to the new electronic patient record system. “These were all clinical incidents where the new system was cited as a causal factor, such as wrong patient wrong notes, lack of notes, incorrect clinic list,” she said.

She added:  “However our robust safeguarding processes, as well as additional checks and balances in all departments, ensured that clinical safety was not compromised and no patients were put at risk. Our priority is always patient safety and there is no indication that this has been affected.”

Last year North Bristol asked PWC to review the Cerner implementation. In its report PWC claimed that the “Trust is now beginning to move out of the crisis and return to normal operations”. That was in July 2012.

The Trust has still not returned to normal operations. Last month the Department of Health singled out North Bristol as one of only two trusts in England that failed to submit to the DH “incomplete RTT” pathway data. Incomplete pathway data refers to patients still waiting for consultant-led treatment. RTT means referral to treatment.

In August and September 2012 North Bristol was the only trust in England that failed to submit to the DH “incomplete RTT” pathway data.

Trust’s “numerous difficulties”

With little explanation, a North Bristol trust board paper in January this year referred to numerous difficulties relating to IT systems. This was in the context of an increasing number of overdue responses to complaints from patients. Said the board paper:

“Difficulties with appointment bookings and notification letters are still numerous. These are all reported to IM&T.” Again with little explanation another North Bristol board report, in November 2012, referred to “ongoing pressure in Cerner recovery …”.

So what are the Cerner problems, why have they continued for more than a year and has the North Bristol Trust’s board of directors been properly informed about them?

To test North Bristol’s openness on its Cerner problems I asked the Trust’s press officer and its media relations manager whether they could send me any trust report on the problems with the Cerner implementation.

Two days later they said that “some patience would be appreciated” but declined to say when they would respond to my question, so I asked it under FOI. The Trust gave no acknowledgement.

Perhaps North Bristol is too busy to deal with external questions and challenges on its record keeping. But that was one of the big problems highlighted by Francis in his report on Mid Staffs: that the Trust did not respond to external questions and challenges.

Worryingly, North Bristol’s reporting culture seems to prefer the positive over the negative.  This was one of its replies to an FOI request in 2012:

“With respect to inpatients, during November (before the implementation of Cerner) 40 patients were cancelled on the same day as admission for non-clinical reasons. During December (after the implementation of Cerner) 33 patients were cancelled on the same day as admission for non-clinical reasons – 7 fewer than in November.”

This reply – and others  – gave the impression, without giving contextual evidence,  that things were better since the Cerner implementation than before.

Francis in his report on Mid Staffs said,

“… for all the fine words printed and spoken about candour, and willingness to remedy wrongs, there lurks within the system an institutional instinct which, under pressure, will prefer concealment, formulaic responses and avoidance of public criticism.”

This would, it seems, apply to North Bristol – and every one of the other NHS trusts that have had electronic patient record implementations go wrong.

Indeed it is unfair to pick on North Bristol. The positive tone of its board reports is standard practice for trust board reporting across the NHS in England.

Francis said the NHS needs to change. In his letter to Jeremy Hunt on his report, Francis referred to an “institutional culture which ascribed more weight to positive information about the service than to information capable of implying cause for concern”.

But can NHS boards change in the absence of compulsion?

Audits of trust board reports?

One thing Francis did not suggest was that trust boards should have their board reports audited independently for honesty and openness.  An audit would detect an overly buoyant tone that downplayed concerns.  “There were 5 serious falls in December an increase of 3 from November. There were 185 falls in December compared to 139 falls in November, which had the lowest number of falls in one month this year.”

This was from a North Bristol board report that gave no explanation of the five serious falls. But the report made the point that November (2012) had the lowest number of falls in one month this year. If you were among the five who’d had a serious fall in hospital – and in Gillian Astbury’s case a fall in Stafford Hospital led to her death – you would probably want the trust’s board to focus on an analysis of the five serious falls, rather than be told how good a month November was for falls.

Board reports are a window on the culture of a public sector organisation. In the NHS nobody in authority seems not to have noticed that an American corporate positivism pervades many NHS board reports.  It’s within this culture that needless deaths such as those at Mid Staffs went unnoticed.

Until NHS trust board reports become more business-like and deal with concerns and potentially serious problems as would a private sector board – instead of giving the impression that they are trying to celebrate so-called achievements – the Francis report may make little difference.

North Bristol’s apparent unwillingness to disclose any detail of its Cerner problems – perhaps to its own board – is to be expected; but that natural reluctance to disclose may be symptomatic of one of the NHS’s biggest problems. The unnecessary deaths at Mid Staffs will be for nothing if the NHS does not change in the light of the Francis report. Complacency, arrogance, a preoccupation with good news and a culture of downplaying or even trying to ignore bad news are the enemy. Unless a board approach of honesty and openness is independently audited and enforced, Francis’s recommendations may bring little lasting change.

Barnet’s undemocratic BT/Capita outsourcing plan?

By Tony Collins

Barnet Council is remarkably defensive about its plan to outsource IT, customer services, finance, payroll, HR, corporate procurement and other services to BT or Capita, by the end of December 2012.

After the controversy in Cornwall about whether the full council or an inner circle of councillors – the “Cabinet” – should make momentous decisions affecting the council’s future, Campaign4Change asked Barnet whether it was putting its decision to outsource to BT or Capita to the full council.

Cornwall’s decision on whether to outsource to BT or CSC was going to be taken by the Cabinet alone but Cornwall’s leader Alec Robertson changed course and decided to put the idea of a mega-outsourcing deal to the full council.

Straightforward question

So would Barnet council’s decision to award a mega-outsourcing contract to BT or Capita go to full council for a vote? It was a straightforward question for Nick Griffin, Media Officer, Chief Executive’s Service, Barnet Council. He did not answer the question directly.

His reply:

“There is quite a bit of information available on our website. Please see the links (at the bottom of this post)  …

But was the information on the council’s website out of date? We wanted to be clear on the facts. We asked Griffin again. His reply was polite but insistent: he would not say whether the council was putting its outsourcing decision on BT or Capita to the full council.

Neither would he answer directly another straightforward question on local democracy: Has the decision to approve/reject One Barnet [transformation programme] gone to full council for a vote?

From the council’s website it appears that all key decisions on the outsourcing plans have been made by Barnet’s Cabinet’s alone. This is from the council’s website:

“A decision will be made by Cabinet in late 2012 as to which bidder [BT or Capita] will win the contract. The new provider will start to run the NSCSO [New support and Customer Services Organisation] in spring of 2013.”

Barnet’s website lists as the relevant previous decisions those taken by the council’s Cabinet alone.

– Cabinet, 29 November 2010 – approved the One Barnet Framework and the funding strategy for its implementation.

– Cabinet …2 March 2011 – Customer Services Organisation and New Support Organisation Options Appraisal

– Cabinet … 29 June 2011 – approved the New Support and Customer Services Organisation business case and the start of the competitive dialogue process…

So one of the most momentous decisions affecting the council, its staff and council services is not being made by the full council.

Undemocratic?

Barnet Council comprises 38 Conservatives, 22 Labour, and three Lib-Dem councillors. Most of them will not have a say on the outsourcing of:

  • Customer Services
  • Estates
  • Finance and Payroll
  • Human Resources
  • IT Infrastructure and Support
  • Corporate Procurement
  • Revenues and Benefits
  • Commercial Services.

The decision will be taken by the Cabinet’s 10 councillors, and perhaps not all of them. Is this local democracy in action?

Accusations of Maladministration?

Given that the decision to outsource to BT or Capita could have a major effect on the council’s future for good or ill, and is controversial –councils including Suffolk and Cornwall are rethinking large outsourcing plans – could Barnet’s decision not to put its outsourcing plans to a vote of the full council leave the Cabinet open to accusations of maladministration if things turn sour?

Links provided by Nick Griffin (1)  (2)

Somerset’s dispute with IBM is “escalating”.

By Tony Collins

Somerset County Council says in a paper due to be discussed next week that its dispute with the IBM-led Southwest One joint venture is “escalating” and that there is a need to “restore a deteriorating relationship with a supplier”.

The poor relationship is in contrast to the mutually content position in 2008, one year after Somerset signed its unique, ground-breaking deal with IBM. At that time Somerset refused a request by Unison for a copy of the business case for Southwest One saying, “We can record, however, that all our cost and performance criteria within the business case were met or exceeded”.

Now Southwest One and the council are in a legal dispute on several fronts. The council’s paper for its cabinet meeting next week says:

“The history of Southwest One [SWo] poor performance is continuing; during 2012 the Client Team have been holding SWo to account; resulting in the serving of 8 contractual notices to SWo.

“Over the past 3 weeks SWo have commenced disputes on several other matters, issuing further financial claims and disputing Somerset County Council’s warning notices.

With a number of escalating disputes, we need to take action to:

• Conduct proceedings

• Respond to these disputes and restore a deteriorating relationship with a strategic supplier.

• Seek to improve value for money and service performance and ensure it is fit for purpose.

• Continue to assertively manage Southwest One to ensure it meets its contractual obligations.

• Maintain Partner relationships

Somerset’s officers recommend to the cabinet that:

“The Leader of the Council authorises the Chief Executive, Deputy County Solicitor, Director of Finance & Performance and other relevant SCC officers to serve and proceed with the defence and any counterclaim, to carry out all subsequent steps in the litigation process and any engagement in connection with the disputes.”

The paper  adds:

“It is also recommended that the Leader of the Council and the Chairman of Scrutiny Committee agree urgency in respect of the above recommendation…

“The Deputy County Solicitor is authorised to institute defend or settle any legal proceedings and to lodge an appeal. This report seeks authorisation to be given to SCC officers to serve and proceed with the Defence and any Counterclaim, to carry out all subsequent steps in the litigation process and any engagement and commit to financial considerations (such as legal costs) in connection with the disputes…

“Due to the contractually binding timetable for resolving disputes SCC officers need a mandate. Risks will be reported and managed through SCC’s governance arrangements.”

A budget exists to support the council’s approach.

The report says that the council is in disagreement with Southwest One over the quality of the procurement service and what payments it is entitled to as a result of savings made by getting better deals through the joint venture. “We had hoped we would be able to settle this through negotiations, but unfortunately that has not been the case.”

Comment:

In mid-2007, about two months before Somerset signed its deal to set up Southwest One with IBM, an external consultancy report on the proposals by consultants “Maana” praised the “immense amount of research and thinking” that went into the IBM bid.

It said that the “whole of the procurement process, from market investigation to preferred bidder selection has been well planned and executed”. Maana added:

“The evaluation process has been more extensive, well thought through and executed than any we have seen before.”

And look what happened to the best laid plans. Many saw at the time that the joint venture was too complicated and put too much responsibility IBM’s way, but the council pushed aside their concerns.

Who now is responsible for the failure of Southwest One? Nobody.

Thank you to Dave Orr whose information made this article possible.

A mega-outsourcing plan in Cornwall beset by naive fanaticism?

By Tony Collins

Comment and analysis

An inner circle of councillors at Cornwall council is rushing plans to sign a big outsourcing deal despite a council vote against it.  The aims of the deal include an IT-based transformation of services,  the creation of “up to” 500 new jobs and tens of millions of pounds in savings – all too good to be true? 

The warning signs are there. The council’s remarkable naivety,  a hurried enthusiasm for signing a deal, and a confident waving aside of internal and external concerns,  may be early indications of a possible disaster.  An internal report warns of a potential “catastrophe” over service delivery.

 If all turns sour could accusations of maladministration follow? Is there still time for the full council to stop the inner circle from pressing ahead with a contract signing?

Major IT suppliers have some exceptional salespeople. They don’t merely sell hardware, software and services. They inspire. They rouse to action. Their promises are believable because they believe them with a conviction that can be contagious.

Joe Galloway might have been a one-off.  He was managing director of a part of one of the world’s largest IT companies EDS (now HP).  He helped to strike a CRM [Customer Relationship Management] deal with BSkyB in 2000. The contract ended in a £709m legal dispute in which Galloway was a main witness for HP. The judge in the case of BSkyB v HP found that some of Galloway’s evidence was untrue.

He demonstrated an “astounding ability to be dishonest, making up a whole story about being in St John [part of the Virgin Islands], working there and studying at Concordia College. EDS properly distance themselves from his evidence and realistically accept that his evidence should be treated with caution,” said the judge.

The judge also said

“I am driven to the conclusion that he proffered timescales (on the CRM project) which he thought were those which Sky desired, without having a reasonable basis for doing so and knowing that to be the position… I consider that he acted deliberately in putting forward the timescales knowing that he had no proper basis for those timescales. At the very least he was reckless, not caring whether what he said was right or wrong.”

During the High Court hearing, when HP discovered Galloway’s dishonesty, it sacked him.

He had held a senior position at EDS and the company’s customer BSkyB believed what he had said.  The case cost HP £318m plus tens of millions of pounds in legal fees – and the dispute lasted more than seven years. HP, it could be said, became a victim of some of the statements made by one of its executives.

The point about mentioning the case is that supplier promises, even if made with the best of intentions, may in the end come to nothing – or worse, a costly and prolonged legal dispute. Good intentions were behind the setting up of a joint venture between IBM and Somerset County Council – Southwest One – in 2007. The two sides are now immersed in a legal dispute that looks like going to court. Other councils have gone into joint ventures with major IT suppliers only to be disappointed.

So why do councils still want to sign mega outsourcing deals?

Councils keen to enter a large outsourcing deal become convinced that failures of such ventures elsewhere do not apply to them because their plans are unique. Indeed Cornwall council says on its website:

“Our strategic partnership is unlike any that has happened before, and as such, we cannot compare our programme accurately to others.”

But how do potential suppliers explain failing contracts?

In talks with potential customers IT companies correct or clarify reports in the media about outsourcing deals that have failed or are failing. It is customary during the bidding process for salespeople to take potential clients to reference sites where the representatives will agree that the media reports of a failing partnership were inaccurate or hyperbolic.

[Councils that have signed failing outsourcing deals will sometimes be reluctant to publicise the fact – and may put on a brave face in which they align themselves with the supplier; until a council changes hands, as at Somerset County Council, when a new administration is happy to publicise the mistakes of the last, and the full extent of the problems begins to emerge publicly.]

Cornwall council says on its website that it has received responses from its two shortlisted suppliers BT and CSC to specific negative press articles. The Council is now untroubled by any of the articles.

Says Cornwall

 “The feedback we received from the references contacted were balanced and gave us no significant causes for concern… We do need to reflect that these are press stories and we know only too well from our own experience that you can find negative reports on most major companies if you look for them.

“As global companies, it is to be expected that you will find a whole range of perspectives on each; it is important we take a balanced and independent view.  Please be assured that we will continue to work with both companies to deal with any issues that may arise throughout the procurement process and beyond…”

Articles BT and CSC were not asked to respond to included one in the Financial Times which said of NHS IT contracts:

“There are big doubts as to whether the government can fire BT and CSC, its two main suppliers, without paying huge sums in compensation.”

Cornwall says it continues to monitor press coverage, with the help of BT and CSC. It suggests that articles not yet written may be biased.

“… We actively monitor the press, and both companies [BT and CSC] make sure that they let us know if a negative or positive story is going to break, making sure that we understand the background. It is important to note that these articles do not always present an unbiased view,” says Cornwall.

Does setting up a “critical friend” group give a false assurance?

On the face of it Cornwall deserves praise for setting up an independent panel of “critical friends” to scrutinise the council’s outsourcing plans. It is called the “Support Services Single Issue Panel” which comprises mostly Cornwall councillors. It had help from, among others, council officers, and BT and CSC. The Panel also visited some customers of BT and CSC that the suppliers chose.

But when the Panel later expressed serious concerns about Cornwall’s outsourcing plans the council’s inner circle simply replied that it did not accept those concerns. This may strike some as a naive response to real risks.

This was part of the council’s response to the Panel:

“We do not accept the magnitude of some of the risks raised in the SIP [Single Issue Panel]. This includes the risk of service delivery failure and the risk of losing senior officers to the partner. Nor do we think there is a significant conflict between profitable trading and a public service commitment. We do not think our timescales are risking service delivery but will advocate delaying those timescales if this is judged necessary to protect the Council’s interests and/or to achieve greater contractual benefit…”

Is there a danger the council will use the setting up of the critical friend group to say that it has considered all the risks – even if it has considered then dismissed the most serious of them?

A poor supplier would be in breach of contract – but then what?

To the Panel’s concerns that the joint venture may fail to deliver, or costs escalate, Cornwall responds that if its suppliers do not deliver they will be in breach of contract.

But then what?

Said the council:

“The contract obliges the strategic partner to deliver. Any initial failure to deliver would be dealt with through a service credit arrangement. Persistent failures would represent a breach of contractual conditions which would lead to breach of contract where the Cornwall Partners would exit the contract.

“The cost for this would be picked up by the strategic partner. Financial difficulty is covered by a guarantee that the parent company would step in and continue delivery. Costs are largely within our control…”

Is it straightforward to exit a contract after an alleged breach of contract? The Department of Health was in dispute with CSC over alleged breaches of contract on the National Programme for IT, NPfIT. CSC made it clear in its statements to US regulators that the DH was unable to exit the NPfIT contracts without large payments. CSC and the Department ended up accusing each other of breaches of contract which made negotiations for a settlement long and costly.

Heading for claims of maladministration?

Is Cornwall being naive when it says simply that after any breach of contract the council “would exit the contract”? In the past this has been the legal cycle of events in some major legal disputes on IT contracts

– Customer alleges breach of contract

– Supplier makes counter-claim

– Customer withholds money

– Supplier instigates legal action

– Customer wishes to exit contract but cannot because of potential costs, counter-claims and need for supplier’s cooperation to maintain existing services.

– Long and costly settlement negotiations – which is good for lawyers – while service delivery remains in the “hold” position, unresponsive to changes that may need to be made or remedial action that may need to be taken.

International IT companies are experts in the legal side of contracts and dealing with disputes. Do Cornwall’s ruling councillors believe that the council’s expertise and legal advice would trump the supplier’s in the event of an alleged breach of contract?

When Cornwall says that in a breach of contract it would exit the contract and “the cost for this would be picked up by the strategic partner”, do the council’s ruling councillors trust that the supplier would say to the council in any dispute, “Let us know your costs of exiting the contract and we’ll settle up.”

There is another worrying sign of Cornwall’s apparent naivety. The council says “The costs would only escalate if the Cornwall Partners make changes to the services required.”

Unforeseen change is endemic in the public sector: governments change, policies change, legislation changes, organisations change, particularly the NHS which is a potential party to Cornwall’s outsourcing plans.

Is any public authority that signs up to a large and complex outsourcing deal on the basis of ‘no unforeseen change’ leaving itself open to accusations of maladministration?

Has Cornwall’s democratic process broken down?

The most extraordinary single thing about Cornwall’s outsourcing plans is that, at a full council meeting on 4 September, a majority of councillors voted against a deal but the inner circle is going ahead anyway.

Says the council’s website: “A motion calling on Cornwall Council to change its decision to enter into a partnership with the private sector to deliver a range of support services was supported by a majority of 17 Members following a three hour debate at County Hall on 04 September.”

[The motion was put and seconded by two councillors, Andrew Wallis and Andrew Long, who are not members of the major political parties.]

In dismissing the vote of the council, a spokesman for Cornwall’s pro-outsourcing group said

“All the concerns which have been raised today have already been considered by the Cabinet… This is a very complex proposal and unfortunately the decision by Members not to move into private session meant that we were unable to share the detailed confidential information they needed to make an informed decision”.

Should the Council rush to sign a deal?

Somerset County Council’s joint venture was characterised by a rush to sign, which culminated in the signing at 2am at the weekend. The failed NHS IT plan was also notable among potential suppliers for the haste before the signing of contracts, as was the failed Firecontrol contract. Is Cornwall’s deal being rushed? Cornwall’s Support Services Single Issue Panel said

“The timetable restrictions placed on the SIP [Single Issue Panel] has condensed the available time such that this report has had to be compiled within one working day. Had the timetable slipped by just that one day it is certain that no report would have been submitted.”

The Panel also said

“The risk is that this timescale is far too short for detailed evaluation and due diligence to be carried out. This is a significant value contract. The estimated value of the contract in the Prospectus for Cornwall …was £210m to £800m. The current estimated value is not known to the Panel…”

The council’s inner circle concedes that its timescales are “tight but achievable”.

Conclusion

When outsourcing plans have taken up much time and money there is always a danger a contract will have to be signed to justify the effort.  But would the signing of a mega deal at Cornwall be a triumph of ideology over objective reasoning?

One has to wonder how a mega outsourcing deal can improve services, provide a good profit margin for an international IT company, save the council money and create hundreds of jobs. Doesn’t something have to give? Is there so much inefficiency, and so much money floating around the council and its potential NHS partners, that a major supplier can cut tens of millions of pounds, spend to transform services, and make money?

In evidence to MPs last year SOCITM, which represents ICT professionals in councils, said of outsourcing ICT that it “carries many risks for local authorities and can come at a heavy price”.

Some praise for Cornwall’s approach

Cornwall’s ruling councillors should be applauded for two things:

– There is every sign that the inner circle’s plans are motivated are by the best of intentions: to save money, improve services, protect existing jobs and create more.

– Although some criticise the council’s lack of openness, the inner circle is not hiding all of its papers and discussions in a blanket of secrecy. It has published the report of the “critical friend” Panel and the council’s responses. There is much information – and links – on the planned deal on the council’s website. This doesn’t always happen in the run-up to a large public sector outsourcing contract.

But good intentions do not make up for naivety and a wish for outsourcing that may border on fanaticism – the pursuit of a Cause whatever the dangers.

If a majority of councillors at a full council meeting cannot stop the signing of a mega-deal can anyone?

It appears that a tiny group within the council will make the final decision – although it is arguably the most momentous decision in the council’s history.

Says the council: “The final approval of, and the date for, the issuing of the said invitations to submit final tenders be determined by the Chief Executive in consultation with the Leader of the Council and the Portfolio Holders for Environment, Waste Management Policy and Shared Services, Health and Wellbeing and Human Resources and Corporate Resources.”

The final decision is due next month. If Cornwall enters a deal in which it relies on the contract to protect services and the council’s reputation is it being naive? Could it end up facing accusations of maladministration, particularly after side-lining a council vote against the deal?

**

Thank you to Dave Orr and a journalist in Cornwall for your emails on Cornwall’s outsourcing plans.

Council says its joint venture is failing – BBC

Some papers on Cornwall’s outsourcing plans

Local MP’s website on Southwest One.

An ill-judged outsourcing?

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

By Tony Collins

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

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

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

Records incomplete

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

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

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

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

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

“Substantial concern”

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

“Systematic failings”

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

Patient safety an issue?

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

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

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

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

Eye off the ball?

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

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

**

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

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

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

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

Does NWL always trust what Imperial says?

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

**

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

“Urgent meeting”

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

Clinical harm?

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

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

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

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

**

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

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

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

Big organisational challenge

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

Imperial responds

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

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

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

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

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

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

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

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

Comment

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

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

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

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

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

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

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

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

Troubled Cerner NPfIT go-lives, so far:

Barts and The London

Royal Free Hampstead

Weston Area Health Trust

Milton Keynes Hospital NHS Trust

Worthing and Southlands

Barnet and Chase Farm Hospitals NHS Trust

Nuffield Orthopaedic

North Bristol.

St George’s Healthcare NHS Trust

University Hospitals of Morecambe Bay NHS Foundation Trust

Birmingham Women’s Foundation Trust

NHS Bury

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

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

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

GPs kept in the dark over hospital cancer blunder – Pulse

Other links:

Halt NPfIT Cerner deployments says MP Richard Bacon

Bacon calls for halt on Millennium.

Poor IT suppliers to face ban from contracts?

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.”

Why is MoD spending more on IT when its data is poor?

By Tony Collins

The Ministry of Defence and the three services have spent many hundreds of millions of pounds on logistics IT systems over the past 20 years, and new IT projects are planned.

But the National Audit Office, in a report published today – Managing the defence investory –  found that logistics data is so unreliable and limited that it has hampered its investigations into stock levels.

“During the course of our study,” says the NAO, “the Department provided data for our analyses from a number of its inventory systems. However, problems in obtaining reliable information have limited the scope of our analysis…”

The NAO does not ask the question of why the MoD is spending money on more IT while data is unreliable and there are gaps in the information collected.

But the NAO does question whether new IT will solve the MoD’s information problems.

“The Department has acknowledged the information and information systems gaps and committed significant funds to system improvements. However these will not address the risk of failure across all of the inventory systems nor resolve the information shortfall.”

MPs on the Public Accounts Committee, who will question defence staff on the NAO report, may wish to ask why the MoD’s is so apparently anxious to hand money to IT suppliers when data is poor and new technology will not plug information gaps.

Comment:

MPs on the Public Accounts Committee found in 2003 (Progress in reducing stocks) that the MoD was buying and storing stock it did not need. Indeed after two major fires at the MoD’s warehouses at Donnington in 1983 and 1988 more than half of the destroyed stock did not need replacing. Not much has changed judging by the NAO’s latest report.

It’s clear that the MoD lacks good management information. Says the NAO in today’s report:

“The summary management and financial information on inventory that is provided to senior staff within Defence Equipment and Support is not sufficient for them to challenge and hold to account the project teams…”

But will throwing money at IT suppliers make much difference? The MoD plans the:

–  Future Logistics Information Services project, which is intended to bring together and replace a number of legacy inventory management systems; and

–  Management of the Joint Deployed Inventory system which will provide the armed services with a common system for the inventory they hold and manage.

But is the  MoD using IT spending as proof of its conviction to improve the quality of data and the management of its inventory?

Managing the defence inventory

Francis Maude talks open govt – and Whitehall does the opposite

By Tony Collins

“If people do not know what you’re doing, they don’t know what you’re doing wrong.” – Sir Arnold Robinson, Cabinet Secretary in a discussion on open government in Yes Minister.

Francis Maude, the Cabinet Office minister, said all the right things at the Intellect World Class Public Services conference 2012.

He said that:

– smaller, innovative and efficient suppliers were finding themselves locked out of the supply of services to Government because of what was described by Parliament as a powerful “oligopoly” of large suppliers

– for the first time in Government “we are using agile, iterative processes, open source technology platforms and world-class in-house development teams alongside the best digital innovation the market can offer”

– “We must eliminate failure waste. At the moment, a large proportion of our service delivery costs are incurred through incomplete or failed digital transactions. And these transactions create cross-channel duplication, which burdens the user and costs Government a huge amount in repeated costs. For HMRC alone, they estimate that 35% of calls to its contact centres are avoidable, which would save £75m.”

– “Transparency is a defining passion for this Government …”

Comment:

How much influence does Maude really have? Can he persuade permanent secretaries to effect major change? The evidence so far is that departmental officials and Maude have different ideas on what reform means.

In “Yes Minister” civil servants were proud of a new hospital that was the best run and most hygienic in the country, with no medical staff, 500 administrators and no patients.

Maude may also recall that Antony Jay and Jonathan Lynn, the acclaimed writers of Yes Minister, spoke of the Whitehall law of inverse relevance – “the less you intend to do about something, the more you have to keep talking about it”.

Open government? 

Perhaps civil servants are letting Maude get on with talking the talk while they find every way to keep things much as they are. A good example: The Guardian reported yesterday that a key part of the Government’s transparency drive has stalled amid reports of ministry opposition.

The paper’s political editor Patrick Wintour reported that plans to publish regular ‘traffic-light’ progress reports on large, costly and risky IT projects “appear to have been shelved”.

When it comes to IT this could have been the coalition’s most important single reform. It would have given MPs and the public a way of knowing when mega projects such as Universal Credit are failing. Usually we don’t know about a failed IT-related project unless there is a leak to the media, or the National Audit Office finds out and decides, with its limited budget, to do a study.

Sir Bob Kerslake, who is head of the civil service,  had indicated to MP Richard Bacon that “Gateway” review reports on large and risky IT and construction projects may be published in the civil service reform plan which is expected to be released this month.

Gateway reports to go unpublished?

Now it seems that departmental civil servants  have persuaded the Sir Bob not to publish “Gateway” reports. So the secrecy over the progress or otherwise of government mega projects is set to continue.

Yes, civil servants will allow the Cabinet Office to have its way on the publication of data about, say, some government spending. But it’s becoming clear that the civil service will not allow any publication of its reports on the progress or otherwise of major projects. It has been that way since Gateway reviews were introduced in 2001.

Some senior officials – by no means all – say they want a confidential “safe space” to discuss the progress of projects. The reality is that they do not want outsiders – MPs, the media and NAO auditors – meddling in their failing schemes – schemes such as Firecontrol and e-filing at the Ministry of Justice.

Unlike Maude, senior civil servants have what Jay and Lynn call a “flexible approach to open government”. This means in practice that Whitehall will happily release data – but not project reports on which the civil servants themselves can be judged.

Activity is not achievement

Maude’s speeches will give the impression of activity. But activity is the civil service’s substitute for achievement. I quote Jay and Lynn again, in part because their depiction of Whitehall seems to have been taken as serious wisdom by those officials who think Sir Humphrey a character worth living up to.

It’s time Maude and his team got a grip on departments. Until they do, permanent secretaries and their senior officials will regard Maude as trying to get out of situations that don’t need getting out of.

Whitehall to relent on secrecy over mega projects?

The empty hospital – Yes Minister

Government’s transparency drive stalls.