Category Archives: private sector lessons for the public sector

More IT-based megaprojects derail amid claims all is well

Posted on 30/10/2013 | 2 comments

By Tony Collins

If one thing unites all failing IT-based megaprojects in the public sector it is the defensive shield of denial that suppliers and their clients hold up when confronted by bad news.

It has happened in the US and UK this week. On the Universal Credit  project, the minister in charge of the scheme, Lord Freud, accepted none of the criticisms in a National Audit Office report “Universal Credit: early progress”.   In a debate in the House of Lords Lord Freud quoted from two tiny parts of the NAO report that could be interpreted as positive comments.

“Spending so far is a small proportion of the total budget … and it is still entirely feasible that [universal credit] goes on to achieve considerable benefits for society,” said Lord Freud, quoting the NAO report.

But he mentioned none of the criticisms in the 55-page NAO report which concluded:

“At this early stage of the Universal Credit programme the Department has not achieved value for money. The Department has delayed rolling out Universal Credit to claimants, has had weak control of the programme, and has been unable to assess the value of the systems it spent over £300 million to develop.

“These problems represent a significant setback to Universal Credit and raise wider concerns about the Department’s ability to deal with weak programme management, over-optimistic timescales, and a lack of openness about progress.”

And a shield of denial went up in the US this week where newspapers on the east and west coast published stories on failing public sector IT-based megaprojects.  The LA [Los Angeles] Times said:

As many as 300,000 jobless affected by state software snags

“California lawmakers want to know why Deloitte’s unemployment benefits system arrived with major bugs and at almost double the cost estimate. The firm says the system is working.”

The LA Times continued:

“Problems are growing worse for the state’s Employment Development Department after a new computer system backfired, leaving some Californians without much-needed benefit cheques for weeks.”

The Department said the problems affected 80,000 claims but the LA Times obtained internal emails that showed the software glitches stopped payment to as many as 300,000 claimants.

Now lawmakers are setting up a hearing to determine what went wrong with a system that cost taxpayers $110m, almost double the original estimate.

Some blame the Department’s slow response to the problems. Others point the finger at a Deloitte Consulting.

The LA Times says that Deloitte has a “history of delivering projects over budget and with problematic results”. Deloitte also has been blamed, in part, for similar troubles with upgrades to unemployment software in Massachusetts, Pennsylvania and Florida, says the paper.

“We keep hiring the same company, and they keep having the same issues,” said Senator Anthony Cannella.  “At some point, it’s on us for hiring the same company. It’s faulty logic, and we’ve got to get better.”

In 2003 California planned to spend $58m upgrading its 30-year-old unemployment benefits system. By the time the state awarded Deloitte the contract in 2010  the cost estimate had grown by more than $30m.

The Department handed out $6.6bn to about 1 million unemployed Californians in 2012. The software was expected to ease the agency’s ability to verify who was eligible to receive benefits.

Problems began when the Department transferred old unemployment data to the new system. The software flagged claims for review — requiring state workers to manually process them.

The LA Times says that officials thought initially the workload would be manageable, but internal emails showed the agency was quickly overwhelmed. Phone lines were jammed. For weeks, the Department’s employees have been working overtime to clear the backlog.

A poor contract?

In a contract amendment signed two months ago California agreed to pay Deloitte $3.5m for five months of maintenance and operations costs. Those costs should have been anticipated in the contract said Michael Krigsman, a software consultant who is an expert on why big IT-based contracts go awry. He told the LA Times:

“It’s a striking oversight that maintenance was not anticipated at the beginning of the contract when the state was at a much stronger negotiation position.”

By the time the middle of a project is reached, the state has no choice but to stick with Deloitte to work out bugs that arise when the system goes live, he said.

System works

Loree Levy, a spokeswoman for the Department, said the system is working, processing 80% of claims on time. As for the troubles, she said, “There is a period of transition or adjustment with any large infrastructure upgrade like this one.”

Deloitte spokeswoman Courtney Flaherty said the new California system is working and that problems are not the result of a “breakdown or flaw in the software Deloitte developed”.

System not working?

While there seems to be no project disaster in the eyes of the Department and Deloitte Consulting, some of the unemployed see things differently. One wrote:

“I am a contract worker who had to fight for my unemployment benefits. I won my case and yet they still cannot pay me… It’s been more than 3 weeks since I won my appeal and as of this moment, I am owed 13 weeks of back payments. To add insult to injury, they cannot send me current weeks to certify and they refuse to even try to help me to get back into the online system.

“I blame Deloitte, but it is California that carries the heaviest burden of fault… We’re nearing November and they still haven’t fixed an issue that began over Labor Day? Nonsense!

“This is untenable for everyone affected …We are owed reparations as well as our money at this point. It’s a funny word, affected. That means families and individuals are going hungry but can’t get food stamps or welfare. It means evictions and repossessed cars. It means destroyed credit, late fees, years of turmoil and shame for people already dealing with unemployment. Shame on you California.”

Another wrote:

“ … Not communicating is NOT an answer. Unemployed individuals caught up in the nightmare were told to be patient.  Rents and other expenses were still accumulating.  But [when you] add on additional fees: late fees, restoral fees, interest fees, etc…….you get the picture.

“Dear Governor Brown,

“Please reimburse me for all additional fees I’ve had to absorb to survive this fiasco.  You are going to make me payback any overpayments, but ignore the cost to the unemployed taxpayer.  This is  appears to unfair.  Perhaps Deloitte should pay us back from their contracted funds before they receive their final payment.  I am saving all of my receipts to deduct from my 2013 tax return.

“BTW Gov Brown – I am still waiting on additional payments as of today and DMV registration for my vehicle was due on 10/20/13.  Are you going to waive the penalty for late payment? Am I the only one with this question?”

Scrutiny

California’s state Assembly has set a date of 6 November 2013 for a hearing into the Department’s system upgrade.

“We’re going to look at EDD, the contractors and others to see how the system broke down so we can avoid this in the future,” said Henry Perea, chair of the Assembly’s Insurance Committee, which has oversight over the jobless benefits program.

On its website Deloitte says:

“Deloitte continues to help EDD [Employment Development Department] transform the level of service it provides to unemployed workers and improve the quality of information collected by EDD. The next time unemployment spikes, California should be ready to meet the increased demand for services.”

Massachutsetts IT disaster?

On the opposite coast the Boston Globe reported on an entirely separate debacle (which also involved Deloitte):

          None admit fault on troubled jobless benefits system

“… even with the possibility that unemployed workers could face months more of difficulties and delays in getting benefits, officials from the Labor Department and contractor, Deloitte Consulting of New York, testified before the Senate Committee on Post Audit that the rollout of the computer system was largely a success.

“‘I am happy with the launch,’ said Joanne F. Goldstein, secretary of Labour and Workforce Development, noting that she would have liked some aspects to have gone better.

“Mark Price, a Deloitte principal in charge of the firm’s Massachusetts business, acknowledged that software has faced challenges during the rollout, but insisted, ‘We have a successful working system today. ‘’’

NPfIT shield

A shield of denial was up for years at the Department of Health whose CIOs and other spokespeople repeatedly claimed that the NPfIT was a success.

Comment

If you didn’t know that Universal Credit IT wasn’t working, or that thousands of people on the east and west coasts of the US hadn’t been paid unemployment benefits because of IT-related problems, and you had to rely on only the public comments of the IT suppliers and government spokespeople, you would have every reason to believe that Universal Credit and the jobless systems in Massachusetts and California were working well.

Why is it that after every failed IT-based megaproject those in charge can simply blow the truth gently away like soap bubbles?

When confronted by bad news, suppliers and their customers tend to join hands behind their defensive shields. On the other side are politicians, members of the public affected by the megaprojects and the press who have all, according to suppliers and officials, got it wrong.

Is this why lessons from public sector IT-based project disasters are not always learned? Because, in the eyes of suppliers and their clients, the disasters don’t really exist?

None admit fault on troubled jobless benefit system

State fired Deloitte

Complaints continue despite claims system is under control

As many as 300,000 affected by California’s software problems

California’s predictable fiasco?

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Posted in Campaign4Change, change management, CIO, consultants, contractors, culture, Deloitte, ERP, Government IT, IT projects, IT-related failures, managing outsourced services, npfit, openness and transparency, operational issues, outsourcing, oversight, private sector lessons for the public sector, public sector, public-private partnerships, supplier relationships, Universal Credit

Who polices police IT reports?

Posted on 24/10/2013 | 5 comments

By Tony Collins

The police, and civil and public servants in central government, the NHS and local authorities criticise journalists for biased reporting – taking selected facts out of context.

They’re sometimes right.  Journalists working for national newspapers can draft an article that is diligently balanced only to find, by the time it’s published, it leaves out facts which would have complicated, blunted, or contradicted the main points.

It’s one thing for this to happen in the world of journalism. You don’t expect public bodies to report on their own affairs with a partiality that rivals out-of-context reporting by some newspapers.

But it appears to be happening so regularly that one-sided self-reporting on organisational performance may be becoming the norm in the public sector.

In the NHS subjective, positive reporting in board papers – where managers tell directors what they think they want to hear – could help to explain why Cerner patient record implementations have, for years, gone badly wrong for the same reasons.

In recent months reports without balance have been published on the performance of Avon and Somerset Police’s IT outsourcing contract with IBM. 

Somerset County Council, Taunton Deane Borough Council and Avon and Somerset Police  are minority shareholders in a private company, Southwest One,  which is owned by IBM.

Confusingly, Taunton Deane Borough Council issued positive reports about its successful partnership with Southwest One – and then it decided to take some services back in-house.

Now it has emerged – only as a result of FOI requests by Somerset resident and campaigner Dave Orr – that two independent organisations, the National Audit Office, and HM Inspectorate of Constabulary, have commented positively on Avon and Somerset Constabulary’s partnership with Southwest One, based entirely on the unaudited opinions of the police force itself.

SAP

From his FOI requests Orr learned that the Avon and Somerset’s outsourcing deal with Southwest One has not gone entirely as expected. The National Audit Office’s FOI team has released notes of a joint visit by the NAO and HM Inspectorate of Constabulary to Avon and Somerset police in December 2012.  The visit was to find out about how well Southwest One was delivering services to the police force.  

The NAO’s notes are positive in parts. They say that performance has improved considerably since the implementation of the contract.

“Implementation of SAP improving the accounts close-down process, initial issues being resolved and a good quality of service being provided regularly.”

But there is another side to the story that is not reflected in the published accounts of Avon and Somerset’s relationship with Southwest One. The NAO’s [unpublished] field notes say:

“Fewer than expected benefits have been realised from IT due to the considerably different security requirements of the Police compared to the Councils.

“It also took a long time for SAP to be implemented. There has yet to be a duty management system implemented by SWOne which is part of the contract… SAP would have benefited from some pre-launch testing or piloting.”

A letter to Orr from the Home Office appears to confirm that Avon and Somerset Police’s participation in Southwest One is an unequivocal success.

“The private sector can help to deliver police support services better and at lower cost. Every pound saved means more money for the front line, putting officers on the streets…

“In its report “Policing in Austerity: rising to the challenge [2013] Her Majesty’s Inspectorate of Constabulary identified the Southwest One partnership as being a key element in achieving savings for Avon and Somerset Constabulary while ensuring better procurement, streamlining business support processes, and ensuring better use of police officer time.

“The report also noted that the Southwest One collaboration was the first of its kind for policing in England and Wales and that to date, no other force has delivered this level of partnership with local authorities.”

A little of the other side of the story comes in the last sentence of the Home Office letter to Orr which says: “We understand that Avon and Somerset Constabulary continues to work closely with IBM to resolve any technical difficulties and improve the services provided by Southwest One.”

Indeed a table on page 155 of HMIC ‘s 2013 report Policing in austerity: rising to the challenge indicates that Avon and Somerset Constabulary has one of the worst records of any police force when it comes to savings delivered between 2010/11 and 2012/13. [Table: Key indicators of the challenge – quartile analysis.]

Southwest One began a 10-year contract providing services to Avon and Somerset Police in 2008. The services included enquiry offices, district HR, estates, financial services, site administration, facilities, corporate human resources, information services, purchasing and supply, and reprographics. The contract involves 554 seconded staff.

Comment

Police forces, councils, the NHS and central government departments need  a few Richard Feymans to report on their organisation’s performance. Feynman was a gifted scientist, MIT graduate and noble prize winner who was chosen as a commissioner to report on the cause , or causes, of the Challenger Space Shuttle “O” rings accident on 28 January 1986.

He reported with such independence of mind and diligence that his hard-hitting findings were not considered acceptable to be included in the main report of the Presidential Commission of inquiry into the accident.  Feynman had to be content with having his findings published as an appendix to the Commission’s report – and an edited appendix at that.  

He suggested in his book “What do you care what other people think?” that his appendix was the only genuinely balanced part of the official inquiry report. 

“For a successful technology, reality must take precedence over public relations, for Nature cannot be fooled,” said Feynman.

One of his questions was whether “organisation weaknesses that contributed to the [Shuttle] accident [was] confined to the solid rocket booster sector, or were they a more general characteristic of NASA.”

One of Feynman’s conclusions:

“It would appear that, for whatever purpose – be it for internal or external consumption – the management of NASA exaggerates the reliability of its product to the point of fantasy.”

If such exaggeration happens at NASA it can happen in UK police force IT reports, and in board papers on the performance of councils and NHS trusts.

When journalists get it wrong it’s usually to their eternal regret. In the public sector positive unbalanced reporting is so “normal” that hardly anyone involved realises it’s a deviant practice. The US author Diane Vaughan coined a phrase for such corporate behaviour.  She called it the normalisation of deviance.  

It’s surely time for public bodies to move away from the norm and start reporting on their performance, and the performance of their outsourcing other private sector contracts, with balance, objectivity and independence of mind.   

If managers knew that reports on the progress of their contracts would be audited for impartiality and competence over organisational self-interest, perhaps they would have a greater incentive to avoid badly thought through outsourcing deals and IT implementations.

Is this why some council and NHS scandals stay hidden for years?

NAO report “Private sector partnering in the police service”

Dave Orr’s HMIC FOI requests and answers

NAO’s FOI responses on Avon and Somerset Police

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Posted in Campaign4Change, Government IT, IT-related failures, local government, NHS, openness and transparency, operational issues, outsourcing, oversight, private sector lessons for the public sector, project management, public sector, public services, public-private partnerships, SAP, supplier relationships

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A reason many govt IT-enabled projects fail?

Posted on 11/09/2013 | 6 comments

By Tony Collins

Last week’s highly critical National Audit Office report on Universal Credit was well publicised but a table in the last section that showed how the Department for Work and Pensions had, in essence, passed control of its cheque-book to its IT suppliers, was little noticed.

The NAO  in 2009 reported that the Home Office had handed over £161m to IT suppliers without knowing where the money had gone.

Now something similar has happened again, on a much bigger scale, with Universal Credit. The National Audit Office said last week that the Department for Work and Pensions has handed over £303m to IT suppliers. The NAO found that the DWP was unclear on what the £303m was providing. Said the NAO

“The Department does not yet know to what extent its new IT systems will support national roll-out … The Department will have to scale back its original delivery ambition and is reassessing what it must do to roll-out Universal Credit to claimants.”

After paying £303m, the “current programme team is developing new plans for Universal Credit,” said the NAO.

Surprising?

More surprising, perhaps, are the findings by PWC on its investigations into the financial management of Universal Credit IT. I and others in the media little noticed the summary of PWC’s work when I first read the NAO report.

PWC’s findings in the NAO’s report are in figure 15 on page 36. The table summarises PWC’s work on Linking outcomes to supplier payments and financial management. This is some of what the NAO says

– Insufficient challenge of supplier-driven changes in costs and forecasts because the programme team did not fully understand the assumptions driving changes.

– Inadequate controls over what would be supplied, when and at what cost because deliverables were not always defined before contracts were signed.

– Over-reliance on performance information that was provided by suppliers without Department validation.

– The Department did not enforce all the key terms and conditions of its standard contract management framework, inhibiting its ability to hold suppliers to account.

– Insufficient review of contractor performance before making payments – on average six project leads were given three days to check 1,500 individual timesheets, with payments only stopped if a challenge was raised.

– 94% of spending was approved by just four people but there is limited evidence that this was reviewed and challenged.

– Inadequate internal challenge of purchase decisions; ministers had insufficient information to assess the value for money of contracts before approving them.

– the presentation of financial management information risked being misleading and reducing accountability.

– Limited IT capability and ‘intelligent client’ function leading to a risk of supplier self-review.

– Charges were on the basis of time and materials, leaving the majority of risks with the Department.

Comment

How can civil servants knowingly, or through pressure of other work, effectively give their suppliers responsibility for the sums they are paid? This is a little like asking a builder to provide and install a platinum-lined roof, then giving it the authority to submit invoices up to the value of its needs, which you pay with little or no validation.

On BBC Newsnight this week, Michael Grade, a past chairman of the BBC Board of Governors, told Jeremy Paxman about the Corporation’s corporate culture. 

“I think the BBC suffers more and more from a lack of understanding of the value of money. A cheque comes in every April – for £3.5bn – and if you don’t have to earn the money, and you have that quantity of money, it is very hard to keep to keep a grip on the reality of the value of money.

“If you run a business, if you own a business, you switch the lights out at 6 O’Clock. Everybody’s gone. You walk around yourself. You own the business. It’s your money. You have earned it the hard way. The culture of the BBC of late has been, definitely, a loss of the sense of the value of money.”

Does this help to explain why so many government IT-enabled change programmes fail to meet expectations? One can talk about poor and changing specifications, over-ambitious timescales, poor leadership and inadequate accountability as reasons that contribute to failures of public sector IT-enabled change programmes.

But, at bottom, is there simply too much public money available and too few people supervising payments to suppliers? Is it asking too much of senior civil servants and ministers to treat public money as their own? Is there a lack of the reality of the true value of money, as Michael Grade says when he refers to the BBC?

It is perhaps inconceivable that any private company would spend £303m and not be sure exactly what it is getting for the money.

It may also be inconceivable that a private company would accept supplier-driven changes in costs and forecasts without fully understanding the assumptions driving those changes.

And would a private company not control what is to be supplied, when it is to be delivered and at what cost? Would it not define what is to be delivered before contracts are signed?

Would a private company not check properly whether submitted invoices are fully justified before making payments?

Perhaps central government is congenitally ill-suited to huge IT-based projects and programmes and should avoid them – unless ministers and their officials are prepared to accept the likelihood of delays of many years and costs that are many times the amounts in the early business cases. They would also need to accept that success, even then, is not guaranteed, as we know from the NPfIT.

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Posted in Agile, Campaign4Change, change management, DWP, Government IT, IT-related failures, managing outsourced services, npfit, outsourcing, private sector lessons for the public sector, procurement, project management, public sector, public services, PWC, supplier relationships, Universal Credit

BT gets termination notice on £300m outsourcing contract

Posted on 22/07/2013 | 4 comments

By Tony Collins

Sandwell Council has issued BT with a 30-day termination notice on a 15-year £300m outsourcing contract that has yet to reach its half-way point.

The metropolitan borough council says there are various defaults BT needs to resolve. Based at Oldbury, West Midlands, about five miles from Birmingham, Sandwell has been an outsourcing reference site for BT.

The company quoted Sandwell Council in its presentations that formed part of the bidding for Cornwall Council’s planned outsourcing work.

The “guaranteed” savings in Sandwell’s contract with BT appear to be based on a level of spending the council is not maintaining. One point of contention appears to be the council’s wish for BT to reduce its charges to the council in line with the authority’s lower levels of activity.

In June 2012 Sandwell submitted a change request that asked BT to recalculate the annual service charge because the service volumes delivered through the contract had reduced significantly.

The council wanted the recalculation to be based on a reduction in the workforce from around 7,400 in 2007 when the contract with BT was signed to 4,688 in mid 2012.

Government Computing quotes a council document on the dispute as saying

“A reduction in the workforce should have a corresponding reduction in volumes such as the size of the ICT estate, the payroll, HR support and budget holders. There have been volume reductions in invoices, the number of contracts administered and calls to the contact centre for some services.”

Sandwell’s 30-day termination notice to BT was issued on 16 July so it will expire around that time next month. The council says it is prepared to take back staff.

Sandwell council leader, Councillor Darren Cooper, told Government Computing: “Cabinet has approved a recommendation to start the process of ending our contract with BT. That termination will take effect in 30 days’ time unless BT puts right various defaults we have asked them to resolve.

“If we have to, I am confident we will be able to bring the services BT currently supplies to us back to the council and run them in the most effective way in future.”

Guaranteed

In 2007 BT and its joint bidder, outsourcing provider Liberata, had set out to run the council’s back-office functions at what was announced as a “guaranteed” reduced cost over the lifetime of the contract.

The deal was aimed at cutting costs and improving Sandwell’s IT infrastructure, HR, finance, payroll and customer services functions.

There was some success. The BT-led ‘Transform Sandwell’ team won the UK’s Best Customer Services Management Team at the National Customer Services Awards in December 2010.

BT built a 75,000 square foot office block for Transform Sandwell. It accommodated 400 employees of Transform Sandwell and a 300-strong customer service team working for BT.

Massive mistake?

Independent socialist councillor Mick Davies said “Someone somewhere has obviously made a massive mistake and the taxpayers of Sandwell will have to foot the bill… The writing seemed to be on the wall when BT’s partner in the project, Liberata, was dumped unceremoniously a couple of years ago.”

Sandwell Council’s deputy leader and cabinet member for strategic resources Councillor Steve Eling said: “In view of the current climate and public expenditure reductions, the council is engaging with its partner to determine services that are needed over the medium term and to reduce the overall costs in light of public spending reductions.”

Technologies used in the Transform Sandwell contact centre have included Verint Impact 360, Siebel CRM and Nortel Contact Centre 6.0.

A BT spokesman told the Halesowen News

“BT continually looks at ways to improve the service it provides to its customers. The original contract was signed in 2007 and as is normal with long-term partnerships BT constantly looks at ways to service the changing needs of both the council and citizens of Sandwell.”

BT told Government Computing it “has throughout – and remains – fully committed to delivering the commitments it made through the Transform Sandwell Partnership.”

The European Services Strategy Unit which has carried out detailed research on outsourcing contracts lists some of the terminated and reduced local authority strategic partnership contracts.

Sandwell has 72 councillors, 67 of which represent Labour.

Comment

At some point in a 10 or 15-year outsourcing contract a major dispute seems almost inevitable because a supplier’s business objectives will rarely change when the council’s priorities change.

BT’s deal with Sandwell was signed in 2007 – as was Southwest One’s deal with IBM – at a pre-austerity period.

Now that councils have been making, and continue to make, radical savings, they want the flexibility to cut their outsourcing costs too. But it may not be in the supplier’s interests to take profits that are much lower than expected.

No such thing as a free lunch

How can the business interests of outsourcing providers and their council clients ever completely align and move in time like synchronised swimmers?

The growing number of disputes in local authority outsourcing deals suggests that councils are not properly weighing up the risks when they sign deals.

Perhaps small groups of ruling councillors – such as those at Barnet – are too easily persuaded by the “guaranteed” savings on offer at the start of a contract.

There is no such thing as a free lunch. But try telling that to council Cabinet councillors who have cartoon-character pound signs in their eyes in the Disney period before a big outsourcing contract is well underway.

Let’s hope BT and Sandwell kiss and make up. It looks like the lawyers are already in the middle of them, though; and at whose expense?

Sandwell and BT consider end of strategic partnership – Government Computing

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Posted in BT, change management, efficiency savings, ERP, IT projects, IT-related failures, law, legal disputes, local government, managing outsourced services, outsourcing, private sector lessons for the public sector, public sector, public services, public-private partnerships, risk, shared services, supplier relationships

The story of Southwest One

Posted on 16/07/2013 | 2 comments

By Tony Collins

Dave Orr worked in a variety of IT and project management roles for Somerset County Council and retired in 2010. For years he has campaigned with extraordinary tenacity to bring to the surface the truth over an unusual joint venture between IBM, Somerset County Council, a local borough council and the local police force.

Now he has written an account of the joint venture and the lessons. It is published on the website of procurement expert Peter Smith.

Orr questions whether Southwest One was ever a good idea, since it was formed in 2007.

The deal has not made the savings intended, a SAP implementation went awry, the contract has been mired in political controversy and criticism, Southwest One has repeatedly lost money, and many of the transferred staff and services have returned to the county council, and some services returned to the borough council. IBM and the county council have ended up in a legal dispute that cost the county council £5.5m to settle. Southwest One was not exactly the partnership it set out to be.

The contract may show how an outsourcing deal that doesn’t have the support of the staff being transferred is flawed fundamentally from the start (which is one reason few people will be surprised if a 10-year £320m deal for Capita to run Barnet Council’s new customer service organisation [NSCSO]  ends in tears).

These are some of Orr’s points:

–  Like other light-touch regulators, the Audit Commission repeatedly gave Southwest One positive reports, without ever qualifying the accounts, even as problems with SAP implementation mounted in 2009 and procurement savings were not being made in line with forecasts.

 – The contract called for transformation based upon ‘world-class technologies’, yet all of the IT Service was placed into Southwest One with no IT expertise back in the Somerset County client (until after a poor SAP implementation in 2009). Was the lack of retained IT skills in the Somerset County client behind the formal acceptance of a badly configured SAP implementation?

– Large scale outsourcing over a long contract of 10 years or more requires an ability to foresee the future that is simply not possible to capture in a fixed contract. In a 10-year contract, there will be three changes of national government and three changes of local government. That is a great deal of unpredictable change to cope with via a fixed, long-term contract.

– Local Government will always be at a disadvantage in resources and skills, to a large multi-national contractor like IBM, when it comes to negotiating, letting and managing a complex multi-service contract.

– What was the culture of Southwest One (75% owned by IBM)? Was it private, public or a hybrid? The management culture remained firmly IBM, yet the councils and police workforces were seconded and remained equally firmly public sector rooted. There is such a thing as a public service ethos. In fact, Southwest One was run like a mini-IBM based upon global divisions, complete with IBM standard structures and processes. Southwest One seconded employees were not allowed anything like a full access to IBM internal systems, thus creating additional complexity, as “real” IBM employees relied entirely upon on-line systems.

–  Mixed teams in a single shared service were hard to amalgamate. This meant the IBM managers of Southwest One never really gained the sort of command & control of the multi-tier workforces that their bonus-oriented model needs to function. “I doubt that IBM would ever again contemplate the seconded staff model over the TUPE transfer model,” says Orr.

– Somerset County Council ran with a “thin” client management team that, in Orr’s view, did not have sufficient expertise or enough staff resources to effectively manage this complex contract with IBM. The councils relied upon definitions of “partnership” that meant one thing to the councils’ side and quite another thing to IBM, says Orr.

– In Southwest One, Somerset County Council handed their entire IT Service over lock, stock and barrel. “Can you really consider IT as wholly a ‘back office’ service? Many successful private Companies see IT as a strategic service to be kept under their own control.”

– The real savings might have been found in optimising processes in big departments (like Social Care, Education, Highways) that lay outside of Southwest One’s reach. “The focus on IT rather than service processes was another flaw in the model.”

Orr  concludes that nobody who played a major part in the Southwest deal has in any way been held to account for what has gone wrong.

Southwest One – the complete story from Dave Orr

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Posted in Campaign4Change, change management, excessive secrecy, FOI, Freedom of Information, governance, IBM, IT-related failures, legal disputes, local government, managing change, managing outsourced services, openness and transparency, Politics, private sector lessons for the public sector, procurement, project management, public-private partnerships, SAP, shared services, supplier relationships

Whitehall to lose its best troubleshooter

Posted on 05/07/2013 | Leave a comment

By Tony Collins

David Pitchford, who is arguably the civil service’s most able troubleshooter, is to quit the civil service in September and return to his native Australia for undisclosed family reasons. The FT broke the story yesterday.

Pitchford is Executive Director at the understaffed Major Projects Authority. It aims to work in partnership with permanent secretaries and senior civil servants to improve the success rate of major departmental IT and other large projects. 

In practice some senior civil servants in central departments resent the intrusion of the Cabinet Office. They do not like having to present their big schemes to the Major Projects Authority, particularly as it has David Cameron’s mandate to stop or re-scope failing projects.

Fighting intransigence? 

One unanswered question about Pitchford’s quitting is: has his morale been beaten down by departmental intransigence and even ill-will? Has the system defeated Pitchford and the taxpayer – the same system that confronted other Cabinet Office reformers John Suffolk, Chris Chant and Andy Tait?

It is possible that Pitchford feels his work is done now that the Major Projects Authority has finally, and after some departmental resistance, produced its first annual report.

The report’s key feature is its “traffic light” status on the projects it is keeping an eye on. In a foreword to the report, Pitchford wrote:

“April 2013 marks two years of the Major Projects Authority… For the first time, the country’s biggest and most high-risk projects are scrutinised so problems are exposed before they spiral out of control. Over two-thirds of major projects are predicted to deliver their promises on time and on budget, more than double the historic success rate. However, the MPA has studied carefully what goes on in every department, and we have uncovered some weaknesses which we are continuing to address.

“The MPA was established following a landmark report by the National Audit Office in 2010, which recommended a wholesale shift in the administration of major projects. It works closely with individual departments’ project teams and Permanent Secretaries to monitor and improve the management of major projects…the MPA’s Government Major Projects Portfolio has improved the rate of successful project delivery from under 30% to over 70%.

“Our success has been achieved by focusing intensively on the three core elements of successful project management: improving leadership; improving the operating environment; and looking closely at the past lessons.”

Pitchford is a much-valued executive in part because he can see why projects are failing and is straight-talking. He joined the Cabinet Office in November 2009 and in 2010 told a conference what he had discovered so far about the reasons for the failure of UK government projects:

– Political pressure

– No business case

– No agreed budget

– 80% of projects launched before 1,2 & 3 have been resolved

– Sole solution approach (options not considered)

– Lack of Commercial capability – (contract / administration)

– No plan

– No timescale

– No defined benefits

Since then Pitchford has been a little more guarded now about what he says in public. Campaign4Change said in February 2013 that the longer he stays in the innately secretive civil service the more guarded he seems to become but he is still one the best assets the Cabinet Office has. His main advantage is his independence from government departments.

Francis Maude, Cabinet Office minister, said he would “much miss David’s sharp wit and impressive leadership”.

Is Pitchford’s departure a sign that the non-reformers in Whitehall departments are winning the battle against major change?

 

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Posted in Campaign4Change, capacity building, change management, cost reduction, G-Cloud, Government IT, IT projects, IT-related failures, Major Projects Authority, private sector lessons for the public sector, procurement, project management, public sector

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When Whitehall shuns statutory scrutiny

Posted on 25/06/2013 | 2 comments

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“

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Posted in Campaign4Change, change management, cost reduction, Freedom of Information, governance, government, Government IT, local democracy, local government, managing change, oversight, Politics, private sector lessons for the public sector, public sector

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Is Major Projects annual report truly ground-breaking?

Posted on 29/05/2013 | 3 comments

By Tony Collins

Francis Maude, the Cabinet Office minister, describes as “nothing short of groundbreaking” a report of the Major Projects Authority which gives the RAG (Rred/Amber/Green) status of more than 100 major projects.

That the report came out late on Friday afternoon as most journalists were preparing to go home, some of them for the whole bank holiday weekend, suggests that the document was a negotiated compromise: it would be published but in such a way as to get minimal publicity.

Indeed the report is a series of compromises. It has the RAG status of projects but not the original text that puts the status into context.

Another compromise: senior civil servants in departments have persuaded Maude to publish the RAG decisions when they are at least six months old.

This enables departmental officials to argue their case in the “narrative” section of the MPA annual report that a red or amber/red decision is out-of-date and that there has been significant improvement since. This is exactly the DWP’s justification for the amber/red status on Universal Credit.

The DWP says in the MPA report: “This rating [amber/red] dates back to September 2012, more than seven months ago. Since then, significant progress has been made in the delivery of Universal Credit. The Pathfinder was successfully launched and we are on course both to expand the Pathfinder in July 2013 and start the progressive national roll-out of Universal Credit in October.”

That the Pathfinder was launched successfully might have nothing to do with Universal Credit’s amber/red status which could be because of uncertainties over how the IT will perform at scale, given the complexities and interdependencies.  The MPA report says nothing about the uncertainties and risks of Universal Credit.

More compromises in the MPA annual report: the Cabinet Office appears to have allowed departments to hide their cost increases on projects such as HMRC’s Real-time Information [RTI] in the vague phrase “Total budgeted whole life costs (including non-government costs).”

The Cabinet Office has also allowed departments to write their own story to accompany the RAG status. So when HMRC writes its story on RTI it says that “costs have increased” but not by how much or why. We know from evidence that HMRC gave to the Public Accounts Committee that RTI costs have risen by “tens of millions of pounds”. There is nothing to indicate this in the MPA annual report.

Another compromise in the MPA annual report: there are no figures to compare the original forecast costs of a project with the projected costs now. There are only the 2012/13 figures compared with whole-life projected costs (including non-government projected spend).

And the MPA report is not comprehensive. It came out on the same day the BBC announced that it was scrapping its Digital Media Initiative which cost the public £98m. The MPA report does not mention the BBC.

The report is more helpful on the G-Cloud initiative, showing how cheap it is – about £500,000. But there is little information on the NHS National Programme for IT [NPfIT] or the Summary Care Record scheme. 

Yet the MPA annual report is ground-breaking. Since Peter Gershon, the then head of the Office of Government Commerce, introduced Gateway reviews of risky IT projects about 12 years ago with RAG decisions, they have remained unpublished, with few exceptions. The Cabinet Office is now publishing the RAG status of major departmental projects for the first time. Maude says

“A tradition of Whitehall secrecy is being overturned. And while previous Governments buried problems under the carpet, we are striving to be more open. By their very nature these works are high risk and innovative.

“They often break new ground and dwarf anything the private sector does in both scale and complexity. They will not always run to plan. Public scrutiny, however uncomfortable, will bring about improvement. Ending the lamentable record of failure to deliver these projects is our priority.”

Comment

The MPA annual report is a breath of fresh air.

Nearly every sentence, nearly every figure, represents compromise. The report reveals that the Universal Credit project was last year given an amber/red status – but it doesn’t say why. Yet the report has the DWP’s defence of the amber/red decision. So the MPA report has the departmental defences of the RAG decisions, without the prosecution evidence. That’s a civil service parody of openness and accountability: Sir Humphrey is allowed to defend himself in public without the case against him being heard.

But it’s still useful to know that Universal Credit is at amber/red.  It implies well into the project’s life that the uncertainties and risks are great. A major project at amber/red at this stage, a few months before go-live, is unlikely to turn green in the short term, if ever.

Congratulations

The Cabinet Office deserves congratulations for winning the fight for publication of the RAG status of each major project. Lord Browne, the government’s lead non-executive director and a member of the Cabinet Office’s Efficiency and Reform group, has said  that billions of pounds of taxpayers’ money is being frittered away because of “worryingly poor” management of government projects.

“Nobody ever stops or intervenes in a poor project soon enough. The temptation is always to ignore or underreport warning signs,” he says.

The management of some large projects – usually not the smaller ones – is so questionable that departments ignore advice to have one senior responsible owner per major project, says the MPA.

The MPA annual report will not stop the disasters. Its information is so limited that it will not even enable the public – armchair auditors – to hold departments to account. Senior civil servants have seen to that.

But the report’s publication is an important development: and it provides evidence of the struggle within Whitehall against openness. Francis Maude and Sir Bob Kerslake, head of the civil service, have had to fight to persuade departmental officials to allow the RAG status of projects to be published. The Guardian’s political editor Patrick Wintour says of the MPA annual report

“Publication led to fierce infighting in Whitehall as government departments disputed the listings and fought to prevent publication.”

Large-scale change

If Maude and Kerslake struggled to get this limited distance, and there is still so much left to reform, will large-scale change ever happen?

Maude and his officials have as comprehensive mandate for change from David Cameron as they could hope for. Yet still the Cabinet Office still seems to have little influence on departments. When it comes to the big decisions, Sir Humphrey and his senior officials hold onto real power. That’s largely because the departments are responsible to Parliament for their financial decisions – not the Cabinet Office.

Maude and his team have won an important battle in publishing the MPA annual report. But the war to bring about major change is still in its very early stages; and there’s a general election in 2015 that could halt Maude’s reform plans altogether.

The Major Projects Authority Annual Report.

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Posted in capacity building, change, change management, DWP, excessive secrecy, Gateway reviews, Government IT, HMRC, IT-related failures, Major Projects Authority, private sector lessons for the public sector, procurement, project management, public sector, public services, Universal Credit

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Cornwall Council rushes to sign BT outsourcing deal before elections

Posted on 08/03/2013 | 2 comments

By Tony Collins

Cornwall council logoCornwall Council was a model of local democracy in the way it challenged and then rejected a large-scale outsourcing plan. Now it has gone to the other extreme.

Amid extraordinary secrecy the Council’s cabinet is rushing through plans to sign a smaller outsourcing contract with BT – a deal that will include IT – before the May council elections.

Councillors who have been given details are not allowed to discuss them. No figures are being given on the costs to the council, or the possible savings. The Council’s cabinet is not releasing information on the risks.

Councillors are being treated like children, says ThisisCornwall. Documents with details of the BT outsourcing plans have to be handed back by councillors, and cabinet papers are being printed individually with members’ names as a watermark, on every page, to guard against copying and to help identify any whistleblowers.

The council’s Single Issue Panel has a timetable for the IT outsourcing plan.

– Recommendation to Cabinet to approve release of ITT – 27 February 2013

– Evaluation of bid – March 2013

– If contract awarded, commencement of implementation work – April 2013

– Staff transfer date – July 2013

The SIP report emphasises that the timetable for signing a deal is tight. “Evidence received is that there is little room for slippage in the timetable, but that potential award of contract is achievable by the end of March 2013… It is expected that a contract could be ready to be issued as part of the ITT [invitation to tender] pack by early in the week commencing 4 March 2013.”

The SIP report concedes that the plan is “fast moving”.

In the past, the SIP group of councillors has been open and challenging in its reports on the council’s plans with BT (and CSC before the company withdrew from negotiations). Now the SIP’s latest report is vague and unchallenging. The risks are referred to in the report as a tick-box exercise. Entire paragraphs in the SIP report appear to have little meaning.

“Risk log and programme timelines are reviewed and updated on a regular basis… 

“The Council and health partners have been working on and have reached agreement on their positions in relation to commercial aspects in the contract and their expectations have been part of the dialogue with BT.”

“Previous concerns of the Panel relating to the area of new jobs have been addressed with BT in contract discussions and contract clauses have been revised to reflect this…”

It is also unclear from the SIP report why the council is outsourcing at all, only perhaps a hint that the deal will be value for money.

“The contract will be fully evaluated by the Head of Finance and her team to ensure value for money once the final bid is received. No savings have been assumed for 2013/14 budgetary purposes, although there are assumptions of savings for the indicative figures for future years,” says the SIP report.

Comment

It is a pity that Cornwall Council’s cabinet is rushing to sign a deal for which it won’t be accountable if things go wrong. In a few weeks a new council will be voted in and, if the outsourcing deal with BT ends up in a dispute or litigation, the new council will simply blame the old, as happened when Somerset County Council’s joint venture deal with IBM, Southwest One, went into dispute.

In essence, with the local elections only two months away, Cornwall Council’s cabinet has a freedom to make whatever decision it likes with impunity; and it appears to be taking that freedom to an extreme, almost to the point of sounding, in the latest SIP report, as if the council is an arms-length marketing agent of BT.

Cornwall Council’s cabinet has a mandate from the full council to move to a contract with BT. The full council has voted to “support” a deal. But that vote was a mandate to negotiate, not to sign anything BT wants to sign.

Openness has gone out of the window and BT, it seems, is no longer being rigorously  challenged – by Cornwall’s cabinet, the full council, the public or the media.

How exactly can BT guarantee jobs and make savings? We don’t know. The Cabinet isn’t saying, and its members are doing all they can to stop councillors saying.

Are BT’s promises reliant on the fact that IT is subject to constant and sometimes costly change – often unforeseen change – and that is bound to continue, at least in the form of supporting changing legislation and reorganisations?

Unforeseen changes could add unforeseen costs which the council may have to pay because IT is at the heart of business continuity.  In any dispute with the council  – and BT knows its way around the world of contested contracts – the company would have the upper hand because of its experience with litigation and the fact that the council would need undisrupted IT at a time of change and could not afford, without risk, to take the service back in-house.

We have seen how normality broke down at Mid Staffs NHS Foundation Trust amid a lack of openness and excessive defensiveness;  and we have seen, in Somerset County Council’s joint venture with IBM, Southwest One, what can happen when a contract signing is rushed.

Cornwall Council’s cabinet is doing both. It is rushing to sign a contract; and it is rushing to sign it amid excessive secrecy.

Surely Cornwall Council can do better than slip into the shadows to sign a deal with BT before the council elections in May?  If it is such a good deal, the new council will want to sign it. A new council should have the chance to do so.

For Cornwall Council to outsource now what is arguably its single most important internal resource – IT – is bad for local democracy: it is snub to anyone who holds true the idea that local councillors are accountable to local people.

Thank you to campaigner Dave Orr who drew my attention to information that made this post possible.

* Cornwall Council, by the way, has one of the best local authority websites I have seen.  If the website is a reflection of the imagination and efficiency of its IT department, Cornwall Council should be selling its IT skills to BT for a small fortune – not giving staff away.

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Posted in BT, Campaign4Change, change management, excessive secrecy, IBM, IT-related failures, legal disputes, local democracy, local government, managing outsourced services, openness and transparency, operational issues, private sector lessons for the public sector, procurement, project management, public sector, public services, public-private partnerships

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Does a Mid Staffs culture still pervade the NHS?

Posted on 06/03/2013 | 1 comment

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.

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Posted in Campaign4Change, change, change management, culture, e-health, health records, NHS, openness and transparency, oversight, Politics, private sector lessons for the public sector