Category Archives: public sector

Worth reading on mutuals: “Are public sector spin-outs on shaky ground?”

Posted on 27/02/2012 | Leave a comment

By David Bicknell

For those contemplating setting  up public sector mutuals, the headline on a piece by Craig Dearden-Phillips in the Guardian about their legal and contractual prospects may start ringing alarm bells.

“Are public sector spin-outs on shaky ground?’ sounds a very pessimistic view in the wake of a successful action by Michael Lloyd to prevent 3000 NHS staff being transferred into Gloucestershire Care Services, a new social enterprise.

The outcome of the case, as Dearden-Phillips points out, is likely to affect the way in which the NHS and local councils approach the question of how they set up mutuals and social enterprises.

“Last week’s events in Gloucestershire were, without doubt, a setback for the mutuals agenda in the NHS and councils,” he says. “Lloyd may well rue the day he took the action he did, particularly if those NHS services end up in the hands of for-profit operators. But Gloucestershire was not a decisive reversal. What events there showed was not that spin-outs from public bodies cannot be engineered, but that those leading them need to navigate the law, and public opinion, with care.”

Links

Leigh Day & Co Solicitors’ statement

Stroud Against the Cuts statement

Stepping Out

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Posted in Campaign4Change, change management, mutualisation, mutuals, procurement, public sector, public services

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TPP stops gift offers to GPs

Posted on 27/02/2012 | 1 comment

By Tony Collins

IT supplier TPP has stopped offering gifts to GPs while it has talks with NHS Connecting for Health and CSC.

TPP has offered tea at The Ritz, theatre tickets, Marks and Spencer vouchers and chocolates to GPs in return for their hosting demonstrations of its SystmOne  product.

Parts of the NHS have clearly-defined rules on the acceptance of gifts or hospitality, though the rules do not apply to GPs. NHS Sheffield tells its staff:

“All offers of hospitality should be approached with caution. Modest hospitality, for example, a drink and sandwich during a visit or a working lunch is normal and reasonable and does not require approval of a manager. Offers of hospitality relating to theatre evenings, sporting fixtures, or holiday accommodation, or other hospitality must be declined…”

The guidance adds:

“Casual gifts by contractors or others, e.g. at Christmas time, must not be in any way connected with the performance of duties …”

On 30 January 2012 Campaign4Change reported that TPP has offered gifts to tea at The Ritz or two tickets to a West End show to GP leaders in return for helping to organise an event that would give the company a chance to demonstrate its systems.

TPP SystmOne has said in its marketing literature that its systems hold a third of the country’s patient records and have about 100,000 users.

In reply to our questions about TPP’s offers to GPs, the Department of Health said in January that TPP had ceased offering the incentives after a DH intervention.

“We were made aware and asked the supplier about this activity,” said a Department of Health spokesperson. “The supplier has subsequently confirmed that they have ceased offering incentives to GPs.”

Ten days later Pulse reported that TPP was still offering incentives to GPs. Pulse quoted TPP as saying that it had “momentarily stopped offering the incentives over Christmas but will be resuming during February”.

TPP told Pulse: ‘The incentives were offered only to GPs and practice managers and were completely optional … ‘Our ‘Tea at the Ritz’ offer actually costs considerably less than the cost of catering for such a practice meeting. We at TPP appreciate that GPs and their staff are extremely busy and so any thank-you gifts we offer staff are simply that, a thank-you for an hour or two of their time.’

Campaign4Change then questioned whether the DH is powerless to stop TPP offering gifts.

We said that a level playing field for suppliers would mean that all suppliers offered tea at the Ritz or Marks and Spencer vouchers in return for a chance to demo their systems to GPs. Alternatively suppliers could agree that none offers gifts.

Now Pulse has reported that TPP has stopped offering gifts to GP, at least while it has talks with CSC and  NHS  Connecting for Health. TPP is quoted in Pulse as saying:

Obviously TPP would not have begun offering incentives as a thank-you for a GP’s time, if we were not highly confident that we are not doing anything wrong legally or ethically. That remains our position.

However following recent communication with CSC and Connecting for Health we have postponed the sending of marketing material that offers incentives for SystmOne demonstrations, until all parties have agreed a way forward.

There may have been miscommunications in the past about what incentives were offered, when and to whom, but TPP has always been upfront about any promotional incentives that are offered. All parties are now keen to ensure we can agree on ways to advertise and promote our products whilst maintaining our high ethical standards.’

‘In the meantime we will continue to consult with GPs, their staff and any NHS guidelines, in order to gain feedback about the best ways to demonstrate SystmOne to them.

Comment:

Whether or not the talks between TPP, CSC and the Department of Health might have been prompted, in part, by recent publicity over TPP’s offering of gifts, we’re pleased the talks are taking place.

If all IT suppliers to the NHS offered gifts to GPs then some doctors could end up seeing IT demos based in part on the attractiveness of the gifts on offer.

Links:

IT company’s “tea at the Ritz” offer to GPs.

Can officials stop TPP offering gifts to GPs?

Is TPP defying assurance on gifts to GPs? – Pulse

Software firm pulls tea at the Ritz incentives for GPs – Pulse

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Posted in managing outsourced services, NHS, npfit, public sector

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Are SMEs getting more Government IT work?

Posted on 22/02/2012 | 1 comment

Good piece by Peter Smith on why the government’s major IT suppliers may continue their rule over the Whitehall IT budgets (for the time being).

Ten reasons government procurement spend on SMEs isn’t increasing.

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Posted in Campaign4Change, procurement, public sector, reducing cost strategically, SME

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Cerner system “too entrenched to be scrapped”

Posted on 22/02/2012 | 2 comments

By Tony Collins

A report by Deloitte on problematic Cerner installations at some hospitals in Australia calls for the government to appoint a chief medical information officer to oversee computer projects across the State.

The Deloitte report is a reminder that new IT in hospitals can have good – and adverse – safety implications for patients.

Obtained by the Sydney Morning Herald under Australia’s Freedom of Information Act, the Deloitte report is said to accept complaints last year that the system put patients’ health at risk by providing insufficient alerts to clinicians when messages did not reach their destination.  Deloitte found no evidence of harm to patients.

Though the Deloitte report is specific to the Cerner “FirstNet”  system as installed at some emergency departments in New South Wales, the idea of a chief medical information officer is arguably a good one for the UK where the Department of Health’s CIO (currently Katie Davis, interim Managing Director, NHS Informatics) is not responsible for the medical implications of IT go-lives in NHS hospitals.

New systems bypass the sort of regulation that helps protects the public against harm from medical devices. After hospital IT disasters there is no requirement for a genuinely independent investigation, as happens after airline crashes.

The Sydney Morning Herald [SMH] reports Deloitte as saying that the FirstNet system, which was installed to help run emergency departments across New South Wales, is chronically underfunded.

Deloitte was asked to report on the system after some hospital staff last year lost confidence in the software and returned to manual record-keeping.

Despite continuing problems and excessive time spent on data entry, the FirstNet system is too entrenched to be scrapped and the government should instead invest in bringing it up to scratch, said Deloitte.

”With some exception, FirstNet reporting is inadequate for effective governance of [emergency department] operations,” said Deloitte as reported by the SMH.

Nurses and doctors had complained that the system increased the amount of time they spent at a screen and reduced contact with patients. But the Deloitte report said more time spent on data entry ”was essential to realise the eventual benefits of an eventual [electronic medical record]”, such as greater accuracy of test results and medicine orders.

Upgrades were improving safety at some hospitals but needed to be across the state.

The government should appoint a chief medical information officer to oversee computing projects across the state, and pay for continuing development and training for FirstNet, said Deloitte.

The Health Minister, Jillian Skinner, said clinicians did not want to scrap FirstNet because they didn’t “want to start anew”.

The list of hospitals that have had serious problems after IT installations is growing, in part because the increasing use of technology in healthcare. Though hospital staff tend to learn in time to manage new systems, the unanswered question is whether patient care and treatment – and potentially their health and safety – should be damaged in an unregulated way until the problems are solved or mitigated.

Below is the UK list where it is known that the installation of new IT has caused serious disruption.  Any effect on individual patients has gone unreported:

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

**

Links:

Does Hospital IT need airline-style certification?

Hospital computer system found lacking – Sydney Morning Herald

Jon Patrick’s essay on the effectiveness and impact of Cerner’s FirstNet system in some hospitals in New South Wales.

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Posted in Cerner, health, health records, IT projects, managing change, managing outsourced services, NHS, npfit, operational issues, Politics, public sector

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CSC may cut 500 jobs after NHS write-off – end of NPfIT?

Posted on 16/02/2012 | 1 comment

By Tony Collins

CSC has confirmed in a statement to Techweekeurope that it may cut 500 jobs on its NHS account.

“We can confirm that, regrettably, we have recently started a formal 90-day consultation process in the UK which could reduce the number of people working on our NHS account by up to a maximum of 500 people,” CSC told TechWeek Europe.

“This action is necessary mainly because we have now substantially completed many key development activities with NHS, and are now moving away from a focus on development work.”

CSC told The Register that it regretted having to take put jobs at risk, but it was necessary because its NHS workload was getting smaller.

CSC has confirmed it is to write-off almost $1.5bn (£957m) as a result of its involvement in the National Programme for IT (NPfIT).

Comment:

CSC is by no means quitting the NHS. Its NPfIT contract is still in force although it remains unrevised, out of date and subject to legal discussions. CSC has large numbers of UK trusts and GP practices as customers, which will need support and upgrades. If it cuts 500 jobs this may indicate the effective end of the monolith that was the NPfIT which will continue in a much diminished, though still expensive, form, largely because of contracts between the Department of Health and BT.

It appears that the dismantling of the NPfIT has begun in earnest, thanks largely to Cabinet Office officials, its Major Projects Group, the Cabinet Office minister Francis Maude, David Cameron and the Department of Health’s Managing Director of NHS Informatics Katie Davis.

The campaign to stop a new deal being signed with CSC was led by the Conservative MP Richard Bacon, a member of the House of Commons’ Public Accounts Committee who was concerned that a new deal would not be good value for money.

It’s to be hoped that CSC will manage to find other work for the 500. The company says it hopes to achieve the job changes through voluntary redundancies and redeploying people within other parts of its business, without the need for compulsory redundancies.

Techweek europe article that includes CSC’s statement.

MP contacts No 10 and Cabinet Office over future of the NPfIT.

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Posted in Campaign4Change, IT projects, NHS, npfit, project management, public sector

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Mutuals: a novel means of driving down demand for public services?

Posted on 09/02/2012 | Leave a comment

By David Bicknell

A recent piece in the Guardian local government network has come up with the intriguing idea that mutuals can help drive down demand for public services.

The article, by Ross Griffiths, a partner at law firm Cobbetts,  suggests that if  as a service user, you are dealing with a provider that is your mutual, you are more likely to think twice about the demands you are making on it, and the effect that might have on the service and other users. It argues that this is the ‘Holy Grail’ of the mutual project – allowing providers to deliver services more cheaply not by making cuts, but by reducing demand.

The piece asks whether in today’s local government, where efficiency must be a big part of any changes to services, this is something that mutual structures can deliver. Or are they, as the article asks, ‘little more than a frivolity that should be saved for less straitened times?’

Links

http://www.guardian.co.uk/local-government-network/2011/dec/08/new-mutuals-pick-winners

http://www.number10.gov.uk/take-part/public-services/start-a-public-service-mutual/

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Posted in Campaign4Change, mutualisation, mutuals, outsourcing, private sector lessons for the public sector, public sector, public services

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Transition Institute launches mutuals ‘spin-out’ camps

Posted on 03/02/2012 | Leave a comment

By David Bicknell

The Transition Institute has come up with a good idea: spin out camps. It plans to hold three over the coming months which will feature networking sessions and practical workshops discussing business design, implementing the business plan and service innovation, all delivered by experts in the field.

The scheduled months for the camps are:

  • North West – March 2012
  • North East – May 2012
  • Midlands – July 2012

Visit the Transition Institute website for more details

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Posted in Campaign4Change, mutualisation, mutuals, public sector, public services, social economy, social enterprise

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Understanding the politics of ‘stepping out’ to create a public sector mutual

Posted on 02/02/2012 | Leave a comment

By David Bicknell

I just read an excellent piece by Craig Dearden-Philips in the Guardian today about the politics involved in the spinning out of a public sector mutual.

He argues that if you, as a public manager, want to ‘step out’, you’ve not only got to do the numbers, you’ve also got to do the politics.

He suggests that politicians, or very senior executives, need three things. Firstly, they need to know if this fits in with the general tenor of where they see things going more widely in the organisation. Secondly, they want to know that the numbers add up.

And finally, and perhaps the most interesting, “politicians and senior managers need to know that they can influence the new body. For councillors and top executives, who are used to directly managing services, a spin-out can present a big operational and financial threat. They can no longer just recover a deficit elsewhere by plundering your budget. Nor, if they are no longer in charge, can they, in the event of a bad headline, tell voters they are putting a rocket under you! Again, the answer here lies in giving them a place at the table and moving the relationship from one governed by command and control to one where influence is exercised through a contract.”

Guardian Public Services Summit

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Posted in Campaign4Change, managing change, mutualisation, mutuals, Politics, private sector, public sector, public services

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DWP civil servants get ready for MyCSP mutual leap

Posted on 01/02/2012 | Leave a comment

By David Bicknell

An article  published yesterday in the Financial Times has focused on the move of 500 civil servants to form a mutual.

The 500 staff, currently in the Department of Work and Pensions (DWP), will leave the public sector in March and become stakeholders in MyCSP, a privately held company that will handle the retirement funds of 1.5m civil servants.

The FT calls the move to create a so-called John Lewis-style mutual, “one of the biggest experiments in public sector reform.”

It writes that under the MyCSP model, profits will be shared between a private sector provider, which will hold a 42 per cent stake; the government, with 33 per cent; and employees, who will own 25 per cent of the shares. 

A shortlist of 16 private sector providers has been whittled down to four – Xafinity, Capita, JLT and Wipro – with the winner due to be announced next month.

In light of the ongoing row over executive pay, the FT points out that the chief executive’s compensation will be capped at 8 per cent above the average employee’s salary while 1 per cent of net profits will be paid to charities and a further 1 per cent used to create apprenticeships.

You can read the full FT article here (subscription required)

Stephen Kelly – the man at the coalface of the Big Society

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Posted in Campaign4Change, change management, managing change, mutualisation, mutuals, public sector, social enterprise

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BRICS countries face identity card IT project delays

Posted on 31/01/2012 | 2 comments

By David Bicknell

Two of the BRICS countries are wrestling with project management challenges as overambitious IT projects face an uncertain future.

India and Russia, which are two of the emerging so-called ‘BRICS’ – Brazil, Russia, India, China, South Africa – nations have implemented large identity card schemes which are now facing implementation hurdles.

In India, an ambitious biometric identification scheme for 1.2 billion people faces is likely to have to be redesigned if it is to survive.

The Asia Times says the Indian government has budgeted US$603 million to give a 12-digit number to each of 600 million residents by March 14, 2014, in the first two phases of the  project, dubbed “Aadhaar”, which means “foundation” or “support.”

The Asia Times says the Indian government had asked the Unique Identification Authority of India (UIDAI) project to enroll 200 million people by January 2012, in a first phase.

The UID number, which is set to prove identity, though not citizenship, would be supported by biometric devices such as facial recognition systems, eye and fingerprint scanners. However, a committee in the Indian Parliament has questioned its practicability and credibility.

The Standing Committee for Finance also challenged the legality, quality of technology and potential misuse of the UID information collected over the past two years.

The project had “no clarity of purpose,” observed the 48-page report from 53 parliamentarians, “and it is being implemented in a directionless way with a lot of confusion”.

It concluded: “In view of the afore-mentioned concerns and apprehensions about the UID scheme, particularly considering the contradictions and ambiguities within the Government on its implementation as well as implications, the Committee categorically convey their unacceptability of the National Identification Authority of India Bill, 2010 in its present form. The data already collected by the UIDAI may be transferred to the National Population Register (NPR), if the Government so chooses. The Committee would, thus, urge the Government to reconsider and review the UID scheme as also the proposals contained in the Bill in all its ramifications and bring forth a fresh legislation before Parliament.”

Meanwhile in Russia, according to the Moscow Times, a universal electronic card is facing delays, with a rollout scheduled for this month now being pushed to January of 2013.

The card – a combination of an electronic ID, driver’s licence, car insurance certificate, ATM card and migration document, among other possible functions – is the result of a project the government estimates will cost as much as 150 billion rubles to 170 billion rubles ($5.2 billion to $5.6 billion) to put in the hands of every citizen.

Limited initial use of the card was scheduled to take place this year, but the law that set up the project was amended in December to allow for a one-year delay.

The Moscow Times reported that the program will begin to function next year and that this year will be spent organising sites that will receive applications for the card. Application sites are expected to be set up at post offices, banks, and other locations.

A ministry spokesman confirmed that infrastructure for the project is just beginning to be created, and only four out of 83 regions having begun work on it.

“The delay in starting the project is related to issues around interagency cooperation and underdeveloped infrastructure in some regions,” said Yulia Kuchkina, a spokeswoman for the Universal Electronic Cards company (UEC). “Pilot cards are being issued — with employees of government agencies and ministries becoming the first users. In Moscow test cards have been received by employees of the Moscow Department of Information Technology,” she added.

Mail Online India: Setback for Planning Commission as Prime Minister bats for UID

Standing Committee for Finance Report

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Posted in BRICS, Campaign4Change, change management, Government IT, IT projects, procurement, project management, public sector

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