Category Archives: public sector

2 councils cut costs of Capita deals, bringing hundreds of staff in-house

By T0ny Collins

Councils in Birmingham and Swindon are cutting the costs of their Capita outsourcing deals, in part by bringing hundreds of staff in-house.

Labour-controlled Birmingham City Council, the largest local authority in Europe, is bringing back about 500 staff after the council negotiated with Capita to cut £20m a year from the cost of running Service Birmingham, a contract which started in 2006 and has 7 years left to run, reports the Birmingham Post.

Service Birmingham is two-thirds owned by Capita and a third by Birmingham Council.

Deputy leader Ian Ward is quoted in the Birmingham Post as saying the changes would bring major savings and a greater degree of control over council communications.

“We have negotiated an agreement with Service Birmingham which provides a major step forward in reducing our cost base for ICT. On balance, the council considers the risk of changing ICT provider at this time too risky.

“It would take a considerable period of time to procure and would cost an additional tens of millions up front in early termination charges and re-procurement costs.”

The council will bring the call centre in house by the end of the year, as part of a “One Contact” vision to resolve queries at the first point of contact.

Councillors routinely face complaints from constituents about poor service when attempting to phone the council, according to a local political blog, The Chamberlain Files.

Ward said: “It’s not just about how quickly we can answer the telephone or how polite the person answering the phone is. These things are important but we need ensure that queries are resolved to the citizen’s satisfaction.”

The blog quotes Birmingham’s leader Sir Albert Bore as saying that Capita had taken a pragmatic view and recognised the changing circumstances faced by the council.

A clause in the existing contract enabling the council to withdraw ‘at will’ from the Capita agreement within 60 days will remain. A controversial 17% mark-up on purchases has been removed.

The council hopes to gain more value from the new contract by limiting the number of projects it requires Capita to oversee and reducing the number of IT applications run by the authority. Capita was appointed originally because the council did not have the expertise to develop a modern contact centre and had invested little in new technology.

Ward said he hoped the council’s relationship with Capita, which has not always been harmonious in the past, would improve.

“What I also want to see coming out of this challenge is for both parties to work harder to make the partnership work better than it has to date. We need to make sure we have an ICT strategy that is fit for purpose and that will improve our control and planning for projects.”

The contract’s cost has reduced from about £120m a year to £80m a year, says The Chamberlain Files.

Swindon Council

Conservative-controlled Swindon Council is set to save about £2m a year by renegotiating with Capita on back-office services, says the Swindon Advertiser. It says that around 200 Capita staff will move to the council’s employment.

A contract with Capita, worth more than £240 million, was signed in 2007 and was set to last for 15 years.

Council leader David Renard is quoted as saying: “A number of years ago we entered into a 15-year contract with Capita but we obviously now live in a very different world.

“The council has to find savings every year and that means nothing is off the cards, so we have asked to sit down and have a look at the contract.

“The potential saving of £2m is very significant so it is something we have to look at. In fairness to Capita, we have asked to look at the arrangement on a number of occasions and they have been receptive.

“We want to maintain a positive relationship with them because there are things, such as revenue and benefits, which they do very well.”

A Capita spokeswoman said: “Swindon Council has undertaken a thorough review of its budget and services, including those services delivered by Capita.

“The council is considering a range of options to ensure it delivers integrated and effective services and Capita is fully engaged in that process.

“Capita’s priority is to continue delivering high quality services to the council and residents in Swindon, and to keep our employees informed throughout the process.”

Since signing the deal with Capita seven years ago many of the services can now be provided in-house, said the Swindon Advertiser. The council has become less reliant on Capita for some of its services, it says.

The deal with Swindon Council has allowed the company to win contracts with other local authorities and there are now fewer specialists to dedicate their time to Swindon, it adds.

 

 

 

Medication errors 6 months after “admin” system goes live

By Tony Collins

When Croydon Health Services NHS Trust went live with Cerner Millennium in October 2013 a spokesman told eHealth Insider:

“The new system will give everyone working at the trust better access to information and an accurate picture of what all of our services are doing. This will allow staff to make quicker, more informed decisions about the care patients need. It will improve the quality, safety and efficiency of care.”

The go-live has indeed brought some benefits. The trust says these include more efficient management of medicines, more detailed patient information being conveyed between shifts and departments, and better management of beds.

But earlier this week Campaign4Change reported on some of the problems associated with the go-live including 50,000 patients on the trust’s waiting list and a “serious incident” declared over diagnostic waits including extended waits for patients with suspected cancer.

Said the trust’s Audit Committee in March 2014 – 6 months after the go-live of the Cerner Millennium Care Records Service [CRS] :

“CRS Millennium Lessons Learned

“KB [COO and Deputy Chief Executive] outlined the context in which the implementation of CRS had taken place from the time the Business case had been approved in 2010 to the commencement of deployment in January 2011 and its subsequent implementation to date.

“She noted the 7 official “go live” dates which were reflected in the lessons learned report many of which fell during a period of organisational change.

“She noted that the deployment in CHS [Croydon Health Services NHS Trust] had been the most comprehensive deployment to take place nationally.

“It was noted that Programme Team had considered the lessons learned from other [NPfIT] Care Records Service deployments as part of the implementation programme at CHS and that there was no evidence of harm to patients despite the challenges around delivery of service.

” However significant operational challenges were experienced and a deep dive into the implementation of CRS was carried out and the findings submitted to the Finance & Performance Committee and the Trust Development Authority.

“In relation to ‘no harm to patients’ SC [Chairman] asked what empirical evidence there was to support the findings of the Deep Dive.

“KB explained from October 2013 to date there were 50,000 patients on the waiting list, but a patient validation exercise had taken place which had confirmed that no patients had come to any harm.

“The potential backlog would be cleared by the end of March but in the meantime those patients on waiting lists would be subject to a further clinical review to ensure that there was no harm.”

In fact the trust is still working through the backlogs; and long waiting times are not the only matters arising from the Cerner Millennium implementation. A medication safety report for the month of March 2004 highlights these lessons:

“The patient was prescribed Furosemide for acute pulmonary oedema on 12/03/2014. The drug was not administered and the reason not documented. On review of the incident, it was identified that there was a mis-communication between both nurses and the fact that they have started using a new computer system had caused confusion which led to the error. Once error identified the dose was given and ward sister has ensured that staff will go for further training if unsure on how to use the CRS Millennium system…

“Third incident was a failure to administer fluids (Normal Saline) in an acute kidney injury patient with an admission creatinine of greater than 700. Again there was confusion with the electronic prescribing system and the nurse thought that patient did not have a drug chart as the electronic prescribing system had gone live whereas in fact there was a paper drug chart for the fluid. The position of the venflon on the patient arm also contributed to the delay. Once error identified the fluids were given but were not running to time and patient improved. Ward sister has ensured that staff will go for further training if unsure on how to use the CRS Millennium system and staff were also briefed about poor documentation of the incident…

“Fourth incident occurred involved a patient prescribed ACS protocol for NSTEMI, Positive trop T. The aspirin 300mg, clopidogrel 300mg and fondaparinux 2.5mg were not administered and not signed for. Omission of medicines was discussed with doctor looking after the patient and the patient did not come to any harm. Omission occurred as agency staff did not know how to use CRS Millennium. On review of incident all staff were briefed on importance of patients being administered medicines on time and in particular a discussion took place between agency staff and for agency staff to have adequate CRS Millennium training. There are champion users nurses on wards who are able to train Agency staff.

NPfIT

Cerner Millennium is provided to the trust under a national contract hosted by the Department of Health and managed via a Local Service Provider (LSP) contract with BT. The contract covers trusts in London and the south of England.

The DH contract expires on 31st October 2015 after which point the DH will no longer fund any of the services currently hosted by them. This includes both the software and licencing costs for Cerner Millennium as well as the BT data storage facilities and other costs.

The DH requires all trusts with Cerner under the NPfIT to commit to an exit strategy before 31st October 2015.

Comment

Is Cerner Millennium merely an administrative system as officials at Croydon Health Services NHS Trust claim it is?  The implication is, with an administrative system, that it cannot be involved in any harm to patients. Officials at Connecting for Health when they ran the NPfIT used to describe Cerner Millennium as an administrative system.

It is the deployment of this “admin” system at Croydon that is implicated in medication errors, a waiting list of 50,000 people, and long waits for diagnostic tests for people with suspected cancer.

If Whitehall and NHS officials cannot see the system as other than administrative, this is a mistake that may help to explain why a poor service for patients, which sometimes has serious potential clinical implications,  is so commonplace, even months after go-live.

50,000 on waiting list and cancer test delays after NPfIT go-live

CEO and CIO resign after troubled EHR go-live

By Tony Collins

At the foot of the Blue Ridge Mountains, Georgia, in America’s deep south, about 70 miles from Atlanta, is Athens .

It was named at the turn of the 19th century to associate its university with Aristotle and Plato’s academy in Greece. It is home to the Athens Regional Medical Centre, one of the USA’s top hospitals.

There on 4 May 2014 the Centre went live with what it described as the most meaningful and largest scale information technology system in its 95-year history – a Cerner EHR implementation.

Now the Centre’s CEO James Thaw and CIO Gretchen Tegethoff have resigned. The Centre’s implementation of the electronic health record system seems to have been no more or less successful than at UK hospitals.

The main difference is that more than a dozen doctors complained in a letter to Thaw and Tegethoff.  A doctor leaked their letter to the local paper.

“Medication errors”

The letter said the timescales to install the Cerner EHR system were too “aggressive” and there was a “lack of readiness” among the intended users. They called the system cumbersome.

The letter referred to “medication errors … orders being lost or overlooked … (emergency department) and patients leaving after long waits”. An inpatient wasn’t seen by a physician for five days.

“The Cerner implementation has driven some physicians to drop their active staff privileges at ARMC [Athens Regional Medical Centre],” said the letter. “This has placed an additional burden on the hospitalists, who are already overwhelmed. Other physicians are directing their patients to St. Mary’s (an entirely separate local hospital) for outpatient studies, (emergency room) care, admissions and surgical procedures. … Efforts to rebuild the relationships with patients and physicians (needs) to begin immediately.”

The boldness of the letter has won praise in parts of the wider American health IT community.

It was signed by the centre’s most senior medical representatives: Carolann Eisenhart, president of the medical staff; Joseph T. Johnson, vice president of the medical staff; David M. Sailers, surgery department chair; and, Robert D. Sinyard, medicine department chair.

A doctor who provided the letter to the Athens Banner-Herald refused a request to openly discuss the issues with the computer system and asked to remain anonymous at the urging of his colleagues.

Swift action

One report said that at a meeting of medical staff 200 doctors were “solid in their vote of no confidence in the present hospital administration.”

Last week Thaw wrote in an email to staff: “From the moment our physician leadership expressed concern about the Cerner I.T. conversion process on May 15, we took swift action and significant progress has been made toward resolving the issues raised … Providing outstanding patient care is first and foremost in our minds at Athens Regional, and we have dedicated staff throughout the hospital to make sure the system is functioning as smoothly as possible through this transition.”

UK implications?

The problems at the Athens centre raise questions about whether problematic Cerner installations in the NHS should have consequences for CEOs.  Health IT specialists say that, done well, EHR implementations can improve the chances of a successful recovery. Done badly an EHR implementation can harm patients and contribute to death.

The most recent installations of Cerner in the NHS, at Imperial College Healthcare NHS Trust and Croydon Health Services NHS Trust, follow the pattern of other Cerner EHR go-lives in the NHS where there have been hints of problems but the trusts are refusing to publish a picture of how patients are being affected.

What has gone wrong at Athens Regional?

IT staff, replying to the Banner-Herald’s article, have given informed views on what has gone wrong. It appears that the Athens Regional laid off about a third of the IT staff in February 2014, about three months before go-live.

Past project disasters have shown that organisations often need more, not fewer, IT staff, advisers and helpers, at the time of a major go-live.

A further problem is that there appears to have been little understanding or support among doctors for the changes they would need to make in their business practices to accommodate the new system.  Had the organisation done enough to persuade doctors and nurses of the benefits to them of changing their ways of working?

If clinicians do not support the need for change, they may focus unduly on what is wrong with the new system. An organisation that is inherently secretive and resentful of constructive criticism will further alienate doctors and nurses.

Doctors who fully support an EHR implementation may find ways around problems, without complaining.

One comment on the Banner-Herald website says:

“While I have moved on from Athens Regional, I still have many friends and colleagues that are trying to work through this mess. Here is some information that has been reported to me…

“Medications, labs and diagnostic exams are not getting done in a timely manner or even missed all together. Some of this could be training issues and some system.

“Already over worked clinical staff are having to work many extra hours to get all the information in the system. This obviously takes away from patient care.

“Senior leadership tried to implement the system in half the amount of time that is usually required to do such things, with half the staff needed to do it. Why?

“Despite an environment of fear and intimidation the clinical staff involved with the project warned senior administration that the system was not ready to implement and posed a safety risk.

“I have ex-colleagues that know staff and directors that are involved with the project. They have made a valiant effort to make things right. Apparently an 80 to even a 100 hour work week has been the norm of late.

“Some questions that I have: where does the community hospital board stand with all this? Were they asking the questions that need to be asked? Why would the software company agree to do such a tight timeline? Shouldn’t they have to answer some questions as well?”

“Hopefully, this newspaper will continue to investigate what has happened here and not cave to an institution that spends a lot of money on frequent giant full page ads.

“Please remember there are still good people (staff, managers and administrators) that work at ARMC and I am sure they care about the community they serve and will make sure they provide great patient care.”

“The last three weeks have been very challenging for our physicians, nurses, and staff,” said Athens Regional Foundation Vice President Tammy Gilland. “Parts of the system are working well while others are not. The medical staff leadership has been active in relaying their concerns to the administration and the administration has taken these concerns very seriously. Maintaining the highest quality of patient care has always been the guiding principle of Athens Regional Health System.”

Keeping quiet

NHS trusts go quiet about the effect on patients of EHR implementations despite calls by Robert Francis QC and health secretary Jeremy Hunt for openness when things go wrong.

Imperial College Healthcare NHS Trust, which comprises St Mary’s Paddington, Hammersmith Hospital, Charing Cross Hospital, Queen Charlotte’s and Chelsea Hospital, and Western Eye hospital in Marylebone Road, went live with Cerner– but its managers and CEO are refusing to say what effect the system is having on patients.

An FOI request by eHealth Insider elicited the fact that Imperial College Healthcare had 55 different consultants working on the Cerner Millennium project and 45 Trust staff. The internal budget for electronic patient record deployment was £14m.

Croydon Health Services NHS Trust, which comprises Croydon University Hospital (formerly Mayday) and the Purley War Memorial Hospital, went live with Cerner last year, also under BT’s direction.

The trust has been a little more forthcoming than Imperial about the administrative disruption, unforeseen extra  costs and effects on patients, but Croydon’s officials, like Imperial College Healthcare’s spokespeople,  refuse to give any specific answers to Campaign4Change’s questions on the Cerner implementation.

Comment

It was probably unfair of doctors at Athens Regional to judge the Cerner system so soon after go-live but their fierce reaction is a reminder that doctors exist to help patients, not spend time getting to grips with common-good IT systems.

Would an NHS CEO resign after a rebellion by UK doctors over a problematic EHR implementation? It’s highly unlikely – especially if trusts can stop news leaking out of the effects on patients. In the NHS that’s easy to do.

Athens Regional CEO resigns

A tragic outcome for Cerner Millennium implementation?

Athens Regional is addressing computer problems encountered by doctors

Athens Regional is addressing computer problems after patients put at risk

CEO forced out?

 

DWP tries anew for leave to appeal FOI ruling on Universal Credit reports

By Tony Collins

The DWP is continuing its protracted legal fight to stop publication of four reports on the Universal Credit programme.

The department this week asked the upper tribunal for leave to appeal a decision of the first-tier information tribunal that the four reports be published.  The first-tier tribunal had refused the DWP leave to appeal.

As expected, the DWP is doing everything possible within the FOI Act to stop the UC programme reports being published. This is despite MPs on the Work and Pensions Committee saying there is a “lack of transparency” on the Universal Credit programme.

The reports in question are more than two years old but they would show how much ministers knew about UC programme problems at a time when the DWP was issuing regular press releases claiming the scheme was on time and to budget.

By law the DWP has to deal with every FOI request individually but in practice the department has rejected every FOI request for reviews and assessments of its major IT-enabled projects and programmes including Universal Credit.

The four reports in question are:

– A project assessment review on the state of the UC programme in November 2011, as assessed by the Cabinet Office’s Major Projects Authority.

– A risk register of possible risks to the development or eventual operation of UC as perceived by those involved.

– An issues register of problems that have materialised, why and how they can be minimised or eliminated.

– A milestone schedule of progress and times by which activities should be completed.

In his request to the upper tribunal for leave to appeal the first-tier tribunal’s decision, the DWP’s lawyer  argues that the first-tier tribunal wholly misunderstood the nature of any “chilling effect” that publishing the reports would have on the frankness of civil servants contributing to them.

He said that the tribunal’s finding that disclosure of the reports would have no chilling effect was “perverse”, and that the tribunal failed to give due weight to the evidence of a senior civil servant Sarah Cox on the chilling effect.

He said that “many ex-ministers and others have spoken of the chilling effect of disclosure as an observable phenomenon within government” though he provided no evidence of this in his submission.

He added that the first-tier tribunal’s reasoning was “defective” in a number of respects. The tribunal had made a fundamental error of law, he said.

The tribunal’s “factual conclusion that disclosure of the disputed information would have no chilling effect whatsoever was one which no reasonable tribunal, properly directing itself as to the relevant legal principles, could have reached,” said the DWP’s lawyer.

Judge refuses DWP leave to appeal FOI ruling on Universal Credit reports

 

Is working on Universal Credit a risk to health or career?

By Tony Collins

IT-related projects are about solving problems – and  if you cannot own up to the most serious of them, how can they be solved? For those working on Universal Credit it may be stressful, perhaps even hazardous to health, if they cannot discuss serious project problems openly.

Could it be that the DWP’s unnatural grip on information – what the National Audit Office called a good news reporting culture that “stifled open discussion and challenge”  – is a major factor in the delays, rising costs and lack of success in the Universal Credit programme?

Could it also explain why the programme has had so many leaders – who perhaps found that speaking their minds was culturally unacceptable?

I had a taste of the DWP’s grip on information when I asked a department press officer last week about Howard Shiplee, Director General  of Universal Credit who went off sick with bronchitis. Was he back at work? He may no longer be working full time, suggests Computer Weekly.

The DWP appointed Shiplee in May 2013 and he went off sick in December 2013. He took over the UC programme from David Pitchford who quit to return to his native Australia. Terry Moran who ran the universal credit programme at its inception retired from the DWP last year after an extended  period of sick leave.

Philip Langsdale, a highly respected IT expert with public and private sector experience, took over responsibility for the UC programme in September 2012 but died four months later.

Another short-serving incumbent was Hilary Reynolds, a departmental civil servant who was appointed programme director in November 2012 but moved to another role four months later. She replaced Malcolm Whitehouse, who had stepped down as UC programme director.

Andy Nelson, Chief Information Officer at the DWP who had partial control of UC, has resigned after little more than a year in the job.

Truthful?

Government press officers and other public-facing officials usually like to be helpful, open and truthful. But they also reflect an organisation’s culture, whether it is open or closed, or liable to dissemble. The DWP press officer I spoke to last week seemed unable to depart from her pre-agreed script. Clearly she was allowed to say that Shiplee was “at work and fully engaged in delivering Universal Credit” – but no more about him.

“Howard Shiplee is at work,” she said.

Is it accurate to say he is “at work” when it’s for one day a week only?

“He is at work and fully engaged in delivering Universal Credit.”

Isn’t it misleading for the DWP to imply that Howard Shiplee is working full time on Universal Credit when he is only working one day a week?

“He is fully engaged in delivering Universal Credit.”

So he is working full-time on Universal Credit?

“He is at work. And we have announced the next steps in the Universal Programme …”

That started a different line of questioning on whether the DWP was being misleading in its announcement that the “full” Universal Credit benefit will be rolled out in the north-west of England in June.

I asked what “full” meant, when the reality is that new UC claimants must be single, without children, newly claiming a benefit, fit for work, not claiming disability benefits, not have caring responsibilities, not be homeless or in temporary accommodation, and have a valid bank account and National Insurance number. Specifically excluded from UC “pathfinder” claims – although the original plan was include them – are income support, housing benefits, working tax credits, child tax credits and difficult cases.

The DWP’s latest announcement on the next steps in the UC programme refers four times to the “full” UC benefit:

From the DWP’s May 2014 UC announcement:

“The expansion of the full [my emphasis] Universal Credit benefit to the rest of the North-West of England will start in June, it was announced today. On top of that claimants in 10 parts of the country are also benefiting from the better work incentives of the full benefit.”

“In total 90 jobcentres, or one in eight jobcentres in Britain, will offer the full Universal Credit once the North-West expansion is completed.”

“During the summer the new benefit will also be made available for new claims from couples in a number of jobcentres that already deliver the full Universal Credit, expanding to all the current live sites over time.”

The DWP press officer did not answer my question directly.  She said couples will soon be able to claim UC in parts of the country. It appears she was not allowed to lie. But was she also forbidden from telling the truth?

For nearly 2 years the press office’s script was that the UC programme was “on time and on budget”. As the Guardian reported in April last year:

“The DWP has repeatedly claimed that the development is on schedule and on budget.”

But after the National Audit Office reported in depth in September 2013 that the UC programme was in a mess and that tens of millions had been written off the press office changed its script. Now press officers are instructed to say, if asked if the programme is on time and to budget, that it is “on track”, whatever that means.

The Work and Pensions Committee has criticised the DWP’s lack of openness and transparency on the Universal Credit programme. It said:

“On two occasions, the Government has made public the details about major changes to the timetable for UC implementation only when forced to do so by the prospect of oral evidence in front of the Committee. This lack of openness and transparency is not acceptable.”

The National Audit Office identified a ‘fortress’ mentality within the programme team; and the Public Accounts Committee said that the DWP’s UC team became

“isolated and defensive, undermining its ability to recognise the size of the problems the programme faced and to be candid when reporting progress”.

Now the DWP may be looking for Shiplee’s replacement. If so, how long will the appointee stay in post – a few months at best? Can any good UC project leader survive the DWP’s closed and dissembling culture?

Comment

As competent and talented UC leaders come and go it’s becoming easier to see why turnover is so high. The DWP and Accenture successfully built the enhanced National Insurance Recording System (NIRS2), in part by having daily round-table discussions about project problems.  I sat in on one of them. The meetings were marked by the openness of the exchanges.

For that reason IDS may unwittingly be the worst sort of person to be boss of a big IT-based programme. Can the UC’s programme leaders take their workplace problems to IDS without their suffering stress or worse?

The DWP was becoming innately secretive, not open to internal or external challenge, even before IDS was appointed. Since he took over in 2010 the department has become more defensive, introspective, closed, and excessively sensitive to its public image and reputation.

Can anyone run a big IT-based government programme amid a good news culture that permeates all levels of the hierarchy and IT teams at the DWP? It especially infects the DWP’s entrenched US-based major IT suppliers.

IDS has the advantage of understanding the UC programme and he is right to slow down its introduction, but if he stood down as UC’s political leader, the programme’s leaders could find their lives becoming less stressful, less hazardous perhaps.

[A more suitable political leader of the UC programme would, perhaps, be a pragmatist who is a good listener and is not preoccupied with self-image and looking strong – perhaps Frank Field (Labour), Norman Lamb (Liberal) or Richard Bacon (Conservative). ]

Privately the DWP’s ministers would probably argue that being open would give ammunition to the opposition which exploits for party political reasons every supposed UC problem. But openness could have pre-empted that.

If the DWP would publish the UC reports it has so far repeatedly refused to publish it could show in detail how it is tackling the problems in a measured and open way.

Nothing will change its culture. All we can hope for is that scrutiny will be intensified. The Work and Pensions committee is doing a good job, as is the NAO, the Public Accounts Committee, the Information Commissioner and the Information Tribunal but the scrutiny is spasmodic, not month to month or week to week, let alone day to day.

So where is the UC programme heading?

It seems that the Universal Credit programme will remain inherently flawed until after the general election when a new administration may own up to the depth of the problems and a new long-term rollout will be announced, perhaps extending beyond 2020.

You won’t hear that from the DWP, and particularly not its press officers.  But if they’re not allowed to tell the truth spare a thought for those working on the programme. Some of them are highly paid. But what’s money when your health is at stake?

Brian Wernham on UC leadership changes

 

Judge refuses DWP leave to appeal ruling on Universal Credit reports

By Tony Collins

An information tribunal judge has unexpectedly refused consent for the Department of Work and Pensions to appeal his ruling that four reports on the Universal Credit programme be published.

The ruling undermines the DWP’s claim that there would be “chilling effect” if the reports were published.

The judge’s decision, which is dated 25 April 2014, means the DWP will have to publish the reports under the FOI Act  – or it has 28 days to appeal the judge’s refusal to grant consent for an appeal.  The DWP is certain to appeal again. It has shown that money is no object when it comes to funding appeals to keep the four reports secret.

In 2012 John Slater, who has 25 years experience working in IT and programme and project management, had requested the UC Issues Register, Milestone Schedule and Risk Register. Also in 2012 I requested a UC project assessment review by the Cabinet Office’s Major Projects Authority.

Last month the “first-tier” information tribunal ruled that all four reports should be published. It rejected the DWP’s claim that disclosure would inhibit the candour and boldness of civil servants who contributed to the reports – the so-called chilling effect.

The DWP sought the tribunal’s leave to appeal the ruling, describing it as “perverse”. It said the tribunal had wholly misunderstood what is meant by a “chilling effect”, how it is manifested and how its existence can be proved.

It claimed the misunderstanding and the perverse decision were “errors of law”.  For the first-tier tribunal’s finding to go to appeal to the “Upper Tribunal”, the DWP would have needed to prove “errors in law” in the findings of the first-tier tribunal.

Now Judge David Farrer QC says his tribunal has understood the chilling effect but found no evidence that it was relevant to the four reports in question. Indeed the judge implies that if the chilling effect existed there would be evidence of it.

“The so-called chilling effect implies Government departments and other public authorities have by now extensive experience of decisions requiring them to disclose information which they sought to withhold for the reasons advanced by DWP here,” says the judge in dismissing the DWP’s request for permission to appeal.

“If the chilling effect is a widespread and damaging result of the fear of disclosure, there is every reason for central government to investigate the matter, enabling a government department to present a case based on its research.

“Quite apart from that, those receiving reports, conducting discussions and reading advice might be expected to observe, over a period, any trend in changing style and content of their colleagues` written work, so as to be able to present examples and relate them to the perceived threat of disclosure.

“Obviously the form of document will remain the same but it is hard to believe that the experienced observer could not spot and demonstrate a general loss of trenchancy, of innovation or of boldness in the content over a period if that were indeed the effect of possible public exposure.

“Such changes would constitute ‘concrete and specific effects’, adopting DWP`s wording.”

Although the reports requested under the FOI Act are now old – they date back to 2011 – their publication could throw light on how much DWP ministers and civil servants knew about the many problems with Universal Credit IT at a time when the department was issuing unswervingly positive press releases about the UC programme.

Judge Farrer hinted that DWP ministers and civil servants could have misled the public about the real state of UC programme.

Having read the four reports in question, the judge said in his ruling that the Tribunal was “struck by the sharp contrast with the unfailing confidence and optimism of a series of press releases by the DWP or ministerial statements as to the progress of the Universal Credit Programme during the relevant period”.

At the information tribunal in January 2014 a senior civil servant Sarah Cox, on behalf of the DWP, spoke on the supposed effects of disclosure on the candour and boldness of reviewers.

But the Tribunal noted that a Starting Gate review of Universal Credit was published [in 2011] which the DWP had refused to release under FOI. The Information Tribunal noted that Ms Cox did not suggest that the revelation of this document had inhibited frank discussion within the Universal Credit programme.

The Tribunal said reports such as the risk register and project assessment review are important indicators of the state of a project. Their disclosure can give the public a chance to test whether ministers and civil servants are giving out correct information on the state of a project.

This week the judge says that the Tribunal “read and heard the evidence of Ms. Cox, considered the subject matter and the withheld material, took account of her experience, applied its own experience of these cases and its commonsense and, on this issue, found her testimony unpersuasive, as it was entitled to do.”

In conclusion the judge says the Tribunal “rejects the claim that its handling of the ‘chilling effect’ issue involved an error of law.”

Comment:

The DWP was claiming in 2012 that all was well with the UC programme when in reality they knew there wasn’t even an agreed project plan.

That is a good reason for the DWP to want to keep the reports secret – but the main reason its senior civil servants want to stop publication is tradition. The DWP does not publish any of its reports on the state of big IT-enabled projects and programmes.

It’s perhaps because the DWP has always buried itself under the covers of secrecy that it is so imperious – to the point of arrogance – in its handling of FOI requests and appeals. It acts like an institution that is not used to having outsiders, including the information tribunal and National Audit Office – peep into its affairs.

Perhaps this is why the NAO found that the UC programme was being managed so badly. When complex institutions operate in secrecy and without effective day to day scrutiny standards can continue to fall to a point when even the best leaders are powerless to intervene.

There may come a time – if that time hasn’t been reached already – when the DWP will be held together, and only remain credible in the eyes of the public and Parliament, because of the solid work of its major IT suppliers that have been there for decades, bolstered by a plethora of media announcements and ministerial assurances.

We are certainly getting the media announcements and ministerial statements, but without the publication of reports on UC’s progress, do the official pronouncements mean anything at all?

FOI ruling judge refuses DWP leave to appeal

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

By Tony Collins

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

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

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

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

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

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

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

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

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

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

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

How Thompson won over PAC MPs

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

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

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

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

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

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

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

“Thank you.”

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

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

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

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

Richard Bacon: Sorry, a real inconsistency?

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

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

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

Hodge: But were you misled, then?

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

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

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

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

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

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

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

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

Hodge: So you were misled?

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

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

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

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

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

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

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

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

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

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

Thompson: I believed it.

Hodge: You believed it?

Thompson: Yes.

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

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

PAC conclusion

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

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

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

Comment

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

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

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

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

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

BBC Digital Media Initiative – Public Accounts Committee report

 

Judge rules that key Universal Credit reports should be published

By Tony Collins

A freedom of information tribunal has ruled that the Department for Work and Pensions should disclose four internal documents on the Universal Credit programme.

The documents give an insight into some of the risks, problems and challenges faced by DWP directors and teams working on UC.

They could also provide evidence on whether the DWP misled Parliament and the public in announcements and press releases issued between 2011 and late 2013.

The DWP and ministers, including the secretary of  state Iain Duncan Smith, declared repeatedly that the UC scheme was on time and on budget at a time when independent internal reports – which the DWP has refused to publish – were highly critical of elements of management of the programme.

Some detail from the internal reports was revealed by the National Audit Office in its Universal Credit: early progress in September 2013.

The FOI tribunal, under judge David Farrer QC, said in a ruling on Monday that in weighing the interest in disclosure of the reports “we attach great importance not only to the undisputed significance of the UC programme as a truly fundamental reform but to the criticism and controversy it was attracting by the time of FOI requests for the reports in March and April 2012”.

It added:

“We are struck by the sharp contrast [of independent criticisms of elements of the UC programme]  with the unfailing confidence and optimism of a series of press releases by the DWP or ministerial statements as to the progress of the Universal Credit programme during the relevant period.”

A measure of the importance of the tribunal hearing to the DWP was its choice of Sarah Cox to argue against disclosure.

Cox is now the DWP’s Director, Universal Credit, Programme Co-ordination.

She led business planning and programme management for the London Organising Committee of the Olympic and Paralympic Games.

Despite Cox’s arguments Judge Farrer’s tribunal decided that the DWP should publish:

– A Project Assessment Review of Universal Credit by the Cabinet Office’s Major Projects Authority. The Review gave a high-level strategic view of the state of UC, its problems, risks and how well or badly it was being managed.

– A Risk Register of Universal Credit. It included a description of the risk, the possible impact should it occur, the probability of its occurring, a risk score, a traffic light [Red/Green Amber] status, a summary of the planned response if a risk materialises, and a summary of the risk mitigation.

– An Issues Register for Universal Credit. It contained a short list of problems, the dates when they were identified, the mitigating steps required and the dates for review and resolution.

– A High Level Milestone Schedule for Universal Credit. It is described in the tribunal’s ruling as a “graphic record of progress, measured in milestones, some completed, some missed and others targeted in the future”.

Campaign for openness

Campaigners have tried unsuccessfully for decades to persuade Whitehall officials to publish their independent reports on the progress or otherwise of big IT-enabled projects and programmes.

So long as the reports remain confidential, ministers and officials may say what they like in public about the success of the programme without fear of authoritative contradiction.

This may be the case with the Universal Credit. The tribunal pointed out that media coverage of the problems with the scheme was at odds with what the DWP and ministers were saying.

The ruling said:

 “Where, in the context of a major reform, government announcements are so markedly at odds with current opinion in the relatively informed and serious media, there is a particularly strong public interest in up-to-date information as to the details of what is happening within the [Universal Credit] programme, so that the public may judge whether or not opposition and media criticism is well-founded.”

The tribunal quoted a DWP spokesperson in 2012 as refuting criticism from the shadow secretary of state. The spokesperson said:

Liam Byrne is quite simply wrong. Universal Credit is on track and on            budget. To suggest anything else is wrong.”

 Sarah Cox implied that the DWP might have regarded a programme as on schedule, even if milestones were not achieved on time, provided that punctual fulfillment of the whole project was still contemplated. In reply to this, the Tribunal said:

 “If that was, or indeed is, the departmental stance, then the public should have been made aware of it, because prompt completion following missed interim targets is not a common experience.”

DWP abuse of the FOI Act?

Under the FOI Act ministers and officials are supposed to regard each request on its own merits, and not have a blanket ban on, say, disclosure of all internal reports on the progress or otherwise of big IT-enabled change programmes.

The tribunal in this case questioned whether the DWP had even read closely the Project Assessment Review in question. The tribunal had such doubts because the DWP, some time after the tribunal’s hearing, found that it had mistakenly given the tribunal a draft of the Project Assessment Review instead of the final report.

The tribunal said:

“…the DWP discovered that the version of the Project Assessment Review supplied to the Tribunal was not the final version which had been requested. It was evidently a draft. How the mistake occurred is not entirely clear to us.

“ Whilst the differences related almost entirely to the format, it did raise questions as to how far the DWP had scrutinised the particular Project Assessment Review requested, as distinct from forming a generic judgement as to whether PARs should be disclosed.”

DWP’s case for non-disclosure

The DWP argued that disclosure would discourage candour, imagination [which is sometimes called creative or imaginative pessimism] and innovation – known together as the “chilling effect”.

It also said that release of the documents in question could divert key staff from their normal tasks to answering media stories based on a misconception, willful or not. These distractions would seriously impede progress and threaten scheduled fulfillment of the UC programme.

Disclosure could embarrass suppliers that participated in the programme, damage the DWP’s relationship with them, and cause certain risks to come closer to being realised. The DWP gave the tribunal further unpublished – closed – evidence about why it did not want the Project Assessment Review released.

My case for disclosure

In support of my FOI request – in 2012 – for the UC Project Assessment Review, I wrote papers to the tribunal giving public interest reasons for disclosure. Some of the points I made:

– the DWP made no acknowledgement of the serious problems faced by the UC programme until the National Audit Office published its report in September 2013: Universal Credit: early progress.

– Large government IT-enabled projects have too often lacked timely, independent scrutiny and challenge to improve performance. Publication of the November 2011 Project Assessment Review would have been a valuable insight into what was happening.

– The NAO report referred to the DWP’s fortress mentality” and a “good news culture” which underlined the public interest in early publication of the Project Assessment Review.

Part of John Slater’s case for disclosure

At the same time as dealing with my FOI request for the PAR, the tribunal dealt with FOI requests made by John Slater who asked for the UC Issues Register, Risk Register and High Level Milestone Schedule.

In his submission to the tribunal Slater said that ministerial statements and DWP press releases, which continued from 2011 to late 2013, to the effect that the Universal Credit Programme was on course and on schedule, demanded publication of the documents in question as a check on what the public was being told.

Information Commissioner’s case for disclosure

The Information Commissioner’s legal representative Robin Hopkins made the point that publishing the Project Assessment Review would have helped the public assess the effectiveness of the Cabinet Office’s Major Projects Authority as a monitor of the UC programme.

A chilling effect?

The tribunal found that there is no evidence to support the “chilling effect” –  the claim that civil servants will not be candid or imaginatively pessimistic in identifying problems and risks if they know their comments will be published.

If a chilling effect exists, said the tribunal, “then government departments have been in the best position over the last ten years to note, record and present the evidence to prove it.

“Presumably, a simple comparison of documents before and after disclosure demonstrating the change, would be quite easy to assemble and exhibit,” said the tribunal’s ruling.

In her evidence to the tribunal Ms Cox did not suggest that the revelation by a third party of the “Starting Gate Review” [which was published in full on Campaign4Change’s website] had inhibited frank discussion within the UC programme, the tribunal said.

The tribunal also pointed out that the public is entitled to expect that senior officials will be, when helping with internal reports, courageous, frank and independent in their advice and assessments of risk.

“We are not persuaded that disclosure would have the chilling effect in relation to the documents before us,” said the tribunal. It also found that the DWP would not need to divert key people on UC to answering media queries arising from publication of the reports. The DWP needed only to brief PR people.

On whether the Issues Register should be published the tribunal said:

“The problems outlined in the Issues Register are of a predictable kind and “unlikely to provoke any public shock, let alone hostility, perhaps not even significant media attention. On the other hand, the public may legitimately ask whether other problems might be expected to appear in the register.”

On the chilling effect of publishing the Risk Register the tribunal said that any failure of a civil servant to speak plainly about a risk and hence to conceal it from the UC team would be more damaging to UC than any blunt declaration that a certain risk could threaten the programme.

“We acknowledge that disclosure of the requested information may not be a painless process for the DWP,” said the tribunal. ““There may be some prejudice to the conduct of government of one or more of the kinds asserted by the DWP, though not, we believe, of the order that it claims.

“We have no doubt, however, that the public interest requires disclosure, given the nature of UC programme, its history and the other factors that we have reviewed,” said the Tribunal.

The DWP may appeal the ruling which could delay a final outcome by a year or more.

Comment

The freedom of information tribunal’s ruling is, in effect, independent corroboration that Parliament can sometimes be given a PR line rather than the unvarnished truth when it comes to big IT-based programmes.

Indeed it’s understandable why ministers and officials don’t want the reports in question published.  The reports could provide concrete evidence of the misleading of Parliament. They could refer to serious problems, inadequacies in plans and failures to reach milestones, at a time when the DWP’s ministers were making public announcements that all was well.

Those in power don’t always mind media speculation and criticism. What they fear is authoritative contradiction of their public statements and announcements. Which is what the reports could provide. So it’s highly likely the DWP will continue to withhold them, even though taxpayers will have to meet the rising legal costs of yet another DWP appeal.

One irony is that the DWP’s ministers, officials, managers, technologists and staff probably have little or no idea what’s in the reports the department is so anxious to keep confidential.  On one of my FOI requests it took the DWP several weeks to find the report I was seeking – after officials initially denied any knowledge of the report’s existence.

This is a department that would have us believe it needs a safe space for the effective conduct of public affairs. Perhaps the opposite is the case, and it will continue to conduct some of its public affairs ineffectively until it benefits from far more Parliamentary scrutiny, fewer safe spaces and much more openness.

FOI Decision Notice Universal Credit March 2014

George Osborne gives mixed messages over UC deadline

Universal Credit now at 10 job centres – 730 to go. 

DWP finds UC reports after FOI request

UC – new claimant figures

Should Liverpool Council smile now it’s ending BT joint venture?

By Tony Collins

Liverpool Direct Ltd describes itself as the largest public/private partnership of its kind in the UK. BT and Liverpool City Council formed the joint venture in 2001. At one point it employed more than 1,300 people.

Last year the joint venture had a visit from  Prince Edward who met its apprentices and trainees.

Now Liverpool City Council is taking full ownership of the joint venture. BT is handing back its 60% share in Liverpool Direct to the council. But the way the dissolution is being handled is like a theatre compere smiling exaggeratedly at the audience while he pushes off stage a performer who has overstayed his welcome.

Indeed the council’s report on why BT is being pushed out has an oversized grin on every page. Too much self-conscious praise for BT, perhaps. Which may show how political outsourcing deals have become.

This is the first sentence of the council’s report on why the joint venture with BT is ending:

“BT and Liverpool City Council have enjoyed a long and successful partnership through the joint venture company Liverpool Direct Limited.”

And then:

“The ethos of the Partnership was to place the ‘customer at the heart’ of the organisation through the development of innovative new ways of working building on BT’s global brand and reputation.”

There’s much more praise for BT. From the council’s report:

Groundbreaking achievements have included:

  • Establishment of the first ever 24x7x365 local government contact centre including a call centre which is top quartile
  • The only ‘Benefits Plus’ service in the UK.
  • A comprehensive and integrated network of One Stop Shops serving 350,000 visitors each year.
  • First class ICT infrastructure.
  • Creation of 300 new jobs supporting 3nd party business won by LDL.

But there’s a give-away line in one of the sets of bullet points on some of the benefits of the partnership. In 2011 came a refresh of the 10 year-old deal. The benefits of the refresh:

  • Further price reduction of £22.5m.
  • Increased share of third party business. Potential investment of £17m.
  • Continued sponsorship of ( e.g. BT Convention Centre 2012-2017)
  • The ‘write off’ by both parties of potential legal claims against Liverpool City Council estimated by BT of approximately £56m.
  • Increased ownership level from 20% to 40% in favour of the council.

Spot the anomaly – a write-of legal claims against each other of £56m? So the partnership wasn’t quite so wonderful. But that was 2011. Why is the council now pushing out BT from the Liverpool Direct joint venture – what the council calls officially “The Way Forward”?

Amid all the praise for BT it is not easy to see at first glance why Liverpool Direct is being taken into the council’s full ownership. It turns out that austerity is the reason. The council needs to make more cuts than BT is willing to make, and it recognises that BT needs to make a profit. Which raises the question of whether the council was willing to pay BT a decent profit during bountiful times until cuts began to bite.

From Liverpool Council’s report:

“In the early Autumn of 2013, both parties were in active discussions in an effort to resolve the serious financial savings Liverpool City Council needed to make between 2014 and 2017.

“As a result of these discussions and negotiations, BT agreed a further price reduction of £5m contribution to the budget process for 2014/15 together with a further £5m for the following financial year.

“Whilst the Council really appreciated BT’s continued commitment to the city, the current budget deficit would require a far more substantive financial contribution from the Contract both for 2014/15 and for future years.

“Unfortunately BT feels unable to commit to any further price reduction within the Contract as they need to sustain their own financial position. Moreover, the City Council is now well placed, as a result of the long collaboration with BT and the learning gained from the Partnership, to continue to drive forward business transformation and run the services with consequent cost savings to the city.”

The result is that negotiations will continue with a view to transferring BT’s 60% share in Liverpool Direct to the council by 31 March 2014; and the good news doesn’t stop there.

“The City Council and BT both believe that the transfer will enable additional savings to flow to the council including all income from third party contracts.

“BT remains committed to serving residents and businesses in Liverpool and its long and successful relationship with Liverpool City Council will carry on with BT continuing to provide a range of services to the council. During negotiations in late 2013 BT announced it plans to recruit a further 240 staff in Liverpool to support the growth of high-speed broadband services and has recently committed to being a major sponsor of the 2014 International Festival of Business.”

A dark side?

Behind the smiles Liverpool City Council has, it seems, an unusually secretive side.   Richard Kemp CBE has been a member of Liverpool City Council for 30 years having held major portfolios in both control and opposition. He is leader of the Liberal Democrats on the Council. He was Vice Chair of the Local Government Association of England & Wales for more than 6 years.

He says on his blog that has “taken the very unusual step of asking for two independent enquiries into activities of Liverpool City Council”. He adds: “The cases are related and refer to the tangled web of relationships which surround the Liverpool/Liverpool Direct Ltd/Lancashire/One Call Ltd/BT activities.

“In the first instance I have asked that the Lancashire Police extend their Lancashire investigation into Liverpool. In the second I have asked the Information Commissioner to look at the appalling record of the council in responding to freedom of information requests about any matter relating to Liverpool Direct Ltd.”

He says the council has an excellent record of responding to FOI requests – except when it comes to LDL. “When I raised this with the Mayor at the Mayoral Select Committee I didn’t get any answers …”

He also says:

“I find it amazing that I have been told that no contract exists between Liverpool, Lancashire and BT only to find that there is a legal agreement! As a layman I am unclear as to what the difference is between these two positions.

“We now need external scrutiny and investigation to examine these tangled relationships and work out not only who agreed what and when but also whether Liverpool and Lancashire tax payers are getting value for money for this deal.

“In a system where there is no internal scrutiny, Liverpool Labour members have to ask permission to raise issues in the scrutiny process, I feel that I have no alternative but to ask for help in looking at these affairs outside the council.

“In my career I have not only been a councillor for a long time but also asked to work in other councils which were in severe difficulties with their governance structures. Liverpool feels as bad as any council that I have worked in. There is no clear definition of Member and Officer roles.

“ No effective challenges exist within the system and a centralised almost Stalinist decision-making process pertains … I hope that these external investigations will take place and then that they force change in this secretive and opaque council.”

Infighting

A local paper, the Liverpool Echo, has also been investigating the council and its deal with BT.

It says the deal “has been dogged by accusations of infighting between BT and the Council, after top QCs were brought in to settle disputes over how much work would be awarded to LDL under the terms of its contract”.

An internal council report obtained by the Echo before agreement for the contract refresh in 2011 “showed the it took place amid the threat of costly legal claims by BT if city bosses pulled the plug and did not stay in partnership with them until 2017”.

Private/public deals too secretive – MPs today

A report by the Public Accounts Committee published today Private Contractors and Public Spending says private and public partnerships are too secretive – and they lie largely outside the FOI Act. Indeed a BBC File on 4 investigation into the growing influence of accountancy companies such as Capita in public life reached similar conclusions. File on 4 suggested that even if the contract between Service Birmingham, Capita and Birmingham City Council were published in full it could prove impenetrably complicated.

Margaret Hodge MP, chairman of the Public Accounts Commitee, said today:

 “There is a lack of transparency and openness around Government’s contracts with private providers, with ‘commercial confidentiality’ frequently invoked as an excuse to withhold information.

“It is vital that Parliament and the public are able to follow the taxpayers’ pound to ensure value for money. So, today we are calling for three basic transparency measures:

– the extension of Freedom of Information to public contracts with private providers;

– access rights for the National Audit Office; and

– a requirement for contractors to open their books up to scrutiny by officials.

Comment:

It’s remarkable how council outsourcing deals are becoming more cabalistic despite many initiatives toward more open government.

It’s a pity that things have reached a point where Richard Kemp, a Liverpool councillor of 30 years, ends up reporting his authority to the police and the Information Commissioner.

Meanwhile Liverpool City Council, which is one of the most self-image-protecting authorities in the UK, ends a long-standing joint venture with BT by giving the supplier nothing but praise – in public.

Democracy is a form of government in which all eligible citizens participate equally, either directly or indirectly through elected representatives. Clearly that’s not happening properly in Liverpool – or  some other parts of local government.

Reasons I have asked police and Information Commissioner to come in 

BT ad Capita  –  outsourcing joint ventures under pressure in Liverpool and Birmingham 

Private contractors and public spending – Public Accounts Committee report published today

Coroner criticises hospital’s new IT after boy’s death

By Tony Collins

Avon coroner Maria Voisin said yesterday that a new booking system at the Royal United Bath was responsible for three year-old Samuel Starr not being seen and given timely treatment.

It’s rare for a coroner to criticise a hospital’s new IT in direct terms. It is also rare for evidence to emerge of a link between the introduction of new hospital IT and harm to a patient.

Since patient administration systems began to be installed as part of the National Programme for IT in 2005, the disruption arising from go-lives has led to thousands of patient appointments being delayed at a number of trusts. Usually  trusts contend that no patients have suffered serious harm as a result.

Yesterday at the coroners court near Bristol, the coroner Voisin said: “Due to the failure of the hospital outpatients booking system, there was a five-month delay in Samuel being seen and receiving treatment. Samuel’s heart was disadvantaged and he died following urgent surgery.”

Catherine Holley, Samuel’s mother, said her first warning of Cerner implementation problems came in June 2012, about three months before her son’s death, when the RUH cardiologist’s post clinic letter said:

“I apologised to the parents that I should have seen him in January of this year, but I am afraid a few patients have fallen foul of the Millennium changeover and I suspect this is the case here”.

The RUH installed the Cerner Millennium system at the end of July 2011. After the go-live the trust’s board reports, and a post-implementation review of the system by Pwc in February 2012, raised no serious concerns.

One of Pwc’s main criticisms of the system was the lack of clinical engagement – a common problem with NPfIT deployments.

Some excerpts from Pwc’s report:

“Given the issues and delays there is a still a good deal of uncertainty about whether the planned benefits can be realised. It is therefore important that there is a concerted effort to focus on driving out these benefits, early in 2012.”

“The go live itself did have some issues, but most of those interviewed felt that, relative to other Cerner Millennium implementations, it had gone well. Since the go-live the Trust has been working hard to address the issues, and to help users use the system more effectively…”

“There are a number of issues which arose during the audit which, although not directly covered within the audit objectives, are important in ensuring that the trust realises all the potential benefits from the Cerner Millennium implementation. These are as follows:

“There is a need for greater clinical engagement to ensure that clinicians are using the system in the most effective way – the Trust operates a Clinical Engagement Group which meets on a monthly basis.

“However feedback from a number of interviewees is that this meeting isn’t as productive as it might be and that the Trust needs to think of other ways to improve clinical engagement.”

Pwc said that the trust needed a clinical lead for Cerner Millennium who would focus on key clinical priorities and “sell” the benefits of Millennium to other clinicians. The trust also needed a CIO who would be responsible for IM&T, the Business Intelligence Unit, the Care Records Service team, Records Management, and managing the end of a [local service provider] contract with BT in 2015.

Pwc said the risks included:

  • The end of the contract with BT in 2015
  • Recent issues with BT delivery, with several significant outages of service
  • The issues with clinical engagement.

None of the trust reports – or Pwc’s review –  mentioned any adverse impact of the new system’s implementation on patients.

In 2011, several months after the go-live, the RUH’s “Insight” magazine quoted the Chief Executive James Scott as suggesting the go-live had been a success.

“Thanks to everyone for their hard work and patience during the switchover period,” Scott is quoted as saying. “It has been a major project for the RUH (and our partners BT and Cerner are describing it as the smoothest deployment yet), but we now have the foundation in place to meet the future needs of the Trust and the NHS.”

Care plan?

Catherine Holley expected Samuel to go onto a care plan after he had successful heart surgery at the age of nine months, in 2010. But it proved difficult to arrange an appointment for a scan on the new Cerner Millennium system installed at Royal United Hospital, Bath.

When the scan was eventually carried out Samuel’s heart had deteriorated and he died in September 2012 after an operation that was more complicated than expected.

This week’s three-day inquest at Flax Bourton Coroners Court heard that although Samuel’s medical records had been created on Millennium, no appointments were transferred across.

Speaking after the inquest, Samuel’s parents said they believe the system at Bath failed their son and that mistakes were made.

“It was devastating to hear evidence that an improperly implemented computer appointments system and a series of human errors resulted in the death of our son,”said Paul Starr’s Samuel’s father.

“We accept that mistakes happen but we believe that leaving a child unmonitored for as long as Samuel was, with so many opportunities to attend to him, goes beyond a simple error.

“Our three year old son had a complex cardiac condition and had been scheduled for regular cardiac reviews. In fact he was not properly assessed or nearly 21 months because of further delays.”

A Freedom of Information request revealed that there were 63 missed paediatric cardiac appointments as a result of problems arising from the Cerner implementation – some of which took nearly two years to discover.

Comment

It’s unlikely to have been the Cerner system itself at fault but an  implementation that involved several organisations including the Southern Programme for IT, a branch of the dismantled National Programme for IT.  As such nobody is likely to held responsible for what the coroner called a “failure” of the IT system.

Then again blaming an individual would be pointless.  Learning lessons – the right ones, and not just technical ones – is the objective. It may make a world of difference if those in charge of major go-lives in hospitals acknowledged that delayed appointments, or difficulties arranging them, and a disrupted administration, can harm patients – or worse.

IT in the NHS is seen as an integral part of hospital care when the technology, clinicians, nurses, administrators and other users are working in alignment. But when the IT is not working well, it is seen as something techie which has little or nothing to do with patient care and treatment.

Samuel Starr’s inquest draws attention to the fact that the difference between a good and bad IT implementation in a large hospital can be the difference between life and death.

But hospital deployments of patient administration systems have been going wrong with remarkable regularity for many years.  Isn’t it time to learn the right lessons?