Category Archives: public services

Universal Credit’s “multiple frustrations and complications”

By Tony Collins

universal creditJournalists who are trying to find out the current state of the Universal Credit programme will get little help from the Department for Work and Pensions unless its press officers sense that the eventual outcome will be positive.

Sometimes journalists call me as part of their research. They want to know whether UC will end up as another government IT disaster. I had such a call yesterday.

The conversation focused on IT. But it’s a maxim in the industry that major change programmes in the public sector usually fail or are delayed for managerial rather than technical reasons.

The introduction of a new passport system failed when a better, more secure system slowed down the issuing of new passport applications.

Instead of halting the roll-out to see how to speed up the issuing of passports – by changing procedures or spending more on staff and equipment – the Home Office continued the rollout and chaos ensured. That wasn’t the fault of the IT.

It may be a similar story with Universal Credit. Even if the IT as far as it goes works well, claims handling is a laborious process,  The main systems do not handle calculations of gross income, net income or back-office integration, all of which are managed manually.

Chaos is unlikely because the rollout is going so slowly.  But the amount of manual intervention required means the slow rollout is enforced rather than merely voluntary.

[This slow rollout is despite an IT budget for UC including migration costs from 2010 to 2014/15 of £812m as at December 2012. Within this budget, £303m had been spent to March 2013, mostly with the DWP’s main IT suppliers Accenture, IBM, HP and BT.]

The programme is also running into non-IT difficulties such as delays in issuing first-time payments to claimants because of a variety of reasons around the complexity of new procedures, and tenants unable to pay rent because the money hasn’t gone directly to landlords.

If UC goes nationwide, as Iain Duncan Smith says it will next year, it will still be able to handle only limited numbers of claimants, in the tens of thousands, not hundreds of thousands and certainly not millions.

This article is a reminder that Universal Credit faces problems that go beyond the IT. A North West housing association said a survey of its tenants had exposed flaws in the universal credit system, with some claimants turning to pay day lenders to get by.

After taking part in a pilot in 2013 of the roll out of UC, First Choice Homes Oldham found that their tenants had suffered “multiple frustrations and complications with the system”. Data collected this summer from 40% of the housing association’s tenants on UC found that:

• 55% found the period between making their UC claim and receiving their first payment very difficult. 44% managed financially by borrowing and 18% had taken out a pay day loan.

• 74% had not been offered personal budgeting support by the Department for Work and Pensions. However, 57% of the tenants that were offered this service took up the offer.

• 37% did not receive their payment on the same day each month, making budgeting even more difficult.

• 59% of tenants had not found work since claiming UC.

When asked by FCHO to name the first three bills that would be paid once they were in receipt of UC, 19% of tenants did not name rent as a priority bill.

So will UC succeed?

It’s laudable that the coalition is trying to simplify the benefits system. No pain no gain. But it’s not doing it openly. IDS pretends all is well when clearly it isn’t.

This means that UC becomes an impossible project to manage well. No programme leader can take big problems to IDS because big problems are not supposed to exist. UC desperately needs a new political leader who has no emotional equity in its success.

It’s right (and largely involuntary) that the DWP is going slowly in rolling out UC. This way chaos is avoided.

But to handle millions of claims, the processing of UC transactions and payments needs to be a fully automated process. The DWP is working on that – what Iain Duncan Smith calls an “enhanced digital service”.  Nobody seems to know much about it. IDS says it is going to be tested later this year.

Uncertainty

Now into its fourth year of implementation, UC is still mired in uncertainty, despite IDS’s self-confident remarks at the Tory conference.

The facts are likely to emerge when the National Audit Office publishes its updated report which is expected before the end of this year. The DWP may already have drafted its press release saying the NAO report is outdated, which is part of the problem with UC and other big government IT-based programmes: they are more governed by politics than pragmatism.

 

DWP’s advert for a £180k IT head – what it doesn’t say

By Tony Collins

Soon the Department for Work and Pensions will choose a Director General, Technology.  Interviewing has finished and an offer is due to go out to the chosen candidate any day now.

The appointee will not replace Howard Shiplee who runs Universal Credit but has been ill for some months. The DWP is looking for Shiplee’s successor as a separate exercise to the recruitment of the DG Technology.

In its job advert for a DG Technology the DWP seeks a “commercial CIO/CTO to become one of the most senior change agents in the UK government”.

The size of the salary – around £180k plus “attractive pension” – suggests that the DWP is looking for a powerful, inspiring and reforming figure. The DWP’s IT makes 730 million payments to a value of 166bn a year.

In practice it is not clear how much power and influence the DG will have, given that there will be a separate head of Universal Credit (Shiplee’s successor) and there is already in place a Director General for Digital Transformation Kevin Cunnington.

What’s a DG Technology to do then?

The job advert suggests the job is about bringing about “unprecedented” change.  It says:

“The department is undergoing major business change, which has at its heart a technology and digital transformation of the services it provides, which will radically improve how it interacts with citizens.”

The role, says the advert, involves:

  • “Designing, developing and delivering the technology strategy that will enable unprecedented business change.”
  • “… Reducing the time to taken to develop new services and cutting the cost of delivery.”

The chosen person needs “a clear record of success in enabling the delivery of service driven, user focused, digital business transformation,” says the advert.

What the DWP doesn’t say

If DWP officials took a truth pill when interviewing candidates they might have said:

  • “No department talks more about change than we do. We regularly commission reports on the need for transformation and how to achieve it. We issue press releases and give briefings on our plans for change.  We write  ministerial speeches on it. We employ talented people to whom innovation and productive change comes naturally. The only thing we don’t do is actually change. It remains an aspiration.
  • “We remain one of the biggest VME sites in the world (VME being a Fujitsu – formerly ICL – operating system that dates back to the 1970s). VME skills are in ever shorter supply and it’s increasingly costly to employ VME specialists but changing our core software is too risky; and there is no commercial imperative to change: it’s not private money we’re spending.  We’ve a £1bn a year IT budget – one of the biggest of any government department in the world.
  • DWP core VME systems run an old supplier-specific form of COBOL used on VME, not an industry standard form.
  • We’ve identified ways of moving away from VME: we have shown that VME-based IDMSX databases can be transitioned to commodity database systems, and that the COBOL code can be converted to Java and then run on open source application servers. Still we can’t move away from VME, not within the foreseeable future. Too risky.
  • We’d love the new DG Technology to work on change, transformation and innovation but he/she will be required for fire-fighting.
  • It’s a particularly difficult time for the DWP. We are alleged to have given what the Public Accounts Committee calls an unacceptable service to the disabled, the terminally ill and many others who have submitted claims for personal independence payments. We are also struggling to cope with Employment and Support Allowance claims. One claimant has told the BBC the DWP is “not fit for purpose”.
  •  The National Audit Office will publish an unhelpful report on Universal Credit this Autumn. We’ll regard the report as out-of-date, as we do all negative NAO reports. We will say publicly that we have already implemented its recommendations and we’ll pick out the one or two positive sentences in the report to summarise it. But nobody will believe our story, least of all us.
  • If we could, we’d appoint a representative of our major suppliers to be the head of IT.  HP, Fujitsu, Accenture, IBM and BT have a knowledge of how to run the DWP’s systems that goes back decades. The suppliers are happily entrenched, indispensable. That they know more about our IT than we do puts into context talk of SMEs taking over from the big players.
  • One reason we avoid major change is that we are not good at it: Universal Credit (known internally as Universal Challenge), the £2.6bn Operational Strategy benefit scheme that Parliament was told would cost no more than £713m, the £141m  (aborted) Benefit Processing Replacement Programme, Camelot which was the (aborted) Computerisation and Mechanisation of Local Office Tasks,  and the (aborted)) Debt Accounting and Management System. Not to mention the (aborted) £25m Analytical Services Statistical Information System.
  • They’re the failures we know about. We don’t have to account to Parliament on the progress or otherwise of our big projects, and we’re particularly secretive internally, so there may be project failures not even senior management know about.
  • We require cultural alignment of all the DWP’s most senior civil servants. This means the chosen candidate must – and without exception – defend the department against all poorly-informed critics who may include our own ministers.
  • The Cabinet Office has some well-meaning reformers we want nothing to do with. That said, our policy is to agree to change and then absorb the required actions, like the acoustic baffles on the walls of a soundproofed studio.

 

 

Secrecy is one reason gov’t IT-based projects fail says MP

By Tony Collins

The BBC, in an article on its website about Fujitsu’s legal dispute with the Department of Health, quotes Richard Bacon MP who, as a member of the Public Accounts Committee, has asked countless civil servants about why their department’s IT-based change projects have not met expectations.

Bacon is co-author of a book on government failures, Conundrum, which has a chapter on the National Programme for IT [NPfIT] in the NHS.

In the BBC article Bacon is quoted as saying that the culture of secrecy surrounding IT-based projects is one of the main reasons they keep going so badly – and expensively – wrong.

He says it has been obvious to experts from an early stage that the NPfIT, which was launched by Tony Blair’s government, would be a “train wreck” because the contracts were signed “in an enormous hurry” and contained confidentiality clauses preventing contractors from speaking to the press.

He says the urge to cover things up means that “we never learn from our mistakes because there is learning curve, but when things go wrong with IT the response is to keep it quiet”.

Citing the example of air accident investigations, which are normally conducted in a spirit of openness so lessons can be learned, he says “It is the complete opposite in IT projects, where everyone keeps their heads down and goes hugger-mugger.”

Fujitsu versus Department of Health

Fujitsu sued the Department of Health for £700m after the company was ejected six years early [2008] from a 10-year £896m NPfIT contract signed in January 2004.  The case went to arbitration – and is still in arbitration, largely over the amount the government may be ordered to pay Fujitsu.  Bacon says the amount of the settlement will have to be disclosed.

“I don’t know how the government can honestly keep this number quiet. It simply cannot do it. It is not possible or sensible to keep it quiet when you are spending this much money,” says Bacon.

The BBC article quotes excerpts from a Campaign4Change blog

Government ‘loses £700m NHS IT dispute with Fujitsu’ – BBC News

 

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

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