Category Archives: supplier relationships

How does this tech team achieve so much on so little money?

Posted on 31/08/2011 | Leave a comment

By Tony Collins

Laura Slatcher dreams of forms – reducing the number of them.

She works with a small IM&T team at Trafford General Hospital that is trying to standardise and reduce the number of paper forms doctors and nurses use in the care and treatment of patients.

As is typical for a hospital of its size there are up to 70 – mostly different – paper forms on every ward. Slatcher is working with clinicians to define ways of switching from paper to electronic records – which they are doing with alacrity.

“We have to standardise here,” says Steve Parsons, Head of IM&T at Trafford Healthcare NHS Trust in Manchester. “The doctors and nurses welcome that. They want to work better and more efficiently because they are under pressure themselves to do that.”

Clinical support 

Trafford General bought its main systems outside of the £11.4bn the National Programme for IT [NPfIT]. The hospital, though, is one of the most technologically-advanced in the UK says Peter Large, Trafford Healthcare NHS Trust’s Director of Planning.

There has been no risky “Big Bang” implementation of a Whitehall-bought patient administration system. Rather, Parsons’s approach has been step by step progress over 10 years: implementing systems, learning from what went well and not so well, and integrating hardware and software from a range of suppliers. This strategy could help to explain why the clinical staff we spoke to at Trafford hold the small IM&T team in high regard.

In 2000 the hospital had rudimentary technology – isolated systems in some departments. Now the IM&T team is able to give clinicians what they have asked for; and at Trafford it’s the doctors and nurses who say what they want. Systems are not imposed on them. Here the technologists are in the background, not centre-stage as in the NPfIT.

Trafford and the NPfIT

Says Large: “We found ourselves in the position of being ahead of the game. When we were asked to commit to the National Programme we held back because we needed to know we would be committing to a better solution than was already available to us.”

Parsons adds: “Some trusts didn’t really have anything at all so were desperate to be in the first wave. From their perspective the national programme was a brilliant step forward. But the right products never arrived.”

Integrated systems

One reason for Trafford’s success is the integration of the hospital main and departmental systems. Before electronic patient records, patients could come into hospital without their paper notes being available. Now doctors across the hospital’s departments and clinics can access at the hospital’s XML-based electronic patient records at any time, day or night – and from home if they have remote access.

Doctors can view x-rays and assessments of them from the patient record; and from system alerts and patient tracking, operational managers can see how well individual doctors and nurses are coping with the numbers of patients on their daily lists.

No black-box technology

The hospital’s three main systems are an electronic patient record from Graphnet, software to schedule and manage appointments from Ultragenda, owned by iSoft (now acquired by CSC), and the “Ensemble” integration engine from InterSystems.

What sets these and the hospital’s other systems apart is that they are not black boxes, impenetrable to Trafford’s technologists. Parsons insists that Trafford’s suppliers make their software transparent so that it can be understood by the hospital’s IM&T staff and integrated with other systems, at database “field” level if necessary. That way Parsons can produce any report clinicians need and usually in real-time.

When a supplier keeps its software opaque for reasons of proprietary and commercial confidentiality, Parsons is restricted in the type of medical and administrative reports he can ask the company to supply – and may have to wait hours or a day to get them. He wants none of that.

It’s this level of control that Parsons believes he has a right to expect – and he seems a little surprised that CIOs don’t always require openness from their software suppliers.

How does this tech team achieve so much on so little money? (2)

How does this tech team achieve so much on so little money [final part]

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Posted in change, change management, collaboration, innovation, managing change, NHS, npfit, public sector, public services, SME, supplier relationships

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Met Office has IBM secondee as CIO

Posted on 25/08/2011 | 2 comments

By Tony Collins

The Met Office gained ministerial approval to appoint an IBM employee for a year as secondee CIO, until the end of October 2011, according to information released under the FOI Act.

It appears that the salary of the IBM executive David Young is being paid, at least in part, by the Met Office. In documents released under the FOI Act the Met Office has redacted [edited out] details of Young’s proposed remuneration and performance bonus.

As a trading fund within the Department for Business, Innovation and Skills, the Met Office is required to operate on a commercial basis. It was part of the Ministry of Defence at the time of Young’s appointment. His recruitment was approved by the Secretary of State.

Internal emails show that the Met Office apparently overcame a recruitment ban and constraints on secondments.

Having your CIO seconded from your biggest IT supplier may be novel but it could be controversial because of the perception of a potential conflict of interest.

It would not the first time a public authority has been involved in a controversy after seconding an IBM employee as head of IT.

In 1993 a report of the district auditor criticised the then Wessex Regional Health Authority after it transpired that a member of the health authority was a director of IBM. The IBM director at Wessex promoted a controversial and successful bid for core systems to be supplied to the health authority by IBM and Andersen Consulting (later Accenture). The director later asked that his letter lobbying for the contract be destroyed.

The auditor also found that the Wessex authority bought an IBM mainframe without proper legal authority, the members of the authority having not been informed. The authority paid an unnecessarily high sum for the mainframe and there were doubts the machine was needed. A decision to proceed with the purchase of the mainframe at Wessex was made on the advice of the regional health authority’s new regional information systems manager who was an IBM secondee.

The Met Office, however, has given full consideration to the potential for a conflict of interest in appointing Young as its CIO. It said in a statement this week:

“Full consideration of any potential conflicts of interest regarding David Young’s appointment were fully considered prior to his appointment and his terms of engagement specifically cover these.

“The Met Office complies with specific rules set by the government with regard to procurement and purchases of IT equipment must be agreed by the Met Office Executive.”

The Met Office is one of IBM’s biggest customers. It says on its website: “We are now using an IBM supercomputer which can do more than 100 trillion calculations a second. Its power allows it to take in hundreds of thousands of weather observations from all over the world which it then takes as a starting point for running an atmospheric model containing more than a million lines of code.”

The Met Office reports that Young is responsible for the organisation’s IT strategy and ensuring that it adapts to support the business strategy.

Its website says that Young worked for IBM but does not make it clear he is still employed by the company while on secondment to the Met Office. It says that before joining the Met Office he “held a number of executive position within the IT industry, working for IBM, CSC and Siemens”.

Young’s Linked In profile says he is CIO at the Met Office and Director, System zStack and Mainframe Platform, Central Eastern Europe, Middle East and Africa at IBM.

In response to an FOI request by Dave Orr, the Met Office has released internal emails relating to Young’s recruitment and later appointment. Young is described in the Met Office’s Register of Interests 2010/11 as an “Executive, IBM UK Ltd (non-active)”.

The email exchanges show that the Met Office was keen and anxious to employ Young. Talks over Young’s recruitment, initially as Chief Technology Officer, began in July last year and took several months to conclude.

In August 2010 John Hirst, Chief Executive at the Met Office, wrote to Young mentioning, among other things, a ban on recruitment.

“It was good to talk to you on the phone this afternoon. This is to confirm that you are interested in joining us at the Met Office and we are interested in offering you a post.

“As we discussed there are issues of the recruitment ban, terms of secondment and security clearances amongst others but we have both declared an intent to try and get something organised between us.”

Also in August 2010 Diana Chaloner, the Met Office’s Director of Human Resources, emailed IBM on the costs and restrictions relating to the “possible secondment of David Young”.

Her email said: “I will need to get confirmation from John Hirst (our CE) before committing to the costs as outlined below. Whilst I don’t see it as a problem, I do also need to seek a way to overcome external secondee restrictions placed on us by central government recently. I will attempt to get this moving as quickly as possible at this end.”

In another email to IBM in August 2010, Chaloner referred again to the costs of seconding Young. She said:

“Following John’s earlier meeting with David (in his garden!) Alan Dickinson [then the Met Office’s Director of Science and Technology] and I met him last week. John has now spoken to David and is keen to try to progress a secondment. I know David is very keen too, but inevitably, with all the various restrictions placed on us, cost may be an issue, as will enabling the secondment contract to be approved.

“Whilst this might be quite challenging , I think there are usually ways to manage these things, so would really like to understand cost and timing…”

The following month, September 2010, Chaloner emailed Hirst on the need for Young’s appointment to be approved.

Her email has in the subject heading: “IBM Confidential: Secondment of David Young to the Met Office”.  Says the email: “At the moment we cannot give a precise date for David to start his secondment. I did mention in an earlier email that there are some added constraints across Government, and one of those is around recruitment and secondments…”

In October 2011 Hirst emailed IBM about a possible delay in appointing Young. “I am sorry this has taken so long and been more complex than anticipated but the rules of engagement have changed at least twice over the last couple of months and therefore keeping things moving forward steadily has been more difficult. I am still confident we can conclude this although I have suggested to David we might need a weeks (sic) delay in starting … the contracts are signed and sitting in my draw awaiting final clearance of the admin hurdles so there is no decrease in my intent to make this happen.”

On 29 November 2011 Chaloner wrote to Hirst saying that Young’s appointment needed the approval of the Secretary of State. “… The situation is looking very positive but we require final approval from Secretary of State. I was told that there seemed no reason for the secondment not to be approved, but it has to go through the appropriate channels. I can only apologise in the delay in David starting, and continue to nudge it from this end, almost on a daily basis.”

Young was appointed by the end of December 2010. The business case for a new Chief Technology Officer (which became a CIO role) says the secondment from IBM would finish on 31 October 2011. It says there is a “need to bring a professional IT expert into the organisation, to reshape the function in order to achieve greater efficiency in delivery of information technology, as well as ensure it is fit for purpose in the future, hence the need, at this time, to manage this as a short term secondment.”

The Job Description, which is headed “Management in Confidence”, says the IBM secondee will “lead the IT function in the effective delivery of 24/7 IT services and enhance our world leading supercomputing and infrastructure capabilities to secure achievement of future corporate objectives.” The main responsibilities will include directing and co-ordinating 300 information technology, programme/project management professionals, and support staff…”

The job also involves overseeing the “selection, acquisition, development and installation of major information systems”. It further includes the need to “determine and manage all outsourced  external IT service provision as appropriate to meet service level agreements.”

Comment:

There is nothing wrong with the Met Office’s decision to hire an IBM secondee except perhaps that it underlines the reliance of the public sector on its major suppliers.

It’s clear that the Met Office has struggled hard to employ David Young because of his expertise. Nobody would understand the Met Office’s IBM systems better than IBM.

But we have seen evidence from the National Audit Office that suppliers all too often understand customer installations in the public sector better than the civil servants know their own systems. In the case of the NPfIT, auditors had to rely on suppliers to explain what they had been paid and why.

It’s time for the civil service to build up its expertise so that it ceases to rely on suppliers that dominate government IT.

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Posted in change management, Government IT, managing change, npfit, public sector, public services, supplier relationships, Uncategorized

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CSC ambivalent on prospects of new NHS IT deal

Posted on 11/08/2011 | 2 comments

By Tony Collins

CSC is not quite as confident as it was on new NPfIT contracts

CSC is meeting UK Government officials next month to discuss the company’s £3bn worth of NHS IT contracts. It follows a review of the NPfIT contracts by the Cabinet Office’s Major Projects Authority.

It’s likely officials will discuss a major revision of CSC’s contracts – and possibly an end to them. The Cabinet Office minister Francis Maude is thought to favour termination but the Health Secretary Andrew Lansley, on the advice of NHS Chief Executive Sir David Nicholson, wants to keep CSC in a revised NPfIT.

Recommendations from the Cabinet Office have gone to David Cameron for a decision.

In a conference call yesterday on the company’s first quarter results CSC’s executives said the outcome of the NHS contracts represented an “elevated” risk factor.  But they said CSC is still on target for signing a new deal.

Mike Laphen, CSC’s Chief Executive, said his company has included in its forecasts about $250m [£155m] of NHS turnover until the end of its financial year in April 2012. Any delay in reaching a new deal in September could affect the $250m forecast said Laphen.

He said: “Right now we are assuming that we are still on target with the MoU [Memorandum of Understanding between CSC and the Department of Health]. We are absolutely staffed up ready to execute. We’ve got the products in the delivery pipeline and we believe we have the demand…”

On its NHS work CSC continues to “execute and deliver against our current commitments across primary and secondary care”. CSC’s iSoft “Lorenzo” remains in production routinely supporting daily operations at three early adopter sites.

“We are progressing delivery modules… including emergency care and outpatient prescribing which are anticipated to be installed at the University Hospitals Morecambe Bay once an agreement is reached with the authority,” said a CSC spokesman.

The company told analysts that for its 2012 financial year “there are still a number of large balls still in the air” which include the NHS contract, integration of iSoft and US government spending. “Our business is sound and we have one of the strongest balance sheets in our industry,” said the company.

UK IT market analysts Techmarketview said CSC’s management team “isn’t quite as confident of a positive outcome [on talks over NHS contracts] as it was a few months ago – and rightly so.”

CSC also noted there had been a “significant shift in the market”  from outsourcing to cloud, though with cloud many companies are still deciding “what they’re going to do, or not do”.

MP contacts No 10 and Cabinet Office on CSC’s NHS IT contracts.

BT slammed over NPfIT value-for-money claim.

Was NPfIT really a programme?

Trust forced to buy NPfIT software or face fine

NPfIT has proved unworkable – BCS

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MP contacts Cabinet Office and No. 10 on future of NPfIT

Posted on 08/08/2011 | 3 comments

By Tony Collins

A Conservative MP has sent detailed suggestions to the Cabinet Office and No.10 on what should happen with the NHS contracts, mainly CSC’s.

Richard Bacon, a member of the Public Accounts Committee, has proved to be an important influence in the Parliamentary debate over the future of the NPfIT. He has now sent to the Cabinet Office and Downing Street a recommendation that CSC’s NPfIT contracts should be cancelled and trusts left to buy systems of choice with a small amount of central subsidy.

His email reveals that NHS Connecting for Health, which is a part of the Department of Health that is responsible for delivering the NPfIT, is rehiring contractors and that the arbitration proceedings between the DH and Fujitsu over the supplier’s £700m legal claim are scheduled to continue until the end of next year. He also says that the DH failed to minute all meetings correctly, which could put the Department at a disadvantage in any legal action against CSC.

It’s possible that Bacon’s suggestions on CSC’s contracts will be considered by David Cameron who may be asked to intervene in any disagreement between the Cabinet Office’s Major Projects Authority and the Department of Health.

The DH’s position is clear. The Health Secretary  Andrew Lansley and the NHS’s Chief Executive Sir David Nicholson are on record as expressing support for continuing CSC’s NHS IT contracts, although in a revised form.

The Cabinet Office’s Major Projects Authority under David Pitchford appears not to share the DH’s equanimity over CSC’s contracts. The recommendations of the Major Projects Authority have now gone to Downing Street.

Into the melting pot will go Bacon’s email to Pitchford, copied to No. 10, which is as follows:

Subject: Dealing with NHS IT’s Local Service Providers

“… As discussed, here are some comments on a possible way forward in dealing with Local Service Providers within the National Programme for IT in the NHS.

The LSP contracts have failed to deliver.  Fujitsu has been terminated.   The CSC contract needs to be terminated.  The BT contract has been renegotiated by reducing its delivery requirement by over 50% in return for a reduction in price of less than 10% (though it’s probably not worth terminating this now).

This would leave half of London acute Trusts, all but 11 Trusts in the South, and all Trusts in the North, Midlands and East outside of the Programme.

The simple answer is to have systems of choice for Trusts with small amounts of central subsidy.  Trusts would select and procure whatever system they wanted.  The NHS would make a contribution of, say, £2 million for every acute Trust purchasing a system within, say, 4 years (total cost for 166 Trusts is £332 million).  In return, the Trusts would allow regular reviews of progress and lessons-learned.  This is what the NHS did with primary care over ten years ago and it resulted in virtually all GP Practices computerising over that period.

GETTING OUT OF THE CONTRACTS

All Local Service Providers clearly failed to do what they promised:

All acute Trusts were to have Patient Administration Systems in place by 2006.

All clinical systems were to have been completed at all Trusts by 2010.

Lorenzo was supposed to ship in 2004.

The interim systems were not supposed to happen at all.

The problem is that in a legal dispute over something this complex, lawyers will be able to claim mitigating circumstances of every type and the NHS is likely to end up paying severance, even when terminating for clear non-delivery.  Problems for the NHS include:

CONTRACTS:  The contracts and deliveries are very complex.  It is easy to drown in the detail –  i.e. we couldn’t deliver ‘x’ because of ‘y’.  One could be arguing for ever.

MANAGEMENT:  CfH managed badly.  Records of Correspondence are poor.  Many meetings were not minuted correctly.  Governance was unclear.

PEOPLE:  Lots of different NHS people and contractors worked on the programme and many have since left.  The NHS made CfH fire the majority of its contractors in April 2010.  CfH has been reduced to writing to ex-employees and contractors and asking them if they will come in for interview.

CHANGE:  The NHS has been in constant change with the introduction of major initiatives such as 18 week wait and the current restructuring.  The LSPs will claim ‘moving targets’.

In truth, the LSPs have been paid a lot and delivered little.  The factors above are convenient mitigation for them, but made no difference to whether or not they delivered.  iSoft (now CSC) is supposed to have delivered Lorenzo in every year for the last decade and even claimed to have done so in annual reports when it was a public company.  However, in 2006 a joint report by CSC and Accenture stated that there was “no believable plan” for delivery and in 2011 we still only have one large acute Trust using it.

The Fujitsu case is in arbitration and this is due to run until the end of 2012.  At the end of that period, the waters will have been so muddied that – although they didn’t deliver – it will be obvious that there were many “mitigating” circumstances and the final compromise will end up with the NHS paying half of what Fujitsu is demanding – say £300 million, plus enormous legal fees.

The same scenario will apply to CSC if the NHS tries to terminate them.  CSC’s defence is very well organised.  Morally, the NHS is completely in the right – i.e. there has not been “delivery” – but no matter how clear cut the moral case, it will not be so clear cut legally speaking; the contracts won’t really help the NHS “win” convincingly because it is so complex.  We shouldn’t spend more than a year and a lot more taxpayers’ money fannying around with this.  It will just end up with arbitration followed by some sort of 50 per cent deal plus £100 million to the lawyers. The only way of avoiding this is getting the right people in a room and applying a big stick.  In my view, the only way to terminate is to use the line from the PAC report  i.e. :

You haven’t delivered.  We know that this is so complex and badly documented that we could end up paying you for that non-delivery.  We want to can the arbitration, and save the legal fees and settle.  We are prepared to pay something.  But be aware that the outcome of this settlement and how you behave will have a direct impact on all other business you do now or in the future with the UK government.

The Cabinet Office’s emphasis on a Whole-of-Relationship-with-the-Crown approach to suppliers is vital here.

Avoid being over a barrel by including as part of the settlement a two or three year contract to CSC for the ongoing maintenance of the interim systems already installed (at Acute Trusts and also the others), so that the NHS does not end up in the position that the South ended up in when Fujitsu was terminated (i.e. paying hundreds of millions to maintain a handful of systems). This will give Trusts the time to make and implement alternative plans.

You could take the same approach in order to can the Fujitsu arbitration.”

Will CSC’s £3bn NHS IT contracts be cancelled?

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Will CSC’s £3bn NHS IT contract be cancelled?

Posted on 08/08/2011 | 2 comments

By Tony Collins

Several people have asked us whether the Cabinet Office’s Major Projects Authority will cancel  CSC’s NPfIT contract or whether draft memorandum of understanding between the Department of Health and the supplier will be finalised and signed.

The position is that a deal with CSC has not yet been agreed – and it’s not clear when it will be. Recommendations from the Cabinet Office’s Major Projects Authority have gone to David Cameron, according to yesterday’s Observer.

We’ve also been asked whether the The Major Projects Authority has any authority over CSC’s NPfIT contracts.

In January Downing Street  gave the Cabinet Office a mandate to “intervene” in projects that are poor value for money, have hit delays or are failing. If there’s a dispute between the Major Projects Authority and a department, the Cabinet Office can ask David Cameron for a decision.  So if the Major Projects Authority wants to cancel the CSC NPfIT contract it can – up to a point.

If the DH doesn’t agree, and it probably wouldn’t, it would be up to Cameron, who would probably back the Cabinet Office’s decision. It would then be the DH that dealt with the consequences.

The Major Projects Authority is under a clear-thinking Australian David Pitchford who is understands what goes wrong with big IT projects and why. He reports to Ian Watmore who also has a good understanding.

These are some of the reasons Pitchford gives for failing government IT-based projects:

1.Political pressure
2. No business case
3. No agreed budget
4. 80% of projects launched before 1,2 & 3 have been resolved
5. Sole solution approach
6. No timescale
7. No defined benefits

Most of these apply to the NPfIT.

One view about what should happen is that at least the part of the CSC contract that relates to acute hospitals should be cancelled, and the NHS should be under no further contractual obligation to buy from CSC – that was always an artificial device. CSC should be under no further obligation to deliver to the NHS.

CSC’s obligation has been a means of Whitehall, through CSC, maintaining some control over trusts and justifying a large central team. End that obligation and you don’t need a large central team. Last week’s Public Accounts Committee report on the NPfIT detailed care records systems said that NHS CfH has 1,300 people.

Whatever happens CSC will maintain a strong  presence in the NHS, at least through its purchase of iSoft. Many trusts with iSoft systems are likely to replace them with iSoft – CSC – products. Patient administration systems are huge investments and changing them can be risky.

EC procurement rules mean that trusts will need to go open tender when their existing contracts expire but some will find ways of awarding new contracts to existing suppliers, if that’s their wish.

So CSC’s future in the NHS is assured, whatever happens with its NPfIT contracts.

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Fujitsu denies Whitehall claim over NHS IT work

Posted on 03/08/2011 | Leave a comment

By Tony Collins

The Department of Health has suggested in a memo to MPs that Fujitsu, after having its NPfIT contract terminated, sought to improve its financial position by doubling service charges and threatening to turn off systems if it was not paid.

Fujitsu has denied the accusations, describing them as “wholly untrue”. It says that “as a trusted supplier of services to many Government departments Fujitsu would never countenance adopting such a position”.

The Department of Health’s claim was in the context of its legal action with Fujitsu after the supplier’s NPfIT contract was terminated in 2008.

In a memo published today in a report of the Public Accounts Committee on the NPfIT detailed care records systems, the DH responds to a question by MP Richard Bacon on what the maximum costs would be if contracts with the two remaining local service providers CSC and BT were to be cancelled.

The DH sets out some of the possible costs including those associated with providing ongoing services after the contract is terminated. Says the DH memo:

“It is likely that suppliers will seek to increase these ongoing costs in an attempt to improve their financial position (Fujitsu, for example, doubled the service charges claiming they would turn the systems off unless we paid).”

But the DH provides no evidence of its claim, and the Committee in its report today casts doubt on the credibility of some DH statements related to the NPfIT.

In a statement Fujitsu said:

“If the suggestion is that that Fujitsu threatened to  turn off its systems unless the Department of Health agreed to a doubling of charges that is wholly untrue. As a trusted supplier of services to many Government departments Fujitsu would never countenance adopting such a position.

“After Fujitsu’s contract terminated Fujitsu continued to provide significant services ( Care Records and PACS / RIS) to a large number of Trusts whilst a replacement temporary contract was negotiated.

“The temporary contract was required to cover the period up to transfer of the services to alternative suppliers. Fujitsu supported this activity for six weeks after termination at its own risk, without a contract and any security of payment.

“Had Fujitsu not done so this the risks to the NHS would have been significant. Far from taking advantage, Fujitsu acted very responsibly and properly in safeguarding the ongoing provision of services to end users.

“Fujitsu’s charges for continuing to provide services were based upon the charging principles set out in it original contract. This was confirmed by the Department’s own audit.”

DH puts case against cancelling NPfIT contracts

BT slammed over NHS value for money claim.

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DH puts case against cancelling NPfIT contracts

Posted on 03/08/2011 | 2 comments

By Tony Collins

The Department of Health has put a detailed case to MPs for not cancelling £4bn worth of NPfIT contracts with local service providers CSC and BT.

Among the points the DH makes is that “the NHS cannot continue without replacing the systems now covered by these contracts” – which refers to the NPfIT contracts with BT and CSC.

The DH also says that CSC and BT “have been clear that they are not willing simply to talk away”. Legal advice to the DH is of a “significant” risk that BT and CSC may, if their contracts are ended, work with Fujitsu in a unified legal action against the Department. Fujitsu and the DH are in a protracted legal dispute after the Department terminated Fujitsu’s NPfIT contract in 2008.

The Department’s memo to the Public Accounts Committee is published today in the PAC’s report entitled “The  National Programme for IT in the NHS: an update on the delivery of detailed care records systems”.

The report is highly critical of all the main parties to the NPfIT including:

– CSC which the report says has delivered only 10 of 166 of its ‘Lorenzo’ systems in the North, Midland and East. The PAC report calls on the Government to give “serious consideration to whether CSC has proved itself fit to tender for other Government work”.

– BT, the other main supplier to the NPfIT, which has “proved unable to deliver against its original contract”, says the report.

– Sir David Nicholson, the Chief Executive of the NHS who is senior responsible owner of the NPfIT, who is criticised by name. It’s rare for the committee’s MPs to personalise their criticism. It says there has been “weak programme management”  and adds: “We are concerned that, given his significant other responsibilities, David Nicholson has not fully discharged his responsibilities as the Senior Responsible Owner for this project. This has resulted in poor accountability for project performance…”

– The Department of Health and NHS Connecting for Health which cannot be trusted to give reliable or complete information on the NPfIT, even to government auditors.  The report says: “Basic information provided by the Department to the National Audit Office was late, inconsistent and contradictory… This occurred despite the fact that Connecting for Health, the NHS organisation responsible for managing the Programme nationally, has 1,300 staff and has spent £820m on central programme management.”

– The Department of Health over its poor ability to re-negotiate contracts with BT and CSC. The report says that the Department ended up “clearly overpaying BT to implement systems …BT is paid £9m to implement [RiO] systems at each NHS site, even though the same systems have been purchased for under £2m by NHS organisations outside the Programme.”  This “casts the Department’s negotiating capability in a very poor light”. The report adds: “We are worried that the Department will fare no better in its current negotiations with CSC …”

– The Department of Health for leaving NHS trusts in a mist of uncertainties. Trusts with NPfIT systems will not know the costs of supporting them after the BT and CSC contracts expire in 2014/15. It’s also uncertain how individual trusts will manage CSC and BT NPfIT contracts when the supplier agreements are held by the Secretary of State for Health.

– The Department of Health for leaving CSC in a controlling position to supply trusts with upgraded interim iSoft systems that were not part of the original contract. Says the PAC report: “It is important that CSC, particularly given its proposed purchase of iSoft, does not acquire an effective monopoly in the provision of care records systems in the North, Eastern and Midland clusters.

“This could result in the Lorenzo system effectively being dropped as the system of choice and many Trusts being left with little choice but to continue with out-dated interim systems that could be very expensive to maintain and to upgrade, or to accept a system of CSC’s choice.

“CSC should not be given minimum quantity guarantees or a licence to sell a product other than that procured and selected by the Programme within the Local Service Provider contract.”

But in its memo to the Committee the Department is unrepentant. Indeed the self-justifying detail and tone of the DH memos, which include selective, apparently corroborating quotations from a KPMG consultancy report that the Department has never published, suggest that, while the NPfIT has changed, the zeal with which DH officials defend the scheme, whatever its problems, has changed little since the programme was announced in 2002.

The DH’s case for not cancelling the contracts with CSC and BT was prompted by a written question from Richard Bacon, a Conservative MP and long-standing member of the Public Accounts Committee who has taken a close interest in the NPfIT.

Bacon asked:

What are the maximum payments to which NPFIT would be exposed for contract cancellation of the detailed care records systems, for each of the LSP providers [CSC and BT]?

The DH said that if the contracts were cancelled for convenience the maximum payments could be [DH italics] in excess of the currently anticipated costs to complete the BT and CSC contracts. If the DH were to cancel contracts for acute hospitals only, the maximum payments may reduce by 50%, said the DH.

The DH adds:

“These costs do not include the deployment or operational costs of any new systems that the NHS would need to procure. The NHS cannot continue without replacing the systems now covered by these contracts.”

Cancellation costs 

Cancellation costs could involve, said the DH:

– Contractual costs: The minimum amount the supplier is allowed to receive under the contract.

– Damages This would include covering some of the suppliers’ unrecovered costs to date and pre-accrued claims at the point of termination

– The costs of providing the ongoing services after termination. It is likely that suppliers will seek to increase these ongoing costs in an attempt to improve their financial position. The Department claims that Fujitsu increased its service charges and claimed it would turn systems off if outstanding sums were not paid.

– Costs of replacing systems, plus support and development of live services.

– Legal and professional fees for terminating, transferring work and investigating the facts around termination.

But the DH makes no mention that the Department would have a strong negotiating position if contracts were terminated because any dispute could cause the Cabinet Office to lose confidence in that supplier, which may affect the ability of the company to win further government work.

Would any major supplier want to fall out with government as a whole, rather than just one department?

Coalition changes mean that government considers itself as a single customer when reviewing the reputation and credibility of individual suppliers.

MPs don’t trust the DH’s information

Many of the points made by the DH in 15 pages of memos appear to have been largely discounted by the committee, partly because MPs did not trust what the Department said.

Comment

The Department of Health has a history of quoting selectively from consultancy and legal reports to support the argument it is making.  This is what tabloids do at times. Indeed the DH  never publishes the consultancy and legal reports it quotes from, so should we trust its arguments that point to keeping the NPfIT contracts with CSC and BT?

There may be good arguments for cancelling the contracts that have not, and are unlikely to be, mentioned by the DH.

Some benefits of cancelling NPfIT contracts

Cancelling could end the uncertainties for trusts that would otherwise be pressured to take NPfIT systems. It could also end the uncertainties for trusts that have yet to buy NPfIT systems and may face punishing costs to keep them running, and in step  with changes within the NHS, after the contracts with BT and CSC expire in 2014-2015.

If Campaign4Change were advising the coalition we would suggest it commission a genuinely independent review of the pros and cons of cancelling the NPfIT contracts.  The review  should not be commissioned by the DH or Connecting for Health because their lawyers and consultants will tend to tell the department what they think it  wants to hear.

One of the messages that comes loud and clear from today’s report of the Public Accounts Committee is that the DH cannot be trusted to make the right decisions on behalf of taxpayers and the NHS. The DH cannot even be trusted to tell the truth to judge from the PAC report.

The Cabinet Office needs to take control of major DH IT spending. Perhaps the sooner the better.

Public Accounts Committee report on NPfIT detailed care records systems.

NHS must consider scrapping NPfIT – MPs.

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MPs to report on £11bn NHS IT scheme on Wednesday

Posted on 31/07/2011 | 1 comment

The House of Commons’ Public Accounts Committee will publish a report on the NHS’s National Programme for IT detailed care records systems on Wedneday 3 August.

The report is likely to be critical of Sir David Nicholson, the Senior Responsible Owner of the NPfIT who told the committee’s MPs that 80% of the total programme has been delivered.

MPs believe that the programme has been a failure, with poor value for money for the systems delivered so far, which have cost about £6bn.

Sir David Nicholson has been overall senior responsible owner of the NPfIT since 2006. He was not responsible for initiating the programme, which happened under the Blair government in 2002, but he accepted responsibility for making the NPfIT a success. He turned down a call by academics for an independent review of the NPfIT.

Detailed care records systems are only part of the NPfIT – but they were the main reason for the programme’s introduction. Staff at the National Audit Office, which has investigated aspects of the NPfIT three times, say they are not convinced that the national programme is under control.

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Excerpts from report on GovIT: Recipe for rip-offs – time for a new approach

Posted on 28/07/2011 | 3 comments

By Tony Collins

Today’s comprehensive report on the government’s use of IT is replete with strong and important messages, particularly on the domination of government IT by a small number of large suppliers, so-called systems integrators.

That said, Techmarketview, which tracks developments in the IT supplier market, has today attacked the report of the Public Administration Select Committee.  Techmarketview’s analyst Georgina O’Toole concedes she has not looked carefully at the full report but says she is irritated by the summary’s sensationalism.

It may be worth remembering that Parliamentary committees compete with each other for media attention. A bland report will be pointless: it won’t be read. Today’s report of the PASC, though, seeks more often than not to give the balacing view whenever it says something tendentious.  

For ease of explanation the Committee’s report “Recipe for rip-offs – time for a new approach” refers to government as if it were a single entity.

But government is, to some extent, at war with itself. The Cabinet Office is trying to have more influence over departments, in encouraging them to use SMEs,  adopt agile methods, simplify working practices and cut costs; and while the Cabinet Office has a mandate from David Cameron to enforce its wishes, in practice departments are giving strong reasons for not acting:

-long-term contracts are already in force

– EC procurement rules mean that SMEs cannot be preferred over other suppliers

– SMEs give insufficient financial assurances and could go bust at any time

– there are not enough internal staff and skills to manage a plethora of smaller companies

– existing (large) suppliers employ hundreds of SME as subcontractors.

There’s a particularly telling passage in the PASC report. It gave details of an exchange between the Department of Work and Pensions and Erudine, an SME. The Committee was given details of the exchange during a private session.

Erudine had given the department a way of migrating a legacy system onto a more modern, cheaper platform, which could generate potential savings of around £4m a year.

A senior DWP IT official rejected the proposal and suggested that the department was maintaining an interest in SMEs for political reasons – the government’s wish for 25% of contracts to be given to SMEs. This was part of what the DWP official said to Erudine:

“.. we have as you know an ‘interest’ in having SMEs present and working in the department for good political reasons. So you have other value to us … purely political.

“You guys need to be realistic. I will be very candid with you […] it is a huge amount of bother to deal with smaller organisations. Huge. And we wouldn’t necessarily do that because it doesn’t make our lives simpler.”

The Department declined to comment on the exchange and said the views expressed did not represent its own. It told the Committee that in 2009/10 SMEs made up 29.3% of their supplier base, either as a prime contractor or a subcontractor.

The Committee welcomed this assurance from the Department but added:

“… this account does suggest that attitudes at official level risk undermining ministers’ ambitions to increase the number of SMEs Government contracts with directly”.

These are other extracts from the PASC report:

Overcharging by large suppliers – an obscene waste of public money?

They [SMEs] also alleged that a lack of benchmarking data enabled large systems integrators (SIs) to charge between seven  to ten  times more than their standard commercial costs.

**

Having described the situation as an “oligopoly” it is clear the Government is not happy with the current arrangements. Whether or not this constitutes a cartel in legal terms, it has led to the perverse situation in which the governments have wasted an obscene amount of public money.

The Government should urgently commission an independent, external investigation to determine whether there is substance to these serious allegations of anti-competitive behaviour and collusion. The Government should also provide a trusted and independent escalation route to enable SMEs confidentially to raise allegations of malpractice.

Vested interests suppress innovation?

We received suggestions from some SMEs that the major systems integrators used legacy systems as leverage to maintain their dominance. Some SMEs reported that there were solutions that could easily transfer data from old platforms, but that a combination of risk aversion and vested interests prevented these solutions being adopted

Large IT contractors are “not performing well”

The Government’s analysis has shown that its large IT contractors are not performing well. A Cabinet Office review in September 2010 of the performance of the 14 largest IT suppliers found that none of them were performing to a “good” or “excellent” level, with average performance being a middling “satisfactory with some strengths”. Some were performing significantly worse.

Openness would help to cut costs

Making detailed information on IT expenditure publicly available for scrutiny would enhance the Government’s ability to generate savings, by allowing external challenge of its spending decisions.

The Government has already taken steps to provide more information about IT projects and expenditure in general, especially through the work of the Transparency Board and its publication of contracts on Contract Finder. To realise the full benefits of transparency, this is not sufficient. More information should be made public by default.

It should publish as much information as possible about how it runs its IT to enable effective benchmarking and to allow external experts to suggest different and more economical and effective ways of running its systems

Will government objectives be achieved?

We received numerous reports from SMEs about poor treatment by both Government departments and large companies who sub-contract government work to SMEs. There is a strong suspicion that the Government will be diverted from its stated policy and that its objective will not be achieved.

The drawbacks of using SMEs as subcontractors to large suppliers

“… subcontracting could lead to the Government paying a high price as it had to cover the margin of both the sub and prime contractor.

**

SMEs approached us informally to express concerns based on their own experiences of subcontracting. We heard of cases where systems integrators [large IT suppliers] had involved SMEs in the bidding process so they could demonstrate innovation, only for the SME to be dropped after award of contract.

In some of these cases SMEs felt that they have provided innovative ideas which had then been exploited by the larger systems integrators. We were also told by SMEs that by subcontracting with an SI they were barred from approaching government directly with ideas that might allow it to radically transform its services and reduce costs. This was because systems integrators did not want the Government to be provided with ideas that could result in them losing business, or having to reduce costs.

“… When we put these [SME] concerns to the Government we were told that their contracting arrangements did not stop subcontractors speaking directly to Departments…However, during our private seminar with SMEs, we were told that this did not reflect their experiences. SMEs reported that they were instructed to approach the systems integrator first in order to obtain permission to talk to a Department and that some Departments refused to deal with them directly.

**

We take seriously the concerns expressed by many SMEs that by speaking openly to the Government about innovative ideas they risk losing future business particularly if they are already in a sub-contracting relationship with a systems integator.

Government should deal directly with SMEs

The Government should reiterate its willingness to speak to SMEs directly, and commit to meeting SMEs in private where this is requested. We recommend that the Government establish a permanent mechanism that enables SMEs to bring innovative ideas directly to government in confidence, thereby minimising the risk of losing business with prime contractors.

Is government policy shutting out SMEs even more?

“…the Government has been moving to act as a single buyer to obtain economies of scale… This approach can be counter-productive. The effect of demand aggregation can be to aggregate supply, further concentrating contracts in the hands of a few large systems integrators.

Departments are following instructions from the Cabinet Office Efficiency and Reform Group to switch away from their existing direct SME contracting arrangements in favour of centralised procurement models. This would mean that SMEs would become tier 2 suppliers behind selected large suppliers, preventing SMEs from contracting directly with departments. The Cabinet Office has confirmed that:

Spend is being channelled into three current channels: a) existing framework contracts where spot buying is undertaken centrally (this is known as Home Office Cix), b) department-specific arrangements based on their unique needs (such as FCO’s arrangements with Hays) and c) an existing contract with Capita, owned and managed by DWP and available to all government departments.

It is unclear to us how narrowing the supply channels will create a more open and competitive market. The nature of this supply-side aggregation of SMEs under large contracts appears to be in direct contradiction of the policy articulated by the Minister when he indicated his desire to encourage Departments to secure more direct contracting with SMEs.

“… the Government’s plan to act as a single buyer appears to be leading to a consolidation towards a few large suppliers. This could act against its intention to reduce the size of contracts and increase the number of SMEs that it contracts with directly. We are particularly concerned with plans to move SME suppliers to an “arm’s length” relationship with Government. The Government needs to explain how it will reconcile its intentions to act as a single buyer, secure value for money and reduce contract size to create more opportunities for SMEs.

Procurement barriers for SMEs

The way procurement currently operates favours large companies that can afford to commit the staff and resources to navigate the convoluted processes. It also encourages the Government to confine discussions to as few potential contractors as possible.

If the Government is serious about increasing the amount of work it awards to SMEs it must simplify the existing processes

**

We recommend that the Government investigate the practices which seem unintentionally to disadvantage SMEs. When contracts and pre-qualifying questions are drawn up thought must be given to what impact they could have on the eligibility and ability of SMEs to apply for work, and whether separate provision should be made for SMEs. We believe it would be preferable if the default procurement and contractual approach were designed for SMEs, with more detailed and bespoke negotiation being required only for more complex and large scale procurements.

Have Departments the people and skills to handle more SMEs?

Increasing the use of SMEs will place extra pressure on departments. The management of smaller organisations is currently outsourced to the large systems integrators.

For example the Aspire framework provides HMRC with access to over 200 IT suppliers. Mr Pavitt, HMRC Chief Information Officer said that:

“managing those individually would be quite a heavy bandwidth for a Government department”.

It is not clear that Departments are willing to take on the additional work that contracting directly with SMEs implies even where this could yield significant savings…

Ministers need to ensure their officials have the skills, capacity and above all the willingness to deliver on ministerial commitments to SMEs.

On agile methods:

“… greater use of agile development is likely to necessitate behaviour changes within Government. As agile methodology requires increased participation from the business to provide feedback on different iterations of the solution, departments will need to release their staff, particularly senior staff with overall responsibility of the project, to allow them to participate in these exercises.

Agile development is a powerful tool to enhance the effectiveness and improve the outcomes of Government change programmes. We welcome the Government’s enthusiasm and willingness to experiment with this method. The Government should be careful not to dismiss the very real barriers in the existing system that could prevent the wider use of agile development.

We therefore invite the Government to outline in its response how it will adapt its existing programme model to enable agile development to work as envisaged and how new flagship programmes will utilise improved approaches to help ensure their successful delivery….

The Government will have to bear in mind the need to facilitate agile development as it renegotiates the EU procurement directive and revises the associated guidance.

Need for more people with the right skills to manage suppliers

Managing suppliers is as important as deciding who to contract with in the first place. To be able to perform both of these functions government needs the capacity to act as an intelligent customer. This involves having a small group within government with the skills to both procure and manage a contract in partnership with its suppliers.

Currently the Government seems unable to strike the right balance between allowing contractors enough freedom to operate and ensuring there are appropriate controls and monitoring in-house.

The Government needs to develop the skills necessary to fill this gap. This should involve recruiting more IT professionals with experience of the SME sector to help deliver the objective of greater SME involvement.

When disaster strikes is anyone responsible?

We are concerned that despite the catalogue of costly project failures rarely does anyone – suppliers, officials or ministers – seem to be held to account. It is therefore important that, when SROs do move on they should remain accountable for those decisions taken on their watch, and that Ministers should be held accountable when this does not happen.

Open source and open standards

Recent initiatives such as the Skunkworks team, dotgovlabs, data.gov.uk, and the Alphagov project suggest that the Government is moving in this direction

Government should omit references to proprietary products and formats in procurement notices, stipulating business requirements based on open standards. The Government should also ensure that new projects, programmes and contracts, and where possible existing projects and contracts, mandate open public data and open interfaces to access such data by default..

Report’s conclusion

“… The last 10 years have seen several failed attempts at reform. The current Government seems determined to succeed where others have failed and we are greatly encouraged by its progress to date.

“Numerous challenges remain and fundamentally transforming how Government uses IT will require departments to engage more directly with innovative firms, to integrate technology into policy-making and reform how they develop their systems.

“The fundamental requirement is that Government needs the right skills, knowledge and capacity in-house to deliver these changes. Without the ability to engage with IT suppliers as an intelligent customer – able to secure the most efficient deal and benchmark its costs – and to understand the role technology can play in the delivery of public services, Government is doomed to repeat the mistakes of the past.”

Links:

Jerry Fishenden, adviser to the PASC, gives his view of the report.

Today’s Public Administration Committee report: Recipe for rip-offs – time for a new approach

Government reliance on large IT suppliers is recipe for rip-offs.

Government IT rip-offs – surely time for a new approach – my view of the report

Techmarketview on the report

Good analysis of PASC report – Centre for Technology Policy Research.

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MP responds to our campaign on £265m extra spend on Siemens passport IT contract

Posted on 27/07/2011 | 1 comment

By Tony Collins

Richard Bacon, a Conservative MP on the Public Accounts Committee, has written to the head of the National Audit Office to ask that he consider an inquiry into £265m of extra payments to Siemens on a passport IT contract.

It comes after the Home Office declined to explain why a contract with Siemens that was expected to cost £80m to £100m ended up costing £265m.

On Monday this week Home Office spokesman Andrew Bell politely declined to answer any of Campaign4Change’s questions on the Siemens contract.

As a result we forwarded to Bacon emails of our questions to the Home Office and its answers.    

Now Bacon has written to Amyas Morse, head of the National Audit Office, drawing his attention to our email exchange with the Home Office.

Says Bacon in his note to Morse:

“I wondered if the NAO might consider looking at the Siemens contract for the IT infrastructure for the passport service?  The Home Office appears to see relatively little need to justify the fact that an £80-100 million contract with Siemens actually cost £365 million.”

Bacon also pointed out to Morse that CSC has replaced Siemens on the passport IT contract. CSC is a main supplier on the NHS National Programme for IT, NPfIT.  In a report due to be published shortly by the Public Accounts Committee, CSC’s work on the NPfIT is likely to be heavily criticised.

Unless the NAO investigates the passport contracts Parliament will have no certain way of knowing whether the CSC passport IT contract, like the Siemens deal, is deviating from the original expected costs, scope or timetable.

Officials are keeping Gateway reviews secret – though these could give MPs an insight into progress of the CSC passport contract.  

My questions to the Home Office, and its reply, are here.

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