How CIOs and IT suppliers view GovIT change

By Tony Collins

CIOs and IT suppliers give their views on Government ICT in an authoritative report published today by the Institute for Government

Inside the wrapper of generally positive words, a report published today on government ICT by the Institute for Government suggests that major change is unlikely to happen, despite the best efforts of  CIOs and the Cabinet Office minister Francis Maude.

The report “System upgrade? The first year of the Government’s ICT strategy”  says progress has been made. But its messages suggest that reforms are unlikely to  amount to more than tweaks.

These are some of the key messages in the report:

If the minister and CIOs cannot direct change who can?

–          “… while the Minister for the Cabinet Office and government CIO are viewed as being responsible for delivering the ICT strategy (for example by the Public Accounts Committee) they currently lack the full authority to direct change.”

Not so agile

–           “While just over half of government departments may be running an agile project, there were concerns that these were often very minor projects running on the fringe of the departments.”

–          “We heard concerns from the supplier community and those inside government that in some areas projects may be being labelled as ‘agile’ without having really changed the way in which they were run.”

–          “CIOs should question whether they are genuinely improving the ways that they are working in areas such as agile, or whether they are just attaching a label to projects to get a tick in the box,” says the Institute for Government.

Savings not real?

–          “There was also an element of challenge to the savings figures provided by government. For example, some from government and the supplier community questioned whether the numbers represented genuine savings or just cuts in the services provided or deferred expenditure. “

–          “Others … cautioned that project scope creep or change requests could reduce actual savings in time. It was pointed out that the NAO [National Audit Office] will scrutinise whether savings have been achieved in future, which was seen as a clear incentive for accuracy – but there were, nonetheless, concerns that pressure to provide large savings figures meant that inadequate attention might be paid to verifying the savings …”

CIOs want faster ICT progress

–          “Among the CIOs we interviewed, there was a clear recognition that government ICT needed to improve.  ‘You expect an Amazon experience from a government department…’ ”

Lack of money good for change

–          “As one ICT lead noted, a lack of money was ‘always helpful’ in driving change as it promoted cross-government solution-sharing and led to more rigour in approving new spend.”

–          “Both ICT leaders and suppliers felt that the ICT moratorium had been a helpful stimulus for increased focus on value for money.”

–          “Though some of the larger suppliers felt bruised by the ‘smash and grab’ of initial interactions with the Coalition government, there was a recognition that the moratorium had been about ‘stopping things which were inappropriate’”.

GDS challenges norms

–          “New ways of working in the new Government Digital Service and the opening up of government through the Transparency agenda were also seen as providing a challenge to existing norms.”

–          The new Government Digital Service (GDS) is providing an example of a new way of doing things, and was pointed to by those inside and outside of government as embodying mould-breaking attitudes, using innovative techniques and … delivering results on very short timescales. Several interviews mentioned being invigorated by the positive approach of the GDS and their focus on delivering services to meet end-user needs.

ICT so poor staff circumvent it

–          “Public servants are increasingly frustrated that the ICT they use in their private lives appears to be far more advanced than the tools available to them at work. Indeed, there are already examples of employees circumventing the ICT that government provides them as they attempt to perform their job more effectively: creating what is known as a system of ‘shadow ICT’ that creates significant challenges for maintaining government security, collaborative working and government knowledge management.”

Joined-up Govt impossible?

–          “The possibility that departmental incentives continue to trump corporate contributions is further suggested by our survey results. Individuals do not yet feel that corporate contributions are valued or rewarded … elements of the [ICT] strategy call for departments to give up an element of autonomy and choice for the ‘greater good’. Several CIOs expressed concerns that by adopting elements of the strategy that were being developed or delivered by another department, they would end up having to accept a service that had been designed  around the needs of a different department.”

–          “Similarly, there were concerns that the host department would be at the top priority in the event of any problems or opportunities to develop services further. This speaks to a strongly department-centric culture. Suppliers noted, for example, that certain parts of government were still happy to ‘pay a premium for their autonomy’.”

–          “… the vast majority of those we spoke to suggested that departmental interests would almost always ultimately trump cross-government interests in the current government culture and context.”

–          “CIOs felt that they would be rewarded for delivery of departmental priorities – not pan-government work …”

CIO Council frustrations

“CIOs noted that there could be a discrepancy between what got agreed at the old CIO Council meetings and what people actually went away and did. Larger department CIOs also expressed frustration that – despite holding the largest budgets and carrying the largest delivery risks – their voices could easily be outweighed by the multitude of other people round the table.”

“The delivery board model [which has superseded CIO Council] has been recognised by both big and small departments as pragmatically dealing with both sides of this issue. Larger departments now form part of an inner-leadership circle, but with this recognition of their clout comes additional responsibility to own and drive through parts of the strategy… the challenge will now be to ensure that the ICT strategy doesn’t become a ‘large department-only’ affair and that other ICT leads can be effectively engaged.”

Canny suppliers?

–          The majority of ICT leads …stated that they believed the ICT strategy would benefit their department and government as a whole. This confidence was less apparent in the attitudes of suppliers who were, on the whole, more sceptical of government’s ability to drive change, though again generally supportive of the direction of travel.

A toothless ICT Strategy is of little value?

–          “…There was also a lack of clarity on how different elements of the [ICT] strategy would be enforced. As one ICT leader commented … ‘Is this a mandatable strategy or a reference document?’ ”

–          … “there are risks that the strategy could be delivered in a way that still doesn’t transform ICT performance.”

Francis Maude an asset

–          “Government ICT has also been a priority of the Minister for the Cabinet Office, Francis Maude – giving the [change] agenda unprecedented ministerial impetus. He has been a visible face of ICT to many inside and outside of government, from demanding departmental data on ICT to being heavily involved in negotiations with ICT suppliers. Though few of his ministerial colleagues appear as passionate about improving government ICT, the CIOs we interviewed overwhelmingly expressed confidence that they would receive the support they needed to implement the changes in ICT.”

Smaller-budget CIOs out of the loop?

–          “With the CIO Council in hiatus for most of the last year, the CIOs of smaller departments felt out of the loop …”

Most ICT spending is outside SW1

–          “Suppliers and other ICT leaders pointed out, rightly, that the vast majority of ICT expenditure happens outside SW1 – with agencies, local government and organisations like primary care trusts and police forces still determining much of the citizen and workforce experience of ICT.”

SMEs still left out?

–          “Smaller suppliers … were generally encouraged that government was trying to use more contractual vehicles which would be open to them – but noted that it was ‘still extremely difficult to get close to government as an SME’.”

Who knows if use of ICT is improving?

–          “Government still lacks the information it needs to judge whether use of ICT across government is improving.”

System upgrade? The first year of the Government’s ICT Strategy.

Too early to claim success on GovIT – Institute for Government

Is internal audit a waste of money?

By Tony Collins

Today’s National Audit Office report “The effectiveness of internal audit in central government” raises questions about whether the £70m cost of internal auditors is a pointless expense.

Internal auditors are supposed to be the “eyes and ears” in the organisation to highlight what is going wrong.  But their reports are kept secret – so why should civil servants take any notice of them, and what incentive do the internal auditors have to blow the whistle on failing schemes if they are going to be ignored?

The NAO suggests that internal audit has not been helpful in providing early warning of IT-repeated disasters such as Firecontrol. But it does not recommend that internal audit reports are published. Neither does yesterday’s Civil Service Reform Plan.

The NAO says

“Our value-for-money studies, such as the procurement of Type 45 destroyers and the development of new fire and rescue regional control centres, have identified many instances where there has been poor value for money because core systems have not provided sufficiently realistic, robust or comprehensive information to allow effective oversight and decision-making.

“In many cases these weaknesses have not been identified by internal audit.”

The NAO concludes in today’s report that the £70m spent annually on internal audit is “poor value for money”. Internal audit in central government employs 1,000 people says the NAO.

The effectiveness of internal audit in central government – today’s NAO report

Gateway reports on major projects to remain secret?

By Tony Collins

Comment

The civil service reform plan, which was published yesterday, is disappointing. It is so consensual that it has nothing particularly punchy to offer. It reads like the report of a tennis club match in which the finalists were such good friends that neither wanted to win; and each surrendered alternate points until those watching drifted into the bar.

The reform plan has been approved by senior civil servants and even former Labour ministers. In the House of Commons yesterday Labour’s spokesmen reacted with indifference and unions too have said little.

One reason, perhaps, is that the plan is full of good intentions that promise further documents and consultations that are full of good intentions. In short there’s nothing for potential opponents to worry about.

On improving the delivery of major projects, the reform plan is vague to the point of being self-mocking. It proposes:

– Requiring greater testing and scrutiny of major projects by departmental boards and the [Cabinet Office’s] Major Projects Authority before they move to full implementation;

– Regular publication of project progress and the production of an annual report on progress, scrutinised by the Departmental Board;

–  Commencing training of all leaders of major projects through the Major Projects Leadership Academy by the end of 2014; and

– Significantly reducing the turnover of Senior Responsible Officers.

The phrase “significantly reducing” means nothing in practice; and does the promise of “regular publication of project progress reports” mean anything in practice, other than, perhaps, the publication of press releases on project progress written by the PR departments of HMRC, the DWP and the MoJ?.

Cabinet Office minister Francis Maude could have confronted permanent secretaries with an important policy change that required the civil service to publish independent Gateway review reports on the progress or otherwise of major IT and construction projects. Perhaps Maude has not done so because he wanted consensus. But he has probably ended up with a reform plan that nobody believes in and to which nobody objects.

The Cabinet Office’s Major Projects Authority will do its best to stop IT-related project failures but it has limited control and civil service secrecy working against it. The reform plan changes none of this.

Doubtless the disasters will continue.

Civil Service Reform Plan

Useful critique of Civil Service Reform Plan by Institute for Government.

Civil service reforms not dramatic but mean real change says Maude

By Tony Collins

Cabinet Office minister Francis Maude announced the publication this afternoon of the civil service reform plan which he said contains “nothing dramatic but when implemented will represent “real change”.

He told MPs there will be a cross-government management information system put in place by October which enable departments to be held account. He did not say how. He said that management information in central government is “poor”. Some other points in Maude’s speech in the House of Commons:

– A smaller civil service than at any time since World War Two – but he did not says whether outsourced civil servants were included in his figures.

– There would be no more than eight management layers in the civil service and fewer where possible.

– Shared services should be the norm.

– A “key goal” will be to give civil servants the IT they need to do their jobs properly.

– Former accounting officers can be called back to give evidence to the Public Accounts Committee.

– The Cabinet Office will consult the Civil Service Commission on how ministers can be more involved in the appointment of permament secretaries. Maude told MPs that secretaries of state should have the final say on appointments, after the involvement of the Commission.

– Ministers can appoint senior officials for time-limted executive roles.

– More civil servants need more financial knowledge. There are “serious deficiencies in managing change” said Maude.

– There are “serious gaps” in project management capability. Officials will seek to identify what skills are missing.

– Civil servants do not believe their managers are not strong enough in leading and managing change. Policy skills have been rated as more important than operational skills. In future some permanent secretaries will need at least two years experience in a commercial and operational role. There will be an equal balance in future between senior officials with skills in policy advice and those with operational experience.

– Poor performance will be “rigorously addressed”. There will be a civil service appraisal system in which the bottom 10% will have to prove they should stay in their jobs.

– Permanent secretaries wll have their objectives published.

– Information on the performance of major projects will be unprecedented.

Maude said the reform plan is a first stage and part of a policy of continuous improvement.

Edward Leigh, former chairman of the Public Accounts Committee said it was time that permanent secretaries were chosen for their implementation and operational abilities rather than their ability to write a memo in Latin.

Civil service reform plan.

Civil service reform plan – real change or a tweak?

By Tony Collins

The civil service reform plan is to be published this afternoon, at 3.30pm.  The Cabinet Office minister  Francis Maude and Sir Bob Kerslake, the head of the civil service, write about it in today’s Daily Telegraph.

They say that the plan will help deliver a civil service culture that is “pacier, more innovative, less hierarchical and focused on outcomes not process”. They write:

“We also need sharper accountability, in particular from permanent secretaries and those leading major projects, and we need more digital services, better data and management information and for policy and implementation to be linked seamlessly together…”

In the same edition of the Telegraph Andrew Haldenby,  director of the independent think tank Reform, criticises the reform plan which, although not yet published, has been foretold in newspapers including the Financial Times yesterday.

He said the reform plan will “leave the flawed structures of Whitehall in place and do no more than propose some minor variations on a theme”.

We await publication of the paper before we judge it. We hope it will, at least, require the publication of “Gateway” review reports on the progress or otherwise of major IT-enabled projects.

Without timely publication of the Major Projects Authority’s Gateway reports, MPs and the public will continue to learn of failed schemes such as the NPfIT and Firecontrol when it is too late to do much about any rescue; and without contemporaneous publication there will continue to be no accountability for the rigour or otherwise of the reviews, or their outcome.

Civil service reform – meltdown or business as usual? – Institute for Government

Cabinet Office promises unprecedented openness on big, risky projects.

Civil service shake-up – Guardian

All change again for management of state IT projects in Florida

It is all change again when it comes to the management of IT and IT projects within one US state government.

According to this report, the state of Florida is preparing to do without a standalone agency that deals with technology, with the eventual demise of the Agency for Enterprise Information Technology (AEIT), a 16-person unit that helped set standards for technology purchasing and information security under the supervision of Florida’s governor and cabinet.

The Florida Legislature has passeda bill,  HB 5011, which would have replaced AEIT with an Office of State Technology (though quite how that would differ is unclear).  The Florida Governor, Rick Scott, vetoed the bill, and although the agency still exists, it will have no funding when the new fiscal year starts in July.

Many of its employees, including former state Chief Information Officer David Taylor, have already begun moving to other agencies, the report says.

As usual, the state of IT projects has come under fire with one politician, Denise Grimsley, arguing that studying some of the state’s technology initiatives – including an attempt to switch most of state government to a single e-mail system – led her to conclude that AEIT “in its current state was ill-suited to provide the statewide vision and oversight needed for certain enterprise information technology projects.”

Plus ca change.

Cabinet Office promises unprecedented openness on risky projects

By Tony Collins

The Cabinet Office has defended its decision not to publish “Gateway” review reports on the progress or otherwise of large and risky IT and construction projects.

Gateway reviews are regular, short and independent audits on the state of medium and high-risk projects. Their publication would allow  MPs and the public to have an early warning of a major project in trouble – rather than know of a project failure only after it has happened.

Campaigners have sought for a decade to have the review reports published; and the  Information Commissioner, in requiring the publishing of ID Card gateway reviews under FOI,  dismissed the generalised arguments put forward by officials for Gateway reviews to remain confidential.

The Conservatives, when in opposition, promised to publish Gateway review reports if they came to power. But departmental heads and senior officials have stopped this happening.

Now the Cabinet Office, in a statement to The Guardian, has suggested that the first annual report of the Major Projects Authority will more than compensate for the non-publication of Gateway review reports.

The statement says that the Authority’s ( delayed)  first annual report will “bring unprecedented scrutiny and transparency to our most expensive and highest risk programmes, changing forever the culture of secrecy that has allowed failure to be swept under the carpet”.

The statement continues:

“Historically, fewer than a third of government major projects have delivered to original estimates of time, cost and quality. Since April 2011 the Major Projects Authority has enforced a tough new assurance regime and begun raising leadership standards within the Civil Service.”

The Guardian asked the Cabinet Office whether the traffic light red/amber/green status of Gateway reviews will be published.  The spokesman replied:

“The annual report will contain details of the status of major projects.“

Comment:

We applaud the Major Projects Authority in scrutinising, and in rare cases helping to stop,  departmental projects that don’t have adequate business cases. The Authority’s work is vital in pre-empting ridiculous schemes such as the NPfIT.

But project  disasters that rely on  IT continue, at the Ministry of Justice for example.  Like the National Audit Office, the  Major Projects Authority has limited resources and cannot scrutinise everything. Even if it could, the system of government is not set up in such a way as to allow the Authority to have final say over whether a project is stopped, curbed or re-negotiated.

Preventing failure

Gateway review reports are a critical component in preventing IT-related project failures. If officials know the whistle is going to be authoritatively blown on their failing schemes they are likely to do all they can to avoid failure in the first place. If they know that nobody will be aware of doomed schemes until those involved have left or moved, they will have less incentive to make projects a success.

An annual report is no substitute for the contemporaneous publishing of Gateway review reports. Each Gateway review is several pages and puts into context the traffic light red/amber/green status of the project. An annual report will not contain every Gateway review report. If just the traffic light status is published that will be a start, but without the context of the report what will it mean?

[And it’s worth bearing in mind that the first annual report of the Major Projects Authority is already six months late.]

The non-publication of Gateway review reports is  a victory by senior officials over ministerial promises.  How can we believe that the coalition is committed to unprecedented openness when the final say remains with Sir Humphrey?

Cabinet Office promises to challenge culture of secrecy on IT projects.

Whitehall to relent on secrecy over mega projects?

Francis Maude talks open govt – and Whitehall does the opposite

By Tony Collins

“If people do not know what you’re doing, they don’t know what you’re doing wrong.” – Sir Arnold Robinson, Cabinet Secretary in a discussion on open government in Yes Minister.

Francis Maude, the Cabinet Office minister, said all the right things at the Intellect World Class Public Services conference 2012.

He said that:

– smaller, innovative and efficient suppliers were finding themselves locked out of the supply of services to Government because of what was described by Parliament as a powerful “oligopoly” of large suppliers

– for the first time in Government “we are using agile, iterative processes, open source technology platforms and world-class in-house development teams alongside the best digital innovation the market can offer”

– “We must eliminate failure waste. At the moment, a large proportion of our service delivery costs are incurred through incomplete or failed digital transactions. And these transactions create cross-channel duplication, which burdens the user and costs Government a huge amount in repeated costs. For HMRC alone, they estimate that 35% of calls to its contact centres are avoidable, which would save £75m.”

– “Transparency is a defining passion for this Government …”

Comment:

How much influence does Maude really have? Can he persuade permanent secretaries to effect major change? The evidence so far is that departmental officials and Maude have different ideas on what reform means.

In “Yes Minister” civil servants were proud of a new hospital that was the best run and most hygienic in the country, with no medical staff, 500 administrators and no patients.

Maude may also recall that Antony Jay and Jonathan Lynn, the acclaimed writers of Yes Minister, spoke of the Whitehall law of inverse relevance – “the less you intend to do about something, the more you have to keep talking about it”.

Open government? 

Perhaps civil servants are letting Maude get on with talking the talk while they find every way to keep things much as they are. A good example: The Guardian reported yesterday that a key part of the Government’s transparency drive has stalled amid reports of ministry opposition.

The paper’s political editor Patrick Wintour reported that plans to publish regular ‘traffic-light’ progress reports on large, costly and risky IT projects “appear to have been shelved”.

When it comes to IT this could have been the coalition’s most important single reform. It would have given MPs and the public a way of knowing when mega projects such as Universal Credit are failing. Usually we don’t know about a failed IT-related project unless there is a leak to the media, or the National Audit Office finds out and decides, with its limited budget, to do a study.

Sir Bob Kerslake, who is head of the civil service,  had indicated to MP Richard Bacon that “Gateway” review reports on large and risky IT and construction projects may be published in the civil service reform plan which is expected to be released this month.

Gateway reports to go unpublished?

Now it seems that departmental civil servants  have persuaded the Sir Bob not to publish “Gateway” reports. So the secrecy over the progress or otherwise of government mega projects is set to continue.

Yes, civil servants will allow the Cabinet Office to have its way on the publication of data about, say, some government spending. But it’s becoming clear that the civil service will not allow any publication of its reports on the progress or otherwise of major projects. It has been that way since Gateway reviews were introduced in 2001.

Some senior officials – by no means all – say they want a confidential “safe space” to discuss the progress of projects. The reality is that they do not want outsiders – MPs, the media and NAO auditors – meddling in their failing schemes – schemes such as Firecontrol and e-filing at the Ministry of Justice.

Unlike Maude, senior civil servants have what Jay and Lynn call a “flexible approach to open government”. This means in practice that Whitehall will happily release data – but not project reports on which the civil servants themselves can be judged.

Activity is not achievement

Maude’s speeches will give the impression of activity. But activity is the civil service’s substitute for achievement. I quote Jay and Lynn again, in part because their depiction of Whitehall seems to have been taken as serious wisdom by those officials who think Sir Humphrey a character worth living up to.

It’s time Maude and his team got a grip on departments. Until they do, permanent secretaries and their senior officials will regard Maude as trying to get out of situations that don’t need getting out of.

Whitehall to relent on secrecy over mega projects?

The empty hospital – Yes Minister

Government’s transparency drive stalls.

HMRC loses an important voice on its board

By Tony Collins

Steve Lamey, who is leaving HM Revenue and Customs as Director General, Benefits and Credits, has worked tirelessly to improve the organisation’s systems and administration; and he has gained a reputation for listening to IT suppliers.

In 2007 he  won a British Software Satisfaction award for his work in promoting collaboration within the business software industry. He joined HMRC in October 2004 as CIO.

He is perceived to be leaving at a time when there are a number of vacancies at the top of HMRC. Accountancylive reported last month there was an “exodus”of senior officials from HMRC, and morale is said to be low.  But a man as influential as Lamey can do only so much.  Anyone who wants to effect major change at  HMRC must move an iceberg with a rowing boat. That said there have been some HMRC IT-related successes.

Was Lamey an unexploded force at HMRC?

But it’s conceivable that Lamey could have achieved more if he had carried on the way he started: by highlighting the need for change.

He unwittingly made a name for himself in 2005 after a speech he gave to a Government IT conference in which he revealed some of the corporate weaknesses of HMRC, an the organisation he had  joined not long before.

He  probably had not expected  his comments to be reported first in Computer Weekly and then on the front page of the Daily Telegraph.

At that time Lamey was HMRC’s new CIO. He told delegates of some of his discoveries, namely that:

– At least 31 million wrongly addressed letters were being sent out.

– Nearly half of self-assessment tax forms were being incorrectly processed and had to be done again.

–  he had been struck by the out-of-date computer systems. He told the conference: “If I were an information technology historian I would love it. We need to move on from there.”

– his  “biggest, biggest, biggest challenge” was correcting “poor quality data”.

Later a Daily Telegraph article, quoted me as saying “Mr Lamey’s frank assessment of the state of the tax department’s processes and systems is a rare and fresh approach for a senior government official.”

But was Lamey muzzled?

After that article it seems that Lamey was effectively muzzled, at least from making disclosures in public about HMRC’s flaws. Board papers at the time indicated that senior civil servants at HMRC would, in future, have to clear their public speeches in advance. Lamey did not make a similar speech in public again, not to my knowledge at least.

Richard Bacon MP, a member of the Public Accounts Committee, spoke at the time of the apparent attempts by HMRC to silence Lamey.

“It was refreshing to have a senior IT specialist, who is familiar with the business issues, and who is prepared to identify clearly what the scale of the problems is. Unless you’ve got that degree of frankness and candour, I don’t think you’re really going to solve the underlying problems. The alternative is to be in denial, to suggest that the problems don’t exist. It is plain that they do.”

The then Shadow Treasury minister Baroness Noakes, who was formerly a partner at KPMG, said she was concerned that it was already hard for parliament to discover how well HMRC was managing its business.

She said HMRC was “apparently silencing people from telling the truth”. She added “Speaking the truth [in the public sector] in the way you do in the private sector may well not be as acceptable.”

Would Lamey have been even more influential if he had continued – in public – to point to the weaknesses HMRC needed to tackle?

So defensive is HMRC that it considered a positive PR campaign to highlight its strengths after the loss of two CDs which contained the details of 25 million people.

Can an organisation that intuitively discounts and suppresses the negatives while trumpeting the positives ever properly reform itself? Probably not. If you cannot accept you have problems you cannot resolve them. We wonder how HMRC is getting on with its part of the Universal Credit project … its officials say all is well.

Attempts to constrain HMRC directors.

Front page Telegraph article with references to Steve Lamey’s speech

HMRC honcho poached.

Time for truth on Universal Credit

Hungry re-seller bags Steve Lamey.

Whistleblower punished?

How London IT director saves millions by buying patient record system.

By Tony Collins

An NHS organisation in London has bought an electronic patient record system for less than a third of the cost of similar technology that is being supplied by BT to other trusts in the capital and the south of England.

The £7.1m purchase by Whittington Health – a trust that incorporates Whittington Hospital near Archway tube station – raises further questions about why the Department of Health is paying BT between £31m and £36m for each installation of the Cerner Millennium electronic patient record [EPR] system under the NPfIT.

Whittington Health is buying the Medway EPR system from System C which is owned by McKesson. The plan is for the EPR to operate across GP, hospital and social care boundaries.

It will include a patient portal. The idea is that patients will use the portal to log on to their Whittington Health accounts, see and save test results and letters, and manage outpatient appointments on-line.

In a board paper, Whittington Health’s IT Director Glenn Winteringham puts the case for spending £7.1m on a single integrated EPR.  Winteringham puts the average cost of  System C’s Medway at £8m. This cost, he says, represents “significant value for money” against the average deployment costs for the NHS Connecting for Health solution (Cerner Millennium) for London of £31m. In the south of England the average cost of Cerner Millennium is £36m, says Winteringham in his paper.

He also points out that the new EPR will avoid costs for using “Rio” community systems. The NPfIT contract with BT for Rio runs out mid 2015. “From this date onwards the Trust will incur an annual maintenance and support cost. Implementing the EPR will enable cost avoidance to the [organisation] of £4m per year to use RIO (indicative quotes from BT are £2m instance of RIO and the [organisation] has 2 – Islington and Haringey).

BT’s quote to Whittington for Rio is several times higher than the cost of Rio when supplied directly by its supplier CSE Healthcare Systems. A CSE competitor Maracis has said that, during a debrief, it was told that its prices were similar to those offered by CSE Healthcare for a Rio deployment – then less than £600,000 for installation and five years of support.

In comparison BT’s quote to Whittington for Rio, as supplied under the NPfIT, puts the cost of the system at more than fifteen times the cost of buying Rio directly.

In short Whittington and Winteringham will save taxpayers many millions by buying Medway rather than acquiring Cerner and Rio from BT.

Why such a price difference?

The difference between the £31m and £36m paid to BT for Cerner Millennium and the £8m on average paid to System C could be partly explained by the fact that Whittington (and University Hospitals Bristol) bought directly from the supplier, not through an NPfIT local service provider contract between the Department of Health and BT. Under the NPfIT contract BT is, in essence, an intermediary.

But why should an EPR system cost several times more under the NHS IT scheme than bought outside it?

Comment:

Did officials who agreed to payments to BT for Cerner and Rio mistakenly add some digits?

Whittington’s purchase of System C’s Medway again raises the question – which has gone unanswered despite the best efforts of dogged MP Richard Bacon – of why the Department of Health has intervened in the NHS to pay prices for Rio and Cerner that caricature profligacy.

Perhaps the DH should give BT £8m for each installation of Cerner Millennium and donate the remaining £21m to a charity of BT’s choice. The voluntary sector would gain hundreds of millions of pounds and the DH could at last be praised for spending its IT money wisely.

Whittington buys Medway and scraps Rio – E-Health Insider

NHS IT supplier “corrects” Health CIO’s statements

MP seeks inquiry into BT’s £546m NHS deal

NPfIT go-live at Bristol – trust issues apology