By David Bicknell
What’s on the ‘must-tackle’ list of the next NHS CIO to replace Christine Connelly? Good piece from Kathleen Hall today in Computer Weekly discussing five key challenges that must be faced.
Third Sector has taken a look at the fortunes of the current mutual Pathfinders and concludes that they have been suffering mixed fortunes.
Plans for lecturers to take over Newton Rigg College in Cumbria were hit when the college was taken over by another institution. And a project to spin out youth services in three London councils has been held up because the councils – Westminster, Hammersmith and Fulham and Kensington and Chelsea – are currently negotiating to merge many of their services as a result of the financial squeeze on local authorities.
Many mutuals, though, are making good progress, and some have already been launched successfully, Third Sector says. However, although the government has created a lot of buzz around mutuals, the piece argues that mutuals need more frameworks and support mechanisms in place.
That particularly includes a framework for council workers to take over services, which will be partly solved when a ‘right to challenge’ is enshrined in the Localism Bill towards the end of this year. However, many observers feel the right as it currently stands is not strong enough.
Third sector has also interviewed Julian Le Grand, who is leading the government’s Mutuals Taskforce. He suggests there are five key issues that the taskforce must help mutuals tackle:
The Cabinet Office’s Katie Davis, who takes over next month, on an interim basis, from Health CIO Christine Connelly, is ex-Accenture.
But that shouldn’t be held against her. Accenture left the NPfIT in 2006 with its reputation untarnished.
A profile of Davis appeared in The Telegraph in 2007. The newspaper described her as a yank at the court of King Tony, set on excellence in IT.
Though it could be assumed that Davis has a “big company” approach, and so would welcome the continued dominance of the NPfIT, she told The Telegraph she found her time at Accenture highly satisfying but after a while she stopped having fun.
“The overheads of working for a huge corporation had slightly impaired my ability to deliver. By overheads, I mean travel and the demands of process. My needs and those of the corporation did not overlap so well.”
She also said she worked in the NHS.
“I had worked with the NHS before, and was seconded to work with some of the cleverest and most committed people I’d ever been in a working environment with. It opened my eyes to the challenges and the excitement of working in the public sector.”
Davis has the advantage of having started her career as an engineer (electrical). Which makes it sound as if she’s more practical and realistic than visionary and idealistic. She may make an excellent (permanent) Health CIO.
By Tony Collins
The departure of Christine Connelly as health CIO at the end of this month will leave the NPfIT’s main civil service supporter, Sir David Nicholson, Chief Executive of the NHS and Senior Responsible Owner of the NHS IT scheme, more isolated.
That Nicholson is a supporter of the continuance of the NPfIT is not in doubt. He spoke about the NHS IT scheme last month in terms of life and death. At a hearing of the public accounts committee on 23 May 2011, Nicholson said:
“We spent about 20% of that resource [the £11.4bn projected total spend on the NPfIT] on the acute sector. The other 80% is providing services that literally mean life and death to patients today, and have done for the last period.
“So the Spine, and all those things, provides really, really important services for our patients. If you are going to talk about the totality of the [NPfIT] system … you have to accept that 80% of that programme has been delivered.”
But without Christine Connelly, who put detailed arguments in favour of continuing with iSoft’s Lorenzo, and who was solidly behind the costly implementations of Cerner by BT, Nicholson may not have the civil service backup he needs to promote the continuance of the NPfIT.
The Cabinet Office’s Major Projects Authority, under the directorship of the independently-minded David Pitchford, is now reviewing CSC’s £2.9bn worth of NPfIT contracts. It is known that the Authority regards the new proposals worked out between CSC and the Department of Health as poor value for money, even with CSC’s willingness to reduce the value of its contracts by £764m, to about £2.1bn.
That promised reduction comes at a cost. A leaked Cabinet office memo said that the CSC’s proposals would double the cost of each Lorenzo deployment.
The easiest thing for Nicholson and the Department of Health would be for the Major Projects Authority to approve the deal worked out between CSC and the Department of Health, and simply sign a new Memorandum of Understanding which would be, in part, legally binding.
Strong grounds for ending CSC’s NPfIT contracts
The more difficult but more practical alternative is for the Cabinet Office to require the Department of Health to end CSC’s NPfIT contracts, which would leave the NHS more able to decide its own IT-based future.
Indeed the signs are in some trusts that officials are not unhappy about Connelly’s departure in that they perceive it may weaken the centre’s control over NHS IT.
Legally it appears that an end to CSC’s contract would be feasible. The Department of Health has accused CSC of a breach of contract because of its failure to achieve a key milestone; the Department has also notified CSC of “various alleged events of default under the contract” which are “related to delays and other alleged operational issues”. The Department is considering its position on termination of all or parts of the contract.
But the Department has not taken its claims to arbitration; its allegations are only a formal legal manoeuvre at the moment.
CSC accuses NHS of failures and breaches of contract
CSC has reacted by accusing the NHS of a breach of contract. The company’s formal legal position is that it has cured or is preparing to cure the faults that led to the alleged breach; it says that failures and breaches of contract on the part of NHS have caused delays and issues.
The DH could end CSC’s contract for reasons of convenience which could trigger a request from CSC for a large sum in compensation. But the Department could give strong legal reasons for not paying. Although CSC could pursue its claim for compensation, it may be on soft ground because of its failures. Also, CSC, if it pursues any legal action, could jeopardise its other work for government: some of its other major contracts with the UK government are with the Identity and Passport Service, which is part of the Home Office.
The Coalition is now supervising its major suppliers, including CSC, in the round, which is reason enough for CSC to do all it can to maintain a good relationship with the Cabinet Office.
CSC would support NHS trusts even if its contracts ended
The Department of Health is concerned that if it ends the NPfIT contracts with CSC, the supplier may leave unsupported many trusts that have CSC’s iSoft software installed. That is highly unlikely, however, because CSC has a $1.03bn investment in the NPfIT contracts according to the regulatory reports to US authorities.
In the NHS CSC has a large customer base. Through its acquisition of iSoft, CSC will want to capitalise on its investment in iSoft’s Lorenzo software by selling it across the globe. That’s its stated plan. So CSC’s continued support for NHS trusts that have installed iSoft software is not in doubt.
What NHS Trusts want
The best outcome of the negotiations with CSC, for NHS trusts that have installed iSoft software, is that they have the:
-choice to continue with CSC if the price is right
– buy support elsewhere, or
– choose a different product.
Will CSC’s NPfIT contracts end by mutual agreement? – it’s possible
The question is: does the Cabinet Office have the courage to end CSC’s contract, freeing up billions of pounds that would otherwise have been spent on the NPfIT without a commensurate return for taxpayers, the NHS or patients?
It seems so, even if it means paying a relatively painless sum to CSC as compensation for termination.
Leaked memo reveals CSC’s plans.
A sign that coalition reforms will change behaviour of major suppliers.
Health CIO resigns – Cabinet Office executive steps in.
Example of a trust that’s succeeding without the NPfIT – Trafford General Hospital.
Posted in NHS, npfit, outsourcing, public sector, public services, supplier relationships, Uncategorized
Tagged BT Health, Cabinet Office, Cerner, CSC, Efficiency and Reform Group, Francis Maude, Lorenzo, NHS Connecting for Health, npfit, outsourcing, procurement, public sector, public services, SME government contracts
The Health CIO Christine Connelly has resigned. I understand it’s for personal reasons and that she has no new job lined up.
She is being replaced on an interim basis by an executive at the Cabinet Office Katie Davis. It’s likely that Davis will remain Director, Operational Excellence at the Cabinet Office until she replaces Connelly on 1 July 2011.
Connelly says in her statement that the Department of Health faces a major reorganisation of its top structures that will result in fewer Director General posts. “I have been reflecting on whether I would wish to go for one of those roles and decided that I will not.”
The Cabinet Office has indicated in recent months that it wishes to have more control over negotiations of a £3bn contract with CSC under the National Programme for IT, NPfIT.
This was the Department’s statement this morning, in full:
“Christine Connelly, Chief Information Officer for Health, has announced that she will be leaving the Department of Health at the end of the month.
“Christine said: “The Department of Health faces a major reorganisation of its top structures that will result in fewer Director General posts. I have been reflecting on whether I would wish to go for one of those roles and decided that I will not.
“I have had a fascinating and challenging time in this role and I have decided that this is the right time to step back and think about what I might do next.
“I believe that information and technology have the potential to dramatically change the way health services are delivered to patients, and we are already seeing this happen in many parts of the service. I am confident that informatics will have a major role to play in delivering both the quality and efficiency challenge that the NHS faces.”
NHS Chief Executive, Sir David Nicholson, said:
“Christine has made a major contribution to the NHS, in promoting both the sharing and management of information, and as a professional with considerable experience of leading change.
“She has tackled a very difficult set of issues around the National Programme for IT, and moved them forward. I wish her well in her future career.”
By Tony Collins
A report published yesterday by the National Audit Office is an example of how the organisation has changed since it appointed Amyas Morse as Comptroller and Auditor General in June 2009.
The NAO scrutinises public spending and its auditors value their reputation for independence from the civil service.
But past NAO reports were sometimes deferential: the impression given at times was of clubby civil servants auditing other clubby civil servants. What needed to be said went unsaid, or was said indistinctly. That doesn’t seem to happen now.
Indeed, in a departure from convention, Amyas Morse and his colleagues put well-aimed questions to civil servants at hearings of the Public Accounts Committee.
In the past NAO representatives would say little at hearings of the Public Accounts Committee except, perhaps, to side with civil servants whom MPs were questioning.
Morse’s report published yesterday on the Equality and Human Rights Commission, which is part of the Home Office, is an example of straightforward reporting, with none of the circumlocution and coded language of the past.
In the report Morse went further than any NAO findings I remember: he questioned whether staff at the Equality and Human Rights Commission are competent enough to manage public funds properly.
He said the Commission is now better able to handle public money than when it was set up in 2007 but “deep-seated” problems remain. The NAO qualified the Commission’s 2009/10 accounts because of a variety of irregular payments and an unauthorised write-off of £874,000 on a failed website.
Said Morse: “In general the Commission continues to be over-reliant on interim staff. Four out of the seven members of the Senior Management Team and eight of the 19 Directors are interim appointments, including the Finance and IT Directors. Other key staff in Corporate Services, such as the Head of Procurement and the Finance Project Manager, are also interim appointments.
“I am concerned that once these interim staff depart, there is a risk that the improvements in controls that they have delivered will lapse…
“I remain concerned, too, about the culture of the Commission with regard to financial and administrative controls. It is clear that there is little general financial understanding or competence in the organisation, and that many managers have limited experience of the effective management of public money.”
Questions about how fit the Commission’s staff are to manage public money are likely to be asked at a hearing of the Public Accounts Committee on the NAO’s report.
Long may the NAO’s new pernicketiness and assiduous search for clarity and truth continue.
**
Posted in Uncategorized
By David Bicknell
The longer the waiting goes on for the open public services white paper to provide some clear direction on the Coalition’s up-to-date thinking, the more the mystique around mutuals grows.
Local Government Chronicle has just carried a blog by Chris Brophy, a partner at the Capsticks health and social care law firm, which discussed the potential of mutuals and social enterprises.
Brophy makes some good – and certainly descriptive – points, suggesting for now that “there is a certain ‘quiet before the storm feeling’. You can sense the sea being sucked back, the birds have gone quiet, the sky is red-stained, there is no breeze, as those interested in new business methodologies wait anxiously to hear whether there is a panacea for financial, staffing and service problems.
“Breathing becomes more steady as anxiety is anaesthetised by contemplating the difference between mutuals on the one hand and social enterprises on the other and then you can start settling down to really understanding what is going on, and settle down you must as you realise you really need to understand this beast before heading back to base and being enveloped by the day to day issues.”
He goes on to make some excellent points about the challenges facing local authorities:
‘One of the difficulties for local authorities developing social enterprises is the time, funding and resources needed to just to consider change, never mind working up business plans including engaging with staff and thinking about the identification and transfer of significant businesses. Despite the difficulties all Councils have, everyone knows this process needs to be commenced, and now, as deadlines start to loom more large and the need to stay in control of the process becomes the main line on the forehead.
‘In many ways Local Authorities have it more difficult than PCTs. At least PCTs knew essentially what services they were looking to transfer as part of the Department of Health’s “Transforming Community Services programme and pursuant to their Right to Request” to take their provider services. The scope of the businesses for the LAs to think about is potentially very extensive and there is also the question of how to package businesses together.
‘Should all the businesses in contemplation be transferred to one social enterprise or would those businesses not work together and need to be packaged in different ways. They might for example have very different kinds of beneficiaries or users of the service and the stakeholders may be very different and therefore it might be more difficult to align the governance of the organisation with the business objectives if they were all combined. However scale is important and of course funding and income is crucial. It serves no useful purpose to set up a business which has no viable business plan. Whatever happens you need to identify the services, the assets, the staff and the support that will be involved and at the same time you will looking to satisfy yourself about the potential management team, its capabilities and skill-sets and then developing the business plan to see if it can all work.
A useful and informative piece. You can read the whole post here
Posted in mutualisation, mutuals, NHS, Uncategorized
Tagged local authorities, mutuals, PCTs, social enterprises
By David Bicknell
A wire story in the Independent discussing a report on public services in the Sunday Times yesterday suggests the long-awaited ‘open public services’ white paper will be circulated to ministers this week ahead of full publication next month.
As well as discussing mutualisation, the paper is likely to echo the recent NHS reforms listening exercise and will offer far greater compass for employee ownership and individual empowerment.
Downing Street has confirmed that it intends to publish the White Paper before the Parliamentary recess at the end of July.
“It is expected to come before the summer recess. It will look at how we take forward reform across the public services,” a No 10 spokesman said.
Posted in Uncategorized
By David Bicknell
I came across an interesting piece regarding the savings Marks & Spencer (M&S) says it is making from its sustainable development initiative, Plan A.
According to this article, initiatives such as being more energy efficient in stores and distribution centres saved £13.5 million last year. It also saved £2 million by using less fuel, £1 million by recycling or reusing clothes hangers, and £11 million on reducing the amount of packaging it uses.
M&S’ total carbon emissions have been reduced by 13%, down by over 90,000 tonnes CO2e from 2006/07 whilst its sales floor footage has continued to grow.
There is a useful story here
You can read more from M&S itself on Plan A progress here
Another familiar name that is reporting on its sustainability initiatives is Ford. It released its annual sustianability report last week, with the highlights being:
* Carbon dioxide emissions for the 2010 model year have been reduced by 10.5 percent for U.S. products and 8.1 percent for European vehicles, when compared with the 2006 model year
* From an operational standpoint, Ford managed a 5.6 percent reduction in carbon dioxide emissions between 2010 and 2009.
* Ford has set a new goal for facility’s related carbon dioxide emissions: A reduction of 30 percent by 2025 on a per-vehicle basis.
One of its key concerns is around water usage, as this report from Smart Planet makes clear.
You can read Ford’s sustainability report here. There is much detail in a well laid out report, though at first sight, not a lot of references to any notable Green IT or technology developments beyond Ford’s core car business.
Posted in Climate Change, greentech, sustainability
Tagged Ford, M&S, profitability, Sustainability, sustainability reports, water
By Tony Collins
David Pitchford Executive Director of Major Projects Authority at the Cabinet Office, told MPs this week of the need for departments to boost skills in drawing up and managing contracts.
Unable to offer salary incentives to recruit the best people, and restricted in the hiring of consultants departments may need to “get innovative about it”, said Pitchford.
This could mean asking suppliers for help in managing supplier contracts.
Pitchford is the antithesis of the circumlocutory, prevaricating and procrastinating Sir Humphrey. He was being questioned by Conservative MP Richard Bacon at a hearing of the Public Accounts Committee on PFI and other projects.
The Major Projects Authority is looking, among other things, at CSC’s £3.1bn contracts on the National Programme for IT in the NHS.
Bacon said he hoped that Pitchford would be able to do more than spread best practice which the Office of Government Commerce “has been doing for the last 10 years and it hasn’t got us very far”.
Pitchford replied that the “environment here is pretty fraught”. He said:
“We cannot buy in people through salary boost. You can’t hire consultants under the operational construct we have at the moment. We have to get innovative about it.
“We need to have a genuine commercial exchange with suppliers that we engage with in procurement to … provide people to come in and help us…”
He said the public sector needs additional commercial and particularly contract management capability.
“This is fundamental. One of the critical failings, in general, in projects, in projects across the civil service, is a lack of contract capability – to draw up a contract and then manage it.”
He said that government should end up as the “best advantaged party”. Departments needed a better commercial understanding when putting a deal together.
“We are also looking to get much more participation from the civil service at the higher level in review of projects, by going to places we have never gone before: that is to seek out at director general level, and director level, within departments, those people who have got specific capabilities.
“We have also looked at – and this is a new area as well – trading functions in the public sector where there are people that are 100% commercially oriented.”
Pitchford says he hopes to have a pilot signed off next week which will allow 12 people to “come in and start to educate operational capability”.
“My focus is on the projects that are high risk, high value. The skills we are talking about here are applicable particularly at the outset of projects.”
Public Accounts Committee hearing where Pitchford gave evidence this week.
Any idea how many projects we have and how much they’ll cost?
Posted in Uncategorized
Campaign4Change 