Tag Archives: npfit

NPfIT – criminal incompetence says The Times

Posted on 05/10/2011 | 2 comments

By Tony Collins

In an editorial not everyone would have seen, The Times said the history of the NPfIT was “one of criminal incompetence and irresponsibility”.

The main leader in The Times on 23 September had the headline “Connecting to Nowhere”.

It said:

“The comically misnamed Connecting for Health will continue to honour its contracts with big companies and to swallow taxpayers’ money for some time to come: up to £11bn on current estimates. The figure demonstrates the truly egregious scale of the previous Government’s incompetence on this issue: this vast sum seems to have been committed irrevocably, even though the project has never achieved its objectives.

“The story is a dismal catalogue of naivity, ambition and spinelessness. NHS managers and officials …were [not] brave enough to question the direction of travel at crucial moments when IBM and Lockheed pulled out of the project early on. Whitehall was sold a grand vision by consultants, software and technology companies charging grandiose fees. It signed contracts that appear to have been impossible to break when the promised land did not appear. Yet no one seems responsible. No one has been sacked. Most of the officials involved have long moved on…

“There have been spectacular failures in the private sector too. But businesses, with tighter controls on spending, tend to halt things earlier if they are going wrong. Many prefer off-the-shelf systems such as SAP or Oracle, which are tried and tested. They know that it is cheaper to adapt their processes, not the software.

“This newspaper is in favour of serious investment in technology, which could play an important part in economic growth. The NHS debacle has done enormous damage to this country’s reputation for expertise in IT systems. The lessons for the future are clear. Governments must hire people who can make informed and responsible procurement decisions. Patients, in every way, are going to end up paying the price.”

A separate article in The Times 0f 23 September included comments by Campaign4Change whose spokesman said that if the Department of Health continues to spend money on NPfIT suppliers it will probably get poor value for money.

Comment:

Compare the remarks in The Times with those of David Nicholson, Chief Executive of the NHS and Senior Responsible Owner of the NPfIT who refused to agree to a request by 23 academics to have an independent review of the scheme. Nicholson could not contain his enthusiasm for the NPfIT when he told the Public Accounts Committee on 23 May 2011:

 “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.”

It’s difficult to accept Nicholson’s figures. But even if we do, we’d have to say that the 20% that hasn’t been delivered was the main reason for the NPfIT: a national electronic health record which hasn’t materialised and isn’t likely to in the near future.

The contrasting comments of The Times and Nicholson’s are a reminder that the civil service hierarchy at the Department of Health operates in a world of its own, unanswerable to anyone, not even the Cabinet Office or Downing Street.

Can the Department of Health be trusted to oversee health informatics when it has such close relationships with major IT companies and consultants? While Katie Davis is in charge of health informatics there is at least an independent voice at the DH. But as an interim head of IT how long will she last? The DH has a history of not being keen on independent voices.

Nicholson: still positive after all these years.

NPfIT goes PfffT.

Beyond NPfIT.

Surge in tenders for non-NPfIT systems.

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Investors’ writ against CSC on NHS contracts – more detail

Posted on 03/10/2011 | 5 comments

By Tony Collins

The Guardian has published the 123-page writ against CSC by lawyers acting behalf of some of the supplier’s investors. The writ contains many allegations against CSC and named directors. The company’s response is that it is corporate policy not to discuss litigation.

The legal action appears to have been based, in part, on CSC’s poor share price, which is today near a five-year low, and the supplier’s repeated positive statements and assurances on the performance of its NHS IT contracts and its iSoft Lorenzo software

These are some of the claims made in the document:

– Lorenzo was originally designed by iSoft as a one-size-fits-all software for use in local medical practices. “However, the UK healthcare system is highly diverse, ranging from large university hospitals to small private medical practices to prison medical facilities. Thus, according to the Deputy Head of Testing for Lorenzo, Lorenzo was never the correct software for the job. Lorenzo therefore required significant development before it could be deployed throughout the UK’s healthcare system.”

– In September 2008, after years of delays in Lorenzo’s development [CSC] sent a Delivery Assurance Review Team to England to assess the development and testing of Lorenzo. In mid-September, the Testing Review Team met with the Deputy Head of Testing for Lorenzo, a CSC employee from December 2007 until April 2011. The Deputy Head of Testing told the Testing Review Team that the level of testing and test results for Lorenzo was “abysmal,” and that the various releases on which the project was based could not be delivered on time. Subsequently [a CSC employee] told the Deputy Head of Testing to “shut up,” which he took to mean that he should not further criticise the quality of the testing nor the testing results.

– The Deputy Head of Testing claimed that the Lorenzo software was rife with severe defects that were unacceptable under the NHS Contract. The Deputy Head of Testing said that the software defects were subject to the following ratings: Severity Level I: the defect cause important part of the Lorenzo system to fail. Severity Level II: similar to Severity I, but the defect has a workaround. Severity Level III: the defect is an important defect, but one that would not stop the system from functioning. Severity Level IV: defect is a minor defect and would not impact the Lorenzo system’s function, but would be a nuisance to a software user.

– According to the Deputy Head of Testing, throughout 2008 and 2009, the level of Severity I and II defects in every release of Lorenzo was “high and grossly beyond” what the NHS would accept. According to the Deputy Head of Testing, while CSC publicly reported that it had met certain delivery milestones and therefore could recognize revenue, CSC’s statements in this respect were misleading in view of the software defects detailed above.

– CSC said in November 12, 2008, when analysts asked about missed deadlines, that “Our confidence continues to build on the program. We are pleased with our progress.”

–  In financial statements CSC continued to assert that the NHS contract was profitable and the Company expected to recover its investment.

– Shortly before the Deputy Head of Testing retired from CSC in early April 2011, he sent an email directly to a CSC director, copying several other CSC executives, in which he said ‘You hope that you will succeed by August 2011. I do too but you won’t. The project is on a death-march where almost as many defects are being introduced as are being fixed.”

–  by 2006 CSC had determined that it had no believable plan for delivering on the NHS Contract and should not have booked revenue under the contract from that point forward.

– The significance of the NHS Contract to CSC “placed the project squarely in the spotlight of Wall Street analysts”.

–  CSC “continuously denied media reports critical of CSC’s performance of the contract”

CSC is expected to file its response to the allegations in due course.

CSC sued on losses over disastrous NHS contracts – Observer

CSC class action – document in full on Guardian’s website

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CSC repays £170m to DH after non-signing of MoU

Posted on 03/10/2011 | 1 comment

By Tony Collins

CSC reports today that it has repaid to the Department of Health £170m of a £200m advance it received earlier this year for NHS IT work that was due to be carried out under a memorandum of understanding.

The MoU was not signed as had been expected by 30 September 2011, so CSC has repaid the money.

But the Department of Health has entered into an “extended advance payment agreement” with CSC for £24m.

In a statement dated 3 October 2011 CSC has also disclosed that uncertainty continues over the future of its NPfIT contracts that are worth about £3bn.

It says that it is having a series of meetings with the NHS and Cabinet Office officials over the “next several weeks” and adds that: “there can be no assurance that the MOU [memorandum of understanding] will be approved nor, if it is approved, what final terms will be negotiated and included in the MOU”.

The statement relates to CSC’s negotiations with the Department of Health and the Cabinet Office’s Major Projects Authority over a draft memorandum of understanding that proposes cutting the cost to taxpayers of CSC’s contracts by about £800m but would cut back planned deployments of Lorenzo by nearly two thirds and could nearly double the cost of each remaining deployment. One Cabinet Office official has described the terms of the memorandum of understanding as unacceptable.

CSC says today that “progress is continuing in development and deployment projects under the contract in cooperation with the NHS, although progress has been constrained due to the uncertainty created by the government approval process”.

It adds:

“Humber NHS Foundation Trust has been confirmed as the early adopter for mental health functionality to replace Pennine Care Mental Health Trust, which withdrew as an early adopter in April 2011, and CSC and the NHS are preparing to formally document this replacement under the contract.

“On April 1, 2011, pursuant to the company’s Local Service Provider contract, the NHS made an advance payment to the company of £200m related to the forecasted charges expected by the company during fiscal year 2012.

“The amount of this advance payment contemplated the scope and deployment schedule expected under the MOU and the parties had anticipated that the MOU would be completed and contract amendment negotiations would be underway by September 30, 2011.

“… the advance payment agreement provided the NHS the option to require repayment of the advance payment if the parties were not progressing satisfactorily toward completion of the expected contract amendment by September 30, 2011.

“Because completion of the MOU has been subject to delays in government approvals and, as a result, contract amendment negotiations have not progressed, the NHS required the company to repay approximately £170m of the April 1, 2011 advance payment on September 30, 2011, and the company agreed and made the repayment as requested.

“Also on September 30, 2011, the NHS and the company entered into an extended advance payment agreement providing for an advance payment of approximately £24m to the company in respect of certain forecasted charges for the company’s fiscal year 2012.

“The extended advance payment agreement acknowledges that the company’s Local Service Provider contract, as varied by the parties in 2010, is subject to ongoing discussions between the parties with the intention of entering into a memorandum of understanding setting out the commercial principles for a further set of updated agreements.

“The company intends to discuss the extended advance payment structure and certain fiscal year 2012 deployment charges with the NHS in connection with the MOU negotiations.

“However, there can be no assurance that the parties will enter into the MOU or that the company’s forecasted charges under the contract for the remainder of fiscal year 2012 will not be materially adversely affected as a result of the delay in completing the MOU and the related contract amendment.”

Meanwhile some investors of CSC have taken legal action against the company.

.

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Investors sue CSC

Posted on 03/10/2011 | Leave a comment

By Tony Collins

The Observer reported yesterday that some CSC investors are suing the company, saying it was giving assurances about the “Lorenzo” software when it had been warned that the software project was on a “death march”.

According to the class action complaint, which was brought on behalf of a number of investors led by a major Canadian fund, the Ontario Teachers’ Pension Plan, CSC knew in May 2008, through reports and testing, that Lorenzo was “dysfunctional and undeliverable”.

The complaint cites one member of an internal CSC “delivery assurance review team” which visited the UK and India, where Lorenzo was developed, in early 2008.

He said the team were consistent in the message that CSC could not meet its deadline. “We could not deliver the solution set that we had contracted with the NHS.”

The review team member added that, at the time, “costs were building up on the balance sheet and the project was behind schedule”. The review team knew that the contract was a loser and CSC should have recognised a loss in 2008, according to The Observer, quoting the team member.

Lorenzo’s deputy head of testing told a second delivery review team that test results were “abysmal”. According to court filings, the test official was later told by his boss to “shut up”, which he took to mean he should no longer criticise testing.

Shortly before retiring in April this year, the deputy head of testing emailed CSC chief executive Michael Laphen saying: “The project is on a death march where almost as many defects are being introduced as are being fixed. Look at the defects reports.” Despite these internal concerns, CSC told investors that Lorenzo and CSC’s work for the NHS was on track.

Investors said they dismissed negative media reports on the basis of reassurances from CSC that the NHS work was on track, making significant progres in testing, and receiving positive feedback from the NHS. In response to press coverage, CSC is said to have told investors: “The press speculated wildly and inaccurately on the status of the NHS programme.”

CSC has made no statement.

Lorenzo is the main NPfIT product to be delivered and deployed to NHS trusts by CSC under contracts worth about £3bn. The Cabinet Office and the Department of Health are negotiating with CSC to continue or drop Whitehall’s commitments to CSC Lorenzo deployments.

CSC’s share price today stood at $26.85,  close to a five-year low.

Class action document – Guardian website

Simon Bowers’ article in The Observer

 

 

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CSC NPfIT deal is a crucial test of coalition strength

Posted on 28/09/2011 | 1 comment

By Tony Collins

Comment:

The Cabinet Office’s Major Projects Authority has intervened in NHS Connecting for Health’s running of the NPfIT.

In particular the Authority has taken a role in the negotiations between CSC and the Department over the future of about £3bn worth of local service provider contracts.

Had the Authority not intervened a memorandum of understanding between CSC and the DH is likely to have been signed several months ago. Fortunately for taxpayers a deal wasn’t signed.

According to a leaked Cabinet office memo the deal would have been poor value for money. It would have cut £700m or more from the cost of CSC’s contracts but doubled the cost to taxpayers of the remaining deployments.

The Cabinet Office memo said the “offer [from CSC] is unattractive”. It added:

“This is because the unit price of deployment per Trust under offer roughly doubles the cost of each deployment from the original contract”.

It could be said that signing such a deal with CSC would be as naive as a shopkeeper asking a Cadbury wholesaler to change his order from 100 chocolate bars to 30, and thus agreeing to paying Cadbury double the price for each bar.

Now it transpires that the official within the Cabinet Office who wrote the memo expressing concern about CSC’s offer is leaving. This could imply that an “unattractive” deal between the Department of Health over Lorenzo will go through after all.

Indeed the Cabinet Office has published its assessment of the NPfIT – the “Major Projects Authority Programme Assessment Review of the National Programme for IT” – which includes a section on CSC that suggests a new deal with the supplier may be signed, even though critics say the NPfIT contract with CSC should be “parked” with no further action taken on it.

The DH has accused CSC of breach of contract and vice versa. A legal dispute can be avoided by parking the contract with the agreement of both sides. If the DH signs a new deal with CSC it will be a sign that the intervention of the Cabinet Office has come to little or nothing.  It will also be a sign of coalition weakness. If the coalition cannot have an effect on a deal the DH has long wanted to sign with CSC when can it effect in terms of central government reform?

This is the worrying  section in the report – dated June 2010 – of the Major Projects Authority:

“… if the decision is taken to allow the Lorenzo development and deployments to continue there needs to be a considerable strengthening of the renegotiated position first to give CSC the opportunity to step up to its failings and for a clear statement of obligations on all parties and a viable and deliverable plan to be created and adhered to.

“There is no certainty that CSC would deliver fully in the remaining time of the contract, but the terms of the renegotiation could enable them to have a completed Lorenzo product which can compete in the market which replaces Local Service Providers…”

Other parts of the Major Projects Authority report are highly critical of Lorenzo. It says that in the North, Midlands and East of England there have been “major delays in the development of …Lorenzo”. As a result of the delays “interim and legacy systems have been used to maintain operational capability”.

The report also says the “productisation of Lorenzo is not mature” and adds: “This is evidenced by the fact that bespoke code changes are still being used in response to requirements from the early adopter trusts. This issue will be exacerbated if the remaining product development (of the modules referred to as Deployment Units) is not completed before future implementation roll-outs commence.”

The report says there is a need to be “certain about the capacity and capability of CSC to furnish sufficient skilled resources to undertake the level of roll-out needed to satisfy the existing schedule”.

It continues: “During the review it was mentioned that on occasion, people needed to leave the Morecambe Bay activity to go to the Birmingham installation at short notice to resolve problems. At this stage of the programme, CSC skills, schedule and utilisation rate, including leveraged resources, should be available to support a proposed roll-out schedule…”

There is still a “significant degree of uncertainty both about the planning of [Lorenzo] implementations and also the capability of the solution. The four key trusts chosen to implement the Lorenzo solution are in very different situations. University Hospitals Morecombe Bay is close to sign-off whilst Pennines Trust has stated its desire to leave the programme. Birmingham Women’s Hospital Trust is being held back by one issue which views have suggested are about a difference of opinion with the Supplier believing that they have met the Deployment Verification Criteria whilst the Trust is not happy about the level of functionality delivered. Connecting for Health expect to resolve this difference of opinion soon.”

And the MPA report says the latest implementation of Lorenzo 1.9 is “a long way short of the full functionality of the contracted solution which has four stages of functionality and is intended to be rolled currently out to 221 trusts”.

Lorenzo was originally due to have been delivered by the end of 2005.  If, after all the MPA’s criticisms, a new Lorenzo deal is signed what will this say about the ability of the Cabinet Office to influence decisions of civil servants?

In 2006 an internal, confidential report of CSC and Accenture on the state of Lorenzo and its future was positive in parts but listed a multitude of concerns. The summary included these words: “…there is no well-defined scope and therefore no believable plan for releases beyond Lorenzo GP…”

The current outdated NPfIT deal with CSC should be set aside , and no further action taken on it by both sides. CSC will continue to have a strong presence in NHS IT, at least because many trusts that have installed iSoft software will need upgrades.

But if a new NPfIT deal is signed with CSC it will greatly undermine the credibility of the Cabinet Office’s attempts to effect major change on the machinery of departmental administration; and it could help consign the so-called reforms of central government to the dustbin marked  “aspirations”. It will certainly give ammunition to the coalition’s critics. The Government has said it is dismantling the NPfIT. It didn’t say it was prolonging it.

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NPfIT: NHS CE is still positive after all these years

Posted on 26/09/2011 | 1 comment

By Tony Collins

 Last week the Department of Health announced the dismantling of the NPfIT. In the Department’s press release the comments of Francis Maude, Minister for the Cabinet Office, were harsh.

“The National Programme for IT embodies the type of unpopular top-down programme that has been imposed on front-line NHS staff in the past,” said Maude.

Not quite in accord with these sentiments is a letter that has been sent out by the Department of Health’s top civil servant Sir David Nicholson the Chief Executive of the NHS. Nicholson is the Senior Responsible Owner of the NPfIT. The letter sums up the current state of the NPfIT without a word of criticism of the scheme.

“The National Programme has provided us with a foundation, but we now need to move to more local decision making if we are going to truly unlock the potential of information to drive improvements for patients and achieve the efficiency and effectiveness required in today’s health service,” says Nicholson.

Having taken on the job in 2006, Nicholson was not responsible for the NPfIT – which was founded in 2002 – but he was appointed by Labour in part to promote the scheme within the NHS.

His positive view of the NPfIT remains a little out of step with the coalition’s criticisms. But Nicholson is part of the permanent civil service and ministers hold office temporarily. It’s easy to get the impression that senior officials see their ministers this way.

Nicholson’s stance reflects the view of senior civil servants that the NPfIT has been a success. Nicholson was party to a briefing in February 2007 of the then Prime Minister Tony Blair on the state of the NPfIT. The briefing paper was entitled “NPfIT Programme Stocktake and said  “ … much of the programme is complete with software delivered to time and to budget.”

In fact much of the National Programme is incomplete, late and the costs far exceed the original budgets, according to the Public Accounts Committee. Nicholson was knighted in 2009.

This is his letter last week to NHS chief executives on the “National Programme for IT and the latest steps to no longer run it as a centralised programme” …

Dear Colleague

In September 2010, we announced that the National Programme for IT (NPfIT) would no longer be run as a centralised programme and today I am writing to update you about the renewed steps being taken to achieve that change.

A modernised NHS needs information systems that are driven by what patients and clinicians want. Restoring local control over decision-making and enabling greater choice for NHS organisations is key as we continue to use the secure exchange of information to drive up quality and safety.

We are undertaking a review, led by Katie Davis, Managing Director for Informatics, of the full portfolio of Department of Health informatics applications and services to determine how we will take this work forward. I expect this to conclude and report in the Autumn. Alongside this, we are introducing new governance arrangements to support local decision-making, which we expect to be in place in the Autumn.

It is important to be clear that this review will build on the substantial achievements that have now been firmly established and are delivering real benefits to patients. Applications and services such as the Spine, N3 Network, NHSmail, Choose and Book, Secondary Uses Service and Picture Archiving and Communications Service will all carry on providing vital support to the NHS. Similarly, key national applications such as the Summary Care Record and the Electronic Prescription Service will continue to develop in line with our commitment to give patients real information and choice about their care.

We are working in partnership with Intellect, the Technology Trade Association, to develop proposals for how we can stimulate the healthcare IT and technology marketplace in future, to offer greater choice of supplier to local NHS organisations, while still achieving value for money across the service.

The National Programme has provided us with a foundation, but we now need to move to more local decision making if we are going to truly unlock the potential of information to drive improvements for patients and achieve the efficiency and effectiveness required in today’s health service.

Yours sincerely

Sir David

Comment:

There is no doubt that Nicholson’s actions are guided by sincerity and integrity. But his letter is a reminder that it is the civil servants that are in charge of Whitehall, not the ministers. The National Audit Office has exposed the blight on NHS IT of the National Programme for IT, as has the Public Accounts Committee and many others including academics.

Nicholson’s voice is the only one that really counts, though.

His views are in line with the institutional resistance in Whitehall to admit mistakes when anything undertaken by the civil service goes wrong. Senior civil servants who preside over failures and defend them in the face of outside criticism  – particularly criticism from MPs and the media – are much more likely to be knighted than those that share the concerns of outsiders.

Andrew Lansley should take control of his civil servants, which may set a precedent for a secretary of state, Department of Health. If this is beyond Lansley,  Francis Maude and Cameron should seek to exercise more control of the department.

Until ministers run the civil service, not vice-versa, reforms of central government IT, or indeed any major change in the machinery of government will not happen. All the signs are that senior civil servants are biding their time until after the next election when, they hope, reforms of government will have run out of steam. If the reforms fizzle out a great opportunity will have been lost.

NPfIT to be dismantled brick by brick

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NPfIT to be “dismantled” – brick by brick

Posted on 22/09/2011 | 6 comments

By Tony Collins

A Department of Health press release issued this morning is headlined:

                        Dismantling the NHS National Programme for IT

I asked a senior official at the Department what is new in the announcement. The official’s diplomatic reply was simply: “I am not sure how to answer that.”

There is nothing new. There is no evidence in the press release of the Department’s claim that the NPfIT is being dismantled. Negotiations continue with CSC over its £3bn worth of NPfIT contracts and BT’s deals will remain in place.

Spending on the NPfIT has been about £6.4bn so far – and about £4bn has yet to be spent. The Government has succeeded in persuading some in the general public that the NPfIT is dead. The Daily Mail’s front page has the headline:

                                £12bn NHS Computer System is Scrapped

The online version of the story has had more than 460 comments, which suggests it has been widely read.

The actual announcement gives a hint of the conflicting views among civil service and ministers. The first paragraph of the Department of Health’s press release says the NPfIT is being dismantled and the second paragraph praises the scheme.

“The government today announced an acceleration of the dismantling of the National Programme for IT, following the conclusions of a new review by the Cabinet Office’s Major Projects Authority (MPA). The programme was created in 2002 under the last government and the MPA has concluded that it is not fit to provide the modern IT services that the NHS needs. In May 2011 the Prime Minister announced in the House of Commons that the MPA would be reviewing the NHS National Programme for IT. 

 “The MPA found that there have been substantial achievements which are now firmly established, such as the Spine, N3 Network, NHSmail, Choose and Book, Secondary Uses Service and Picture Archiving and Communications Service.  Their delivery accounts for around two thirds of the £6.4bn money spent so far and they will continue to provide vital support to the NHS. However, the review reported the National Programme for IT has not and cannot deliver to its original intent.”

The signs are that the scheme will be dismantled brick by brick – and will be almost completely dismantled by the time the NPfIT contracts with BT and CSC expire in 2013 and 2014.  The coalition has achieved a PR coup with the Daily Mail story because the public has the impression that in these austere times a £12bn NHS IT scheme initiated by Labour has been scrapped.

The reality is that nothing has changed.

Department of Health announcement

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End of NPfIT? – Campaign4Change on BBC R4 Today programme

Posted on 22/09/2011 | 3 comments

By Tony Collins

Link to Campaign4Change audio on BBC R4 Today programme

BBC Radio 4’s Today programme this morning reported a Daily Mail article that the National Programme for IT in the NHS is being scrapped and that a coalition announcement is to be made this morning.

The Mail says that the money spent on the NPfIT would pay for 60,000 nurses for a decade, and that the scheme will be replaced by a “cheaper alternative”.

It says that there will be a new urgency in “dismantling the scheme”. Campaign4Change told the BBC R4 Today programme this morning that the NPfIT is not being scrapped and that about £4bn has yet to be spent on it. It said that trusts have the freedom to buy their own IT systems but using their budgets. The NPfIT will continue to provide Cerner and Lorenzo systems that are subsidised centrally, which gives the NHS an incentive to continue using NPfIT.

There is a difference of opinion within Whitehall over the NPfIT: that the Cabinet Office takes a rigorously independent view of the NPfIT and wants to wind it down. The Department of Health’s civil servants at a press conference last year justified the spend on the programme and said the contracts with CSC and BT would continue.  Campaign4Change told Today that the Cabinet Office should have the final say, not the Department of Health.

The Government clearly wishes it to be known that the NPfIT is being scrapped but that is not what is happening in practice. Contracts with CSC, which at present are worth about £3.2bn, are unlikely to be scrapped because of the compensation that would have to be paid to the supplier. The contracts may be cut back  by about £800m, though the cost of deployments remaining may double. BT’s contracts worth more than £1bn are also likely to remain.

The Daily Mail says the NPfIT will be “replaced with cheaper regional alternatives” and that the Coalition will “today announce it is putting a halt to years of scandalous waste of taxpayers’ money on a system that never worked”.

“Following an official review, the ‘one size fits all’ IT project will be replaced by much cheaper regional initiatives, with hospitals and GPs choosing the IT system they need.

“And a new national watchdog will be established to ensure such huge sums can never again be thrown away on uncosted projects.”

The decision to accelerate the dismantling of the scheme has been made by Health Secretary Andrew Lansley and Francis Maude, the Minister for the Cabinet Office, says the Mail.

It quotes from what appears to be a leaked memo from the Major Projects Authority of the Cabinet Office which has been reviewing CSC’s contracts.

“The authority said the IT scheme, set up in 2002, is not fit to provide services to the NHS – which as part of austerity measures has to make savings of £20billion by 2014/15.

It concluded: ‘There can be no confidence that the programme has delivered or can be delivered as originally conceived.’

The report is said to recommend that the Government  “dismember the programme and reconstitute it under new management and organisation arrangements”.

It added: “The project has not delivered in line with the original intent as targets on dates, functionality, usage and levels of benefit have been delayed and reduced.

“It is not possible to identify a documented business case for the whole of the programme.Unless the work is refocused it is hard to see how the perception can ever be shifted from the faults of the past and allowed to progress effectively to support the delivery of effective healthcare.”

Daily Mail article on the NPfIT today

Department of Health announcement

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Firecontrol: same mistakes repeated on other projects

Posted on 20/09/2011 | 2 comments

By Tony Collins

A report published today by the Public Accounts Committee on the £469m Firecontrol project reads much like its others on government IT-enabled project disasters.

Margaret Hodge, chair of the Committee said:

“This is one of the worst cases of project failure that the committee has seen in many years. FiReControl was an ambitious project with the objectives of improving national resilience, efficiency and technology by replacing the control room functions of 46 local Fire and Rescue Services in England with a network of nine purpose-built regional control centres using a national computer system.

“The project was launched in 2004, but following a series of delays and difficulties, was terminated in December 2010 with none of the original objectives achieved and a minimum of £469m being wasted.

“The project was flawed from the outset, as the Department attempted, without sufficient mandatory powers, to impose a single, national approach on locally accountable Fire and Rescue Services who were reluctant to change the way they operated.

“Yet rather than engaging with the Services to persuade them of the project’s merits, the Department excluded them from decisions about the design of the regional control centres and the proposed IT solution, even though these decisions would leave local services with potential long-term costs and residual liabilities to which they had not agreed.

“The Department launched the project too quickly, driven by its wider aims to ensure a better co-ordinated national response to national disasters, such as terrorist attacks, rail crashes or floods. The Department also wanted to encourage and embed regional government in England.

“But it acted without applying basic project approval checks and balances – taking decisions  before a business case, project plan or procurement strategy had been developed and tested amongst Fire Services. The result was hugely unrealistic forecast costs and savings, naïve over-optimism on the deliverability of the IT solution and under- appreciation or mitigation of the risks. The Department demonstrated poor judgement in approving the project and failed to provide appropriate checks and challenge.

“The fundamentals of project management continued to be absent as the project proceeded. So the new fire control centres were constructed and completed whilst there was considerable delay in even awarding the IT contract, let alone developing the essential IT infrastructure.

Consultants made up over half the management team (costing £69m by 2010) but were not managed. The project had convoluted governance arrangements, with a lack of clarity over roles and responsibilities. There was a high turnover of senior managers although none have been held accountable for the failure.  The committee considers this to be an extraordinary failure of leadership. Yet no individuals have been held accountable for the failure and waste associated with this project.”

Comment:

Firecontrol was a politically-motivated project which used  bricks, mortar and IT to try and change the way people worked. The users in the fire service didn’t want a single national approach of nine new regional centres – complete with new hardware and software – just as NHS clinicians, in general, did not want the National Programme for IT [NPfIT]. The Firecontrol regional centres were built anyway and the NPfIT went ahead anyway.

One lesson is that, in the public sector, you cannot engage users who won’t support the scheme. If they want to change, and they want the new IT, they’ll find ways to overcome the technology’s deficiencies. If they don’t want the scheme – and fire personnel did not want Firecontrol – the end-users will be incorrigibly harsh evaluators of what’s delivered, and not delivered.

It’s better to get the support of users, and involve them in the prototype design and test implementations, long before the scheme is finalised. It’s different in the private sector because the support of users is not essential – those who don’t accept business change and the associated IT will be expected to quit.

So what today is the mistake that is being repeated? The Public Accounts Committee touched on it when it said that the Department for Communities and Local Government – which was responsible for Firecontrol –  “failed to provide appropriate checks and challenge”.

During the life of Firecontrol, the Office of Government Commerce carried out “Gateway reviews” which independently assessed progress or otherwise. The reviews  could have provided an early warning of a project that was about to waste hundreds of millions of pounds. But the Gateway review reports were not published. They had a limited internal distribution and, it appears, were ignored.

According to the Public Accounts Committee, a Gateway review in April 2004, near the start of the Firecontrol project, said the scheme was in poor condition overall and at significant risk of failing to deliver.

Why was this Gateway review not published? If it had, Parliament and the media could have held ministers to account – and perhaps have campaigned to stop the project before millions were thrown away.

There was indeed a media campaign in 2004 – and before – to have Gateway reviews published, but ministers – and particularly civil servants – said no.

Now the same thing is happening. The civil service has persuaded the coalition government to carry on Labour’s tradition of keeping Gateway reviews secret. So Parliament and the media will continue to be kept in the dark on whether a major project is going wrong.

By the time details of the reviews are published, perhaps years later in a report of the National Audit Office,  it may be too late to rescue the scheme. By then tens or hundreds of millions may have been wasted. Gateway reviews should be published around the time they are written, not years later.

Ministers do not have to pander to civil servants. They are paid to stand up to them. They receive a premium over the salary of MPs in part to be independent voices – to provide a challenge.

Subservient ministers in the DWP are among those who continue to allow Gateway reviews to remain hidden. If you ask the DWP under the Freedom of Information Act for the release of the Starting Gate report on Universal Credit (which I am told is not the same as a Gateway review report) the DWP will refuse your request. It refused mine.

So we have to accept the word of civil servants that the Universal Credit programme is going well; but haven’t there been enough IT-related disasters in government for all to know that the word of civil servants on whether things are going well needs to be tested independently? The publication of Gateway reviews – and Starting Gate reviews – could help outsiders hold a department to account. It’s time ministers began to realise this.

Are ministers such as Iain Duncan Smith in control of their departments – or are their civil servants in control of them?

Links:

Margaret Hodge on BBC “Today” programme 20/9/11 – “what could go wrong did go wrong” – did PA Consulting get away without blame?

What the NPfIT and Firecontrol have in common.

Firecontrol:  should PA Consulting share some responsibility for what happened?

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Posted in Campaign4Change, change, change management, Government IT, managing change, npfit, procurement, public sector, public services, risk, supplier relationships

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An NHS success story – what’s to learn from it?

Posted on 06/09/2011 | Leave a comment

By Tony Collins

IM&T at Trafford General Hospital makes visits to hospital safer for patients and gives managers the information they need to monitor the work of clinicians. Even doctors like the advanced technological environment and come up with ideas for improvements. So what lessons can be learnt? Here are four:

–           Be in control of your IT suppliers. Too often in the public sector it’s the other way around

–           Don’t buy from suppliers that seem excessively secretive and talk much about their proprietary information – which may include your data. Know their systems well enough to produce the reports you want, when you want them and in the format you want, rather than wait for your information to be given to you when the suppliers want to give it, and in their format.

–           Don’t impose change. Have the push come from the business users [in Trafford’s case clinicians] who understand what technology can do for them.

–           Keep IT in the background – not centre stage.

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Posted in change, change management, collaboration, innovation, managing change, NHS, npfit, openness and transparency, private sector lessons for the public sector, public sector, public services, SME, supplier relationships, Uncategorized

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