Tag Archives: public services

Unison ready to fight against mutuals and rails against ‘self-interested’ third sector

By David Bicknell

It would be nice to think that the unions might see something positive in mutuals, a new (old) way of doing business, perhaps. Maybe an open mind?

But no. The latest communication from Unison – call to arms might be a better description – is profoundly depressing for anyone who sees the possibilities offered by mutuals and co-operatives. It is dismissively critical of what it calls the ‘self interested’ third sector. I suppose I shouldn’t have been that surprised by the tone.

Here’s a taste of its invective:

“Whilst the Cabinet Office desperately struggles to reinvent the failing ‘big society’ policy the LGA recently reported that less than 3% of councils responding to a survey have had any interest from staff in setting up employee led mutual arrangements and very few intend to encourage or push this route.
 
“Despite these figures which would depress the most committed ‘big society’ proponent The Cabinet Office are intent on flogging a dead horse are now issuing guidance and changes to legislation to take forward coops and mutuals to make it easier to set them up to run public services:
http://www.cabinetoffice.gov.uk/news/mutuals-get-go-ahead
 
“This is now for the unions a ‘back to CCT’ moment. In the late 80’s and early 90s we made sure anyone who wanted to pick over the bones of public services were able to support the continuance of staff terms and conditions and we fought hard to enforce TUPE.
 

“We fought for continuation of staff pensions and made pensions a key negotiating point. We fought against the cowboy contractors by insisting that they had proper health and safety assessments, method statements, competency to do the work and financial security to run public services without going into bankruptcy.

“This latest missive from the Cabinet Office should remind us as a union to dust down the old CCT advice. It is no different now to then in many ways – if enthusiastic amateurs attempt to run local public services they should be held to account in the same way that we held private companies to account under CCT.

“Public services shouldn’t be put at risk nor public sector workers thrown onto the scrap heap because councils or other employers are seduced by the language of good intent spun by the self-interested third sector intent on privatising public services.”

So, I guess we should probably take that as a ‘No to mutuals’ then.

Less than third of civil servants on strike says Maude

By Tony Collins

The Cabinet Office says that “significantly less” than a third of civil servants are taking strike action today.

Francis Maude, Cabinet Office minister, said: “I want to thank the majority of dedicated and committed public sector workers who have turned up to work today to deliver essential services.”

He added that early indications indicate that the majority of key public services remain open.

Officials pay supplier invoices – then raise purchase orders

This morning the National Audit Office has published a report that says the Equality and Human Rights Commission, in up to 35% of cases, raises its purchase order after it gets the invoice from suppliers.

It’s unlikely that any private sector company could survive if it didn’t know what it owed, didn’t know what it had bought, and had to wait for an invoice from the supplier to raise the purchase order.

Amyas Morse, the head of the NAO, says in his report today:

“While I welcome the considerable improvements that the Commission has made in its controls over procurement, there are still areas where it needs to make improvements. In particular, up to 35% of the Commission’s purchase orders are still not raised until after the Commission has received an invoice for goods and services.

“This means that Commission staff are committing funds without going through proper processes and are avoiding some of the checking processes. Consequently the Commission does not have an accurate understanding of its committed expenditure at any one point in time.

“The Chief Executive has made it clear that he takes noncompliance with these processes seriously such that in cases of repeated non-compliance delegations will be withdrawn.”

A common practice? 

Is this absence of proper accounting worryingly common in central government and its agencies, particularly on IT contracts?

Auditors told us that in the case of NPfIT contracts they found some invoices that were paid when they came in, awaiting reconciliation with any past paperwork.

This, perhaps, ties in with the experiences of Conservative MP Richard Bacon, a member of Public Accounts Committee who, when asking civil servants for a breakdown of IT spending has, in the past, been referred to the department’s IT supplier.

On the C-Nomis IT project for prisons, the National Offender Management Service paid £161m without keeping any record of what the payments were for.

The Cabinet Office wants to cut the £17bn or so spent every year on public sector IT. But before departments, agencies and other organisations cut their costs they’ll need to know what those costs are. Maybe they should ask their major IT suppliers? We wonder if the domination of GovIT by a small number of suppliers has got to the stage where it’s the suppliers managing the civil service IT budgets. If that’s the case it is not the fault of suppliers.

Praise for departing Deputy government CIO

By Tony Collins

Bill McCluggage, the departing Deputy government CIO, has been praised by friends and colleagues for his strength of purpose as a change advocate, and for steering through the government ICT Strategy.

He is also admired by friends for “telling it like it is” despite the Cabinet Office’s restrictive communications policy.

Said one friend: “To get the ICT strategy out and into delivery underlines Bill’s credentials as a deliverer not just a strategist; and he regularly held his ground with those who sought to maintain the status quo.”

McCluggage announced this week he is leaving government to join storage supplier EMC. He said on Twitter that it’s “sad to leave excellent team that have delivered real change but time to move on and address new challenge”.  He said he counted himself “lucky to have been part of the vanguard of new GovtIT”.

Mike Bracken, Executive Director of Digital, Efficiency and Reform Group, Cabinet Office, said that Whitehall will be poorer in McCluggage’s absence.

McCluggage joined the Cabinet Office as Deputy Government CIO in September 2009. He has been Director of ICT Strategy & Policy and Senior Information Risk Owner with overall responsibility for the formulation, development and communication of cross-Government ICT strategies and policies.

He was IT Director at Harland & Wolff Heavy Industries in Belfast and was an engineering officer in the RAF. He is a chartered engineer and member of the Institution of Engineering and Technology.

As Deputy government CIO McCluggage has been a firm advocate of agile techniques, cloud computing, open source, cutting out waste and duplication, and bringing many more SMEs into GovIT.

Deputy Government CIO to join EMC.

Deputy government quits.

Cabinet Office loses another top ICT man.

Mutuals regain recognition as form of business ownership

By David Bicknell

The rebirth and acceptance of mutuals as a form of business ownership has been recognised in an article by Charles Batchelor in the Financial Times published yesterday.

In a piece headlined “Different kinds of company ownership are gaining in popularity” as part of a special report ‘The Future of the Company’, Batchelor listed mutuals alongside family businesses, publicly quoted joint-stock companies and sole traders and partnerships as forms of ownership.  

On mutuals, Batchelor said this:

“Mutuals, represented mainly by building societies in the UK, were a popular form of ownership in previous years, although their numbers have shrunk dramatically as many societies have demutualised in recent decades. One mutual that is thriving, however, is John Lewis, the owner of the John Lewis chain of department stores as well as Waitrose, the upmarket grocery store. The employee-owned company has been extremely successful in weathering the retail downturn that has affected the rest of the UK high street, and in the process has shown that mutuals do, perhaps, have a place in the future.”

Admittedly for those already in or in the process of creating mutuals and social enterprises, it may not mean much, but it is perhaps a sign of the times to see the prospective growing role of mutuals specifically recognised by the FT in this way.

Agile for Universal Credit – a good choice says report

By Tony Collins

Universal Credit is one of  the government’s biggest IT-based projects and the biggest test for agile in the public sector. It is due to start rolling out in April 2013.

The choice of agile for the scheme is supported by a “Starting Gate” review which was carried out for the Cabinet Office’s Major Projects Authority, and for Terry Moran, the Director-General, Universal Credit at the Department for Work and Pensions. The review was carried out between 28 February 2011 and 4 March 2011.

This is what the Starting Gate report says on agile aspects of the project.

Agile

The challenging timetable for delivery of UC meant that DWP elected to use an Agile approach to the delivery. There is no evidence of such a methodology being used on a public sector programme of such scale and during the course of the review it was evident that there had been some initial scepticism to the use of such a methodology with a programme of this scale.

However, during the review there was overwhelming evidence of buy-in to the methodology at all levels up to and including the highest levels. DWP have set about thoroughly educating all involved on what can be expected from them and there was clear evidence within the interviews that this is being taken up enthusiastically.

There was a view that policy decisions being made later in the programme would pose a problem for delivery. This was countered by the view that the methodology should allow decisions to be made when they need to be made, which is in contrast to fixing requirements early in more traditional (‘waterfall’) methodologies.

On balance, the review team found that the use of the chosen methodology here was judged by interviewees to provide greater assurance of delivery in such an environment. The review team agrees with this finding.

In terms of the use of Agile within Government, DWP also have the best current experience via their Automated Service Delivery (ASD) Programme, which used a slightly less ‘lean’ version of the methodology based on an Accenture interpretation.

However, there are still valuable lessons that can be transferred from this programme and there exists experience that is being directly deployed on UC. The review team felt that whilst effectively piloting this methodology on a programme such as UC did pose a risk, this was acceptable in view of the risk of delivery out of line with expectations, for example in terms of timing or quality of service to the public.

Accenture remain involved in UC, although DWP have brought in consultants (Emergn) to provide an independent methodology not based on any ‘out of the box’ methodologies, but rather one that Emergn have tailored.

New contracts supporting this development are due to be awarded in June 2011 and DWP state that their use of this independent methodology will serve to remove any supplier advantage.

There was evidence that DWP have understood the need for decision-making delegated to the level at which the expertise exists, with the appropriate empowerment supported within the planned governance re-design.

There was also an acknowledgement that the right domain/business knowledge needs to be made available at the workshops that will drive the detailed design processes. It was also accepted that there is a continuing need for this knowledge to be made available and also that it will need to keep pace with the changing policy.

One key risk identified by DWP is how an Agile methodology will interact successfully with the various approvals processes that will come into play across the programme – most especially the ICT Spend Approval process (formally known as the ICT Moratorium Exception process).

Engagement has begun already with the Major Projects Authority (MPA) on designing the Integrated Assurance and Approval Plan (IAAP) that will ensure the correct internal and external assurance is brought to bear for the identified approval points. The production of this plan is seen by the review team as a key mitigating factor for the risk identified and it is recommended that this is produced, with MPA guidance, by the end of March 2011 at the latest. This may need fine-tuning as approval points are finally agreed.

Recommendation:

DWP, with guidance and assistance from the MPA, produces an Integrated Assurance and Approvals Plan (IAAP) by the end of March 2011.

As noted earlier, there are contracts that are relevant to this development that are being re-competed at this time, with a wish to award in June 2011. There was some evidence that the design of contracts to deliver in an Agile environment will require a different design in order to draw out supplier behaviour in line with an accelerated delivery environment.

There is a always the risk that any development methodology will fail to deliver and whilst this methodology itself provides early warning of failure, there is recognition that in such a circumstance the prioritisation of customer journeys with high-value returns would be needed.

There was much evidence of the reliance of UC on successful delivery of the HMRC PAYE Real-Time Information (RTI) programme. There was also recognition that whilst ‘just-in-time’ decisions as a consequence of policy development could be made within UC, the RTI requirement would need to be more rigidly fixed as the traditional ‘waterfall’ development methodology in use cannot so easily absorb such changes without consequence.

There was some concern that fraud would remain a major issue for UC and appropriate Information Assurance should be built into the requirement from the outset – rather than being a ‘bolt-on’. Also, as UC and its interface with PAYERTI [PAYE RTI] will become part of the UK Critical National Infrastructure, appropriate discussions should be maintained. There was evidence that DWP have gripped these requirements.

Overall, the use of an Agile methodology remains unproven at this scale and within UK Government; however, the challenging timescale does present DWP with few choices for delivery of such a radical programme.

That said, there has been evidence of strong support at all levels and DWP do have some expertise within their own organisation that they can call upon from the outset. The review team not only felt that an Agile development is an appropriate choice given the constraints, they also believe that DWP are well placed with their level of support, knowledge and enthusiasm to act as a pilot for its use at such a scale.

Compound failure

DWP has made a strong start in identifying risks to delivery.   This could be developed further by thinking through the likelihood and impact of a number of risks being realised simultaneously (eg lack of synchronisation between reduced income and UC top-up, plus wrong employer data plus labour market downturn).and what the responses might be.

The programme could extend its preparedness by drawing on a wider range of experience the elements of recovery and their prioritisation; and test their robustness in advance, including an early warning system for Ministers.

Agile and Universal Credit – Secret report.

Agile can fix failed GovIT says lawyer.

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

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.

.

Agile and Universal Credit – secret report

By Tony Collins

Below are excerpts  from the supposedly confidential “Starting Gate” report by the Cabinet Office’s Major Projects Authority on Universal Credit.

The main finding is that, despite inherent challenges, “the programme can deliver Universal Credit”.

Media reports on Universal Credit have depicted the scheme as an impending disaster that may blight the coalition in the run-up to the next general election, but the Authority’s report says the programme has got off to an impressively strong start.

This will encourage advocates of agile in government as Universal Credit is the Government’s biggest agile development.

We requested the Starting Gate report on Universal Credit under the Freedom of Information Act but the Department for Work and Pensions refused to release it; and turned down our appeal.

We obtained the report outside the FOI Act, via the House of Commons Library. It appears that one part of the DWP was trying to keep the report secret while another part had released it to two Parliamentary committees [the Public Accounts Committee and the Public Administration Select Committee].

It may be that the DWP, when it comes to FOI, doesn’t know clearly what it’s doing – or is all but indifferent to the FOI Act and chooses secrecy to keep things simple. The DWP’s FOI reply to us was, at best, in  perfunctory compliance with the FOI Act. It made no attempt to set out the arguments for its decision not to disclose the report, other than to say disclosure was not in the public interest.

The Starting Gate  report was dated March 2011 and was largely positive about the start of the Universal Credit . These were some of the findings.

Deliverability

“The review team finds that the Programme has got off to an impressively strong start given the demanding timetable and complexity of the design and interdependency with other departments.

“This involves liaison with HMRC in particular, but also with CLG and local government in respect of the replacement of Housing Benefit as part of the Universal Credit.

“We found that the foundations for a delivery Programme are in place – clear policy objectives, a coherent strategy, Ministerial and top management support, financial and human resources – with no obvious gaps.

“The strong working relationship with HMRC and the inclusive approach with other key stakeholders within and outside DWP have quickly established a high level of common understanding.  All this gives a high degree of confidence that, notwithstanding the inherent challenges, the programme can deliver Universal Credit.

“There is a greater degree of uncertainty around the achievability of the intended economic outcomes because of factors which are not within DWP’s control e.g. the general state of the economy and availability of jobs.

“There are other risks which derive from trying new approaches: the Agile methodology offers much promise but it is unproven on this scale and scope.  The actual response of different customer groups to UC may pose a risk to its transformational impact if, for example, factors other than net pay turned out to be a greater barrier to take up of work than expected.

“The development of a range of approaches to contingency planning (which could be beyond changes to UC) could cover off unintended customer behaviour, whether ‘no change’, or ‘change for the worse’.”

Campaign4Change will publish more excepts next week.

Links:

Agile can fix failed Gov’t IT says lawyer

DWP FOI team hides Universal Credit report

Universal Credit – guaranteed to fail?

DWP gives IBM and Capgemini 60 application maintenance and development apps

DWP partners with IBM to help deliver Universal Credit

CSC NPfIT deal is a crucial test of coalition strength

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.

NPfIT: NHS CE is still positive after all these years

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