A senior executive at services supplier Fujitsu, a
primary supplier to the NHS's £12.4bn National Programme for IT
(NPfIT), has
questioned whether key aspects of the scheme are working - or are
going to work.
The comments of Andrew Rollerson, healthcare consultancy
practice lead at Fujitsu, won general acceptance from a small,
diverse group of IT executives at a conference last week entitled
"Successful implementation of NPfIT 2007".
Twenty-three senior academics and, separately, the British
Computer Society, have also raised fundamental concerns about the
scheme.
Rollerson, who is responsible for the delivery of Fujitsu's
healthcare professional services, said there was a "gradual coming
apart of what we are doing on the ground because we are desperate
to get something in and make it work, versus what the programme
really ought to be trying to achieve".
He added, "The more pressure we come under, both as suppliers
and on the NHS side, the more we are reverting to a very sort of
narrowly focused IT-oriented behaviour. This is not a good sign for
the programme."
A main aim of the programme - now in its fifth year - is to
provide electronic health records for 50 million people that can be
shared. This part of the programme is running two years behind
schedule, and there are concerns about whether it is possible to
achieve fully joined up systems given the size and complexity of
the NHS.
Rollerson questioned whether standard project and programme
management techniques needed to be rethought given the enormity of
the programme.
He said, "What we are trying to do is run an enormous programme
with the techniques that we are absolutely familiar with for
running small projects. And it isn't working. And it isn't going to
work."
He added, "Unless we do some serious thinking about that - about
the challenges of scale and how you scale up to an appropriate size
- then I think we are out on a limb."
Rollerson's criticisms were not directed specifically at
Connecting for Health, which is running the IT part of the
programme, but at what he saw as a lack of vision and focus related
to the wider changes within the NHS that are needed to make best
use of new technology.
He said that Connecting for Health was, in effect, a national IT
department. "There is a belief that the National Programme is
somehow going to propel transformation in the NHS simply by
delivering an IT system. Nothing could be further from the truth. A
vacuum, a chasm, is opening up. It was always there."
There are concerns about whether the systems being delivered by
suppliers will meet the priorities of the NHS, which have changed
since the programme was announced in 2002. Trust boards are now,
for example, under greater pressure to show precisely how money is
spent, which requires IT support.
Rollerson said there was a danger that suppliers would end up
delivering "a camel, and not the racehorse that we might try to
produce".
Fujitsu is one of three companies that are local service
providers to the NPfIT. It has an £896m contract to supply systems
in the South of England.
Responding to Computer Weekly's reporting of Rollerson's speech,
Ian Lamb, NHS account director at Fujitsu Services, said, "This is
a significant misrepresentation of a presentation made in support
of the National Programme.
"We refute any inference that has been drawn to the effect that
Fujitsu in any way questions the success of the National
Programme."
A Department of Health spokesman said, "David Nicholson, the
chief executive of the NHS, has clearly said that he is fully
committed to the National Programme for IT as it is a necessary
part of a modern health service, fit for the 21st century. He sees
this as one of his key strategic priorities as it is key to the
successful delivery of patient-centred care."
Connecting for Health declined to comment.
Details of
inquiry into the NPfIT
Tony Collins' IT projects blog
Against the
current: exploring the challenges of complex IT projects
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