Tony Collins's IT Projects Blog

Analysis/comment

A BBC Radio Four “File on 4” programme on 31 July 2007 on ID cards gave a useful insight into how ministers approve a major new IT-based project, then leave the rest to committed civil servants who have no clear what they’re supposed to be doing.

Some in the IT industry are concerned about facets of the ID cards programme: the costs, the lack of a robust business case, and uncertainties over how well the technologies will work when applied to millions of people.

But not everyone is complaining. Indeed a by-product of the government's decision to award a plethora of contracts under the ID Card scheme is that parts of the IT industry have signed up to non-disclosure terms, which has reduced the number of cognoscente who could speak openly about the scheme even if they wanted to.

These are some of the organisations and individuals that have won contracts so far under the Identity Cards scheme ...

Chief information officer: Steve Lamey
Title: Chief Information Officer and Director General, HM Revenue and Customs.
Salary: £240,000 to £245,000 in the year 2006-7, according to the department’s annual report which is published this month.
How does this compare with his boss’s salary? The permanent head of HM Revenue and Customs earned between £170,000 and £180,000. The other board directors earned less than £200,000.
Annual IT-related spend (latest figure available): £989m
Some key tasks: Modernise an IT estate that is heavily dependent on Fujitsu “VME” mainframes dating back decades; gaining an overview of the tax affairs of 30 million Pay As You Earn taxpayers; clearing discrepancies in millions of tax records; ironing out inconsistent working practices among 100,000 staff; reduce billions of pounds of tax credit overpayments; tackle fraud and error which auditors say is “unacceptably high”. His work so far is praised by even critics of the Revenue’s cost-cutting policies.
When joined: October 2004 on a four-year contract
CV highlights: Graduated in mining engineering at University College Cardiff in 1978. He became BOC’s Director of Global Information and Management User Services and later became the CIO at British Gas.

What the top three Whitehall chief information officers [CIOs] earned, according to the latest figures

- Steve Lamey, CIO and director general, HM Revenue and Customs: £240,000 to £245,000.

- Joe Harley, IT director general and CIO, Department for Work and Pensions: £249,000.

- Richard Granger, director general of NHS IT and chief executive of NHS Connecting for Health: £270,000 to £285,000.

Link:

Three chief information officers get pay packets that are among the biggest in Whitehall

What some CIOs in Whitehall earn compared with other top officials

Whitehall's highest-paid chief information officers - do they earn more than their bosses?

Three chief information officers are among the highest paid civil servants in Whitehall, with salaries that outstrip that of the prime minister and the most senior leaders in government.

The salaries reflect the importance placed by the government and the civil service on the IT-based modernisation of some large central departments. The three top-paid CIOs are running IT-based change programmes that together are worth at least £16bn.

Research by Computer Weekly has established that the three – Steve Lamey of HM Revenue and Customs, Joe Harley of the Department for Work and Pensions, and Richard Granger, Director General NHS IT – received salaries that were higher than those of their bosses and permanent secretaries who run other departments, such as the Treasury and the Foreign and Commonwealth Office.

Title: Director General NHS IT
Salary: £270,000 to 285,000

Title: IT Director General, Department for Work and Pensions
Salary: £259,000

Title: CIO and Director General, HM Revenue and Customs
Salary: £240,000 to £245,000

Title: Executive Director, Service Planning and delivery, Identity and Passport Service (IT lead for ID cards and biometric passports)
Salary: About £125,000

Title: Chief Information Officer at the Department for Constitutional Affairs: Salary: £145,000 to £150,000

Title: Head of Strategy and information, Foreign and Commonwealth Office
Salary: About £95,000

Title: Director General, Department for Transport (and member of Government CIO Council)
Salary: About £125,000

Title: Head of police IT before Police Information Technology Organisation which has been subsumed into the National Policing Improvement Agency
Salary: £130,000

Title: IT director, Ministry of Justice
Salary: Up to £110,000

The government under Gordon Brown has rejected a call by an all-party group of MPs for an independent review of the business case for the NHS’s National Programme for IT [NPfIT], in the light of progress and experience to date.

It has also rejected a call by the Public Accounts Committee for an urgent independent review of the performance of local service providers to the NPfIT, against the obligations of their contracts, which are worth £6.2bn.

Some people are finding it hard to find this report ...

Link to the governmnent's response to the report of the Public Accounts Committee on the NHS's National Programme for IT [NPfIT].

The government accepts some of the all-party committee's recommendations - in principle - but none of those that call for independent assessments of facets of the programme.

The Department of Health's rush to push chairs and sofas against its locked doors whenever there is a call for external scrutiny of the NPfIT will give even the programme's enthusiasts the impression that all is not well.

The Times has published a leaked email written by Roger Hill, Director of the Probation Service. It said that costings on a C-NOMIS IT project were over-optimistic.

The email said: “Many of you will be aware that, in light of subsequent developments, the original costing for the C-NOMIS programme has proved to be optimistic.

"We have advised ministers that we will need to undertake a fundamental review of the work, to return to an affordable programme ...Whilst we are reviewing the programme we had instituted a moratorium on further development work.”

In an interview before he announced he was leaving his job as Director General of NHS IT, Richard Granger is reported to have criticised some early installations of software from Cerner, a US-based health software supplier.

In CIO Magazine Richard Granger referred to Cerner whose "Millennium" software is scheduled to be deployed by NHS trusts across Southern England and in London as part of the £12.4bn National Programme for IT [NPfIT].

Fujitsu, the local service provider to the NHS in Southern England, has chosen Cerner as its main software subcontractor.

Richard Granger was quoted as saying:

“Sometimes we put stuff in that I’m just ashamed of. Some of the stuff that Cerner has put in recently is appalling. It really isn’t usable because they have been building a system with Fujitsu without listening to what the end users want. They have taken some account but they then had to take a lot more. Now they’re being held to account because that’s my job.”

We asked for a comment from NHS Connecting for Health, whose chief executive is Richard Granger. We put it to CfH that a number of hospital trusts were preparing to implement to Cerner's systems and were already, before Richard Granger's reported comments, concerned about the risks of failure and the uncertainties over how well Cerner's Millenium product could be adapted for widespread use in the UK. We asked whether such concerns may be deepened by the reported comments about Cerner.

An official at NHS Connecting for Health did not play down Richard Granger's remarks.

David Nicholson, Chief Executive of the NHS, has appointed three top-level executives who could provide some of the skills of the outgoing Director General of NHS IT Richard Granger.

The appointments, to strengthen leadership at the Department of Health, could indicate that top management of the £12.4bn National Programme for IT [NPfIT] in the NHS is to become more diffuse.

The most notable appointment is that of Mark Britnell, one of the NHS's most experienced NPfIT executives, who has been appointed Director General for Commissioning and System Management.

Last year Mark Britnell was Chief Executive of University Hospital Birmingham which installed a "Reference Solution Patient Administration System" from CSC, the main NPfIT local service provider with contracts worth about £3bn.

The President of CSC Europe, Guy Hains, met Britnell last year at the hospital.

CSC said in a promotional brochure that Britnell's hospital was "at the forefront of the current transformation in the NHS".

Mark Britnell was later appointed as Chief Executive of the South Central Strategic Health Authority and was lead Senior Responsible Owner of the NPfIT for the South of England.

He has worked closely with David Nicholson on plans to try and revive support for the NPfIT among the boards of directors of local trusts and strategic health authorities. Britnell was national Senior Responsible Owner of the NPfIT Local Ownership Programme [NLOP].

NHS Connecting for Health, which is largely responsible for the NHS's £12.4bn National Programme for IT [NPfIT], is facing new financial pressures.

In the foreword to his first annual report of the NHS’s National Programme for IT [NPfIT], Richard Granger gave an account of the scheme's progress and some of its challenges.

At that time, in 2005, Granger expected that the organisation he managed, NHS Connecting for Health, would publish another annual report a year later.

This was the prediction he made in NHS Connecting for Health's 2004/5 annual report: “I am confident that our Annual Report for 2005-2006 will contain details of our success in delivering systems which will help tens of thousands of NHS personnel to better serve millions of patients using tools which have been delivered by NHS Connecting for Health”.

But there would be no more annual reports on the NPfIT. And thus no further annual account on the progress NHS Connecting for Health.

In London in May 2007 a senior health official gave an assurance – of sorts – about the future of the NHS’s £12.4bn National Programme for IT [NPfIT].

Andy Burn, head of IM&T planning at NHS Connecting for Health, which runs much of the NPfIT, told the government IT summit: .

“It has three wheels still on, and it is still moving. But things are in hand to a certain degree. They are not in other respects but we are going to get there.”

Not all trust boards of directors are as certain as Burn about the future of the NPfIT. An assessment of the programme by Birmingham and Solihull NHS Trust has raised a question about whether the NPfIT will achieve its objectives

The future of the National Programme for IT [NPfIT] is looking indistinct.

Computer Weekly is today [14 August 2007] publishing a series of articles that, when considered together, suggest that the government wants the NPfIT to blend into NHS IT in general. The NPfIT would, therefore, have less of a clearly discernible – and controversial – character.

There are some of the recent developments:

- There are signs the programme is in flight from ruthless standardisation

- Whitehall has dropped plans to give NHS Connecting for Health, the organisation set up to run the programme, the status and independence of an executive agency

- Officials are struggling to find money for plans to localise the scheme

- A more diffuse leadership at the Department of Health is poised to subsume some of the skills of Richard Granger, the departing Director General of NHS IT.

Cerner, an NHS software supplier in the South of England, including London, has commented briefly on criticisms by Richard Granger, senior responsible owner for the IT part of the NHS's National Programme for IT [NPfIT].

The recent financial results of Cerner, the main supplier of NHS software in London and the South of England, are strong. But Cerner’s local paper in Kansas, USA, is a little irresolute in its support for the company.

We congratulate Barnet and Chase Farm Hospitals NHS Trust on becoming the first London hospital to go live with the Cerner Millennium patient administration system as part of the National Programme for IT [NPfIT]

Although it’s the basic, non-integrated R0 release of the system, it combines the data from two separate patient administration systems, the McKesson TotalCare system and IRC PAS - no small feat. Another major challenge has been training staff to work in a different way.

Corporate America hates the word “but” whether spoken or written. But sometimes it’s unavoidable.

Progress is a beguiling thing. Pushing a broken car up a hill is a form of progress. Before the advent of the NPfIT in 2002, there were regular announcements of advances in regionally-based electronic patient record systems. Now we’re delighted when a single patient administration system – unlinked to others – goes into a hospital without too much disruption.

Links:

Head of IT at Barnet and Chase Farm NHS trust quits

Barnet and Chase Farm Hospitals NHS Trust announces go-live of new Cerner system

Barnet and Chase Farm switch on Cerner

October 2001 - MInisterial statement on progress with electronic patient record systems

The Information Commissioner Richard Thomas has ordered the disclosure of “highly sensitive” papers about a meeting at Downing Street which led to the launch of the UK’s largest IT-based project, the £12.4bn NHS national programme.

The ruling is a breakthrough in favour of openness over how Whitehall and Downing Street take decisions which lead to the award of large contracts on large and risky IT-based programmes.

And it vindicates Computer Weekly’s campaign against excessive secrecy over the National Programme for IT – a complaint made by many in the IT industry including the British Computer Society.

The ruling comes two and half years after Computer Weekly made a request under the Freedom of Information Act for details of a seminar on NHS IT at Downing Street in February 2002, which was chaired by the then Prime Minister Tony Blair.

A separate posting on this blog refers to a decision of the Information Commissioner to order the release of "sensitive" papers from a meeting at Downing Street in 2002 at which the NHS's National Programme for IT was given tentative approval.

The meeting was chaired by the then Prime Minister Tony Blair and attended by several ministers, civil servants and business consultants. Computer Weekly requested the Downing Street papers in January 2005 under the Freedom of Information Act.

The Cabinet Offfice, on behalf of Downing Street, rejected our request. We appealed to the Information Commissioner who has now ruled that the papers should be published.

Today, 21 August 2007, we asked the Cabinet Office if it would appeal to the Information Tribunal against the decision of the Information Commissioner. It has until 10 September 2007 to submit a formal notice of an appeal.

Its spokesman said only: "We are still studying the decision." He would not say whether the Cabinet Office will appeal. We would be surprised if it didn't.

So what are Whitehall, Downing Street and the Cabinet Office hiding?

We know from Sir John Pattison, a participant at the seminar at Downing Street in February 2002, that ministers were told that a national programme would take less than three years, from April 2003 to 2006. It is now a programme lasting more than 10 years.

We also know that the Department of Health in early 2002 filled out a Project Profile Model - a form in which departments and agencies self-assess the scale, complexity and risks of IT- based programmes and projects. On the form, the Department of Health put the whole-life project costs of an NHS IT-based modernisation at an estimated £5bn. It is now estimated to cost £12.4bn.

The Department of Health did not publish the Project Profile Model for the NHS's National Programme for IT [NPfIT] and indeed did not give a copy to the National Audit Office which spent nearly two years investigating the programme. I'll publish separately on this blog the Project Profile Model for the national programme.

Health blogger Rod Ward who's in Australia - home of healthcare software supplier IBA - reports today (22 August 2007) that the supplier has submitted an increased bid for iSoft, which supplies one of the two main patient administration systems being offered under the NHS's National Programme for IT [NPfIT].

Rod Ward says the bid has generated discussion at the Medinfo 2007 conference which he is covering in Brisbane, Eastern Australia.

The position of NHS Connecting for Health, which manages the contracts with the NPfIT's three local service providers, is that the matter of any takeover of iSoft by IBA is a matter for CSC. iSoft is contracted to CSC, the local service provider for the North and mid-England.

"NHS Connecting for Health's position in respect of this transaction is that this is a matter for CSC," said the organisation.

The House of Commons' Health Committee, which is investigating aspects of the NPfIT, was told in June that a deal between IBA and iSoft was likely to happen in the next few days.

The Health Committee, incidentally, is due to publish a report The Electronic Patient Record on 13 September 2007.

On 22 August 2007 iSoft issued a statement in response to the revised offer by IBA Health. It said: