Tony Collins's IT Projects Blog

NHS Connecting for Health, which runs part of the National Programme for IT [NPfIT], is to write to the BBC about parts of its documentary “Wiring the NHS”.

The Radio 4 documentary on the NPfIT included a slip of the tongue by Dr Gillian Braunold, Clinical Director for the NPfIT summary care record and HealthSpace.

GP Mary Hawking writes in response to the blog entry "Whitehall has no firm plans to replace Richard Granger or conduct unrestricted review of National NPfIT":

"If there is to be no appointment to replace Richard Granger [Director General of NHS IT], how is Connecting for Health [which runs part of the National Programme for IT [NPfIT] going to be managed?

Imagine if the Department for Transport were to argue that its programme for reducing road deaths had been successful on the basis that:

- 10,589,446 tonnes of an innovative anti-skid road surface have been deployed
- 61,778 new traffic lights have been installed
- More than 100,000 new tax discs have been issued to vehicles with the highest safety ratings
- Registration of Blackberry-carrying lollipop ladies has reached 10,000
- Government road safety experts have exchanged more than one million e-mails
- More than two million points have been issued to 550,000 new users of the Safety Camera Partnership Scheme
- At least 1,600 road humps of both flat top and round top, of heights varying from 50mm to 100mm, have been installed in 49 towns and cities under the Highway (Road Humps) Regulations and their map coordinates are available to billions of users via the internet.

Such statistics without context would be meaningless. And statistics in support of claims that the NHS’s National Programme for IT [NPfIT] is a success are almost as meaningless.

Yet below is part of a speech by the Exchequer Secretary to the Treasury Angela Eagle MP in the House of Commons on 23 October 2007.

NHS Connecting for Health, which runs part of the National Programme for IT, NPfIT, has issued a statement on the Choose and Book system that bears similarities to a government announcement five years ago, in 2002.

Both statements – on 6 October 2007 and 20 May 2002 – said that more than five million patients have been able to pre-book hospital appointments.

HM Revenue and Customs has struck a deal with its IT supplier Capgemini that cuts the annual technology spend by hundreds of millions over the life of the contract. The agreement compensates the company with a contract extension worth more than £1bn.

The combined legal costs of the High Court dispute between British Sky Broadcasting Group [BSkyB] and EDS are likely to exceed £55m, more than first thought.

BSkyB has made provisions in its accounts of £32m in legal costs. If EDS's costs are not markedly lower, the combined legal costs of the dispute could be £55m or more.

In a report on its latest financial results BT has issued a reassuring statement about its work on the NHS’s National Programme for IT [NPfIT]. The statement does not deviate from the government’s position that the NPfIT is a success.

Comment and analysis on investigation by Computer Weekly and Channel 4 News on the £5bn Defence Information Infrastructure [DII]

Like the NHS National Programme for IT, the Ministry of Defence’s DII is unarguably a good idea. But it’s a good idea impeded by the practicalities.

I've posted on this blog answers to questions I had put to two senior executives who are running the £5bn contract for a new Defence Information Infrastructure [DII]. They talk about the scheme’s progress, problems and lessons learned.

It’s difficult to avoid making a comparison between their openness on the DII and the defensiveness of officials over the NHS’s National Programme for IT [NPfIT].

Both are huge IT-based programmes. Both schemes have a one-size-fits-all approach. And on both projects those with old technology welcome having it upgraded, though others complain when their advanced systems are replaced with something that does less in the interests of all.

But there’s a big difference in the way the MoD and the Department of Health confront dissidents.

In this blog entry the two leaders of the £5bn Defence Information Infrastructure contract [DII], who represent the Ministry of Defence and the Atlas consortium of suppliers, led by services company EDS, answer our questions about progress and challenges, and the lessons learned.

Their defence of the DII follows a joint investigation of the DII by Computer Weekly and Channel 4 News. Bob Quick, the MoD's programme director for the scheme, and Howard Hughes, Chief Operating Officer of a consortium of suppliers, Atlas, did not deny there have been problems but said the scheme was on a sound footing.

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Why was there a need to change the DII contract in December 2006? [The Atlas consortium was awarded a DII add-on contract, increment 2a, worth an extra £750m, in December 2006. The first increment was worth £2.3bn to Atlas. Under increment 1 about 70,000 systems should have been delivered by mid-2007. Today only about 16,000 terminals have been delivered.]

Bob Quick said:

“The contract wasn’t changed. We did add at the end of 2006 another increment. It’s an incremental contract to de-risk the delivery. At the end of 2006 increment 2a was added which is a further set of UADs [user access devices such as desktop systems and laptops]. The programme has had some challenges as we have rolled forward.

“As of today we [have] in the order of 16,000 UADs and about 56,000 account holders. The early part of the programme very much concentrated on the delivery to the users who had some of those older systems because we needed to get the infrastructure out there to support the HR applications, both civilian and military, and some of the other defence change applications coming through.

“So we certainly were not rolling out the volume of UADs that we anticipated at the time of contract award. But we have now done about 400 of the 600 sites in increment 1 so [we're] about two thirds of the way through in terms of sites. The number of terminals we are now rolling out has ramped up over the last few months and we are regularly rolling out 3,000 and 4 ,000 a month which will assist in getting the programme back to the combined plan for [increments] 1a and 2.”

The two leaders of the £5bn Defence Information Infrastructure contract [DII], who represent the Ministry of Defence and the Atlas consortium, which is led by services supplier EDS, have spoken about progress and challenges, and the lessons learned.

Answering our questions following a joint investigation of the DII by Computer Weekly and Channel 4 News, Bob Quick, the MoD's programme director for the scheme, and Howard Hughes, Chief Operating Officer of a consortium of suppliers, Atlas, did not deny there have been problems but said the scheme was on a sound footing.

The results of the latest Medix survey of more than 1,000 doctors, who were questioned on the NHS’s National Programme for IT [NPfIT], make grim reading.

Looked at on their own, the results imply that the NPfIT is failing, at least in terms of its big objectives and gaining the support of doctors.

The practice of sending across the country unencrypted, CD-based files on millions of child benefit claimants could have continued indefinitely if the discs hadn’t gone missing, we have learned.

Seven months before the CDs went missing, HM Revenue and Customs had already established a practice of transferring onto CD, for despatch by post, insecure, though password-protected, files on millions of child benefit claimants.

The lost discs contained details of all child benefit recipients: records for 25 million individuals and more than seven million families.

Evidence has emerged of why the National Audit Office asked HM Revenue and Customs for a large download of information from the child benefit database.

What’s disturbing is the way the Chancellor of the Exchequer Alistair Darling and the Prime Minister Gordon Brown are using the incident of the missing discs to dent the credibility of the NAO, an organisation that’s not answerable to them but to Parliament.

Analysis and comment

Staff at the National Audit Office cannot be criticised for wanting so much child benefit data. They were doing their job of checking diligently for fraud and error in child benefit payments.

When the Department of Work and Pensions ran systems that paid child benefits, the NAO's auditors did not need to request a copy of the database of claimant information. Its auditors trusted the DWP, mainly because the department did its own checks on a large sample of records - about 20,000 child benefit files.

But when the Revenue took over the running of child benefit systems under the Tax Credits Act 2002, the department's staff checked too small a small sample - of only about 1,500 child benefit records. This wasn’t good enough for the NAO’s auditors. They decided to ask for the whole child benefit database, but suggested it was stripped of parent names, addresses and bank account details.

A Department of Health document reveals that a review has been underway into the possibility of allowing sensitive NHS patient data to be processed overseas, we have learned.

Some GPs are concerned that if patient records are sent abroad there is a risk their contents could be revealed.

The disclosure comes only days after the government’s statement on two missing CDs that contained the personal details of all families in the UK with a child under 16. It has been described as the UK’s worst IT security breach.

The document seen by Computer Weekly said in August 2007 that the review into the possibility of patient data being processed overseas was “current” and that further guidance would be issued. The document has not been updated.

On 22 November I asked a straightforward question of NHS Connecting for Health which runs part of the NHS’s £12.4bn National Programme for IT [NPfIT].

The question: Could you let me know, by end of today please, if the possibility is being considered of having patient data processed abroad? If so could I have a statement please?

NHS CfH’s answer was straightforward: “No,” said its spokesman.

A computer systems manager has written to us about an extreme reaction by HM Revenue and Customs to two CDs which went missing. The CDs contained the names and bank details of more than seven million families that receive child benefit.

A reader Neil McIntosh makes the worthwhile point that media interest over HMRC's two missing CDs, which contain child benefit data, is waning - which is inevitable - but does this let the government off the hook?

He writes: