Tony Collins's IT Projects Blog

This is summary of a conversion with a senior executive who is working on the NHS’s National Programme for IT [NPfIT]. He lamented the departure of Richard Granger who has resigned as Director General of NHS IT and Chief Executive of NHS Connecting for Health which runs part of the national programme.

- A case study on NHS Connecting for Health’s handling of news of £5m worth of penalties accrued under the NHS National Programme for IT

Comment and analysis

Officials at NHS Connecting for Health who run part of the £12.4bn National Programme for IT [NPfIT] are deeply committed to the success of the programme: they’re doing their best in trying circumstances.

When they make public statements on the state of the NPfIT they have no wish to deceive. So why, when we ask difficult questions on the NPfIT, do they respond by reaching for a form of words that is anything but an affirmation that problems exist?

The reason, it seems, is that they’re hidebound by Whitehall’s convention of sidelining openness and honesty as two naughty schoolboys in a classroom of gifted pupils.

A culture of introspection and defensiveness reigns. It means that officials are allowed to answer difficult questions from journalists with statements that are succinct or prolix, imaginative or dull, but not artless and simple.

GP Mary Hawking makes the point that the NHS is receiving penalties from CSC under the National Programme for IT [NPfIT] - but CSC also has a contractual right to claim penalties from the NHS if the health service fails to meet obligations to the supplier.

The NHS's contractual obligations to CSC were negotiated centrally by the Department of Health; and the Department has now kindly transferred these commitments to the NHS under the NLOP, the NPfIT Local Ownership Programme.

NLOP means in part that primary care trust chief executives are senior responsible owners with accountability for the delivery of NPfIT in their geographical areas. They also have direct deployment responsibility for the NPfIT Electronic Prescription Service , Choose and Book, and GP systems.

And they have the responsibility of ensuring that the NPfIT's Care Record Service is implemented in hospital trusts - and that it delivers benefits, when fit-for-purpose is software is available.

Now that penalties from CSC have accrued in the North, Midlands and East of England region of the NPfIT, is CSC more likely to claim penalties from the NHS?

An IT project to computerise the Isle of Man’s hospital services has gone live on time and within budget.

The successful project – systems went live without delays or changes in the contract or requirements – sets a different tone to some of the delays and changes in England’s NPfIT, the NHS National Programme for IT.

Some of the major NPfIT issues identified by Helen Bellairs, Chief Executive, Western Cheshire Primary Care Trust, seem at odds with a briefing paper to the prime minister in February 2007

Helen Bellairs is a local senior responsible owner of the National Programme for IT [NPfIT] in the NHS. Under NLOP, the NPfIT Local Ownership Programme, all chief executives of primary care trusts in England have been appointed senior responsible owners. It means they may be held accountable for failures and realising any benefits of NLOP and the NPfIT.

In a briefing paper to the North West Strategic Health Authority NPfIT board, Helen Bellairs outlined what has been achieved locally; and she identified six “major issues” with the NPfIT. Some of the issues have a general significance to the national programme.

The Health Service Journal has a story of a leaked letter, dated 19 December 2007, which reveals that Alan Johnson, the Health Secretary, believes he was not well briefed about the C difficile outbreak at Maidstone and Tunbridge Wells, which led to the deaths of 90 people.

The briefings to ministers in advance of the go-live of the Rural Payment Agency’s Single Payment Scheme gave no clear hint of the disaster to come. A briefing to the then prime minister in February 2007 on the NHS’s National Programme for IT - NPfIT – was largely positive, though the programme is in travail.

So how accurate and candid are briefings to Alan Johnson on the NPfIT?

Comment

The executive chairman and CEO of Australian company IBA Health Gary Cohen has spoken briefly about the future of the “Lorenzo” product. IBA has acquired iSoft which is due to supply Lorenzo, a product that's important to the success of the NHS's National Programme for IT [NPfIT].

The board of an NHS trust has learned of a “significant” risk of Fujitsu ending its £900m contract to supply and implement hospital systems across Southern England as part of the National Programme for IT [NPfIT].

The warning was issued to the board of the Royal United Hospital Bath which has waited nearly three years to go live with systems under the NHS’s National Programme for IT [NPfIT].

A withdrawal of Fujitsu would add to delays in installations of NPfIT systems and deepen scepticism among doctors over whether the programme is feasible - though it could leave NHS trusts with the benefit of dealing directly with Fujitsu’s main software subcontractor Cerner.

NHS Connecting For Health which runs part of the NHS's National Programme for IT, announced yesterday [22 January 2008] that the Choose and Book electronic referrals system has "broken through the six million patients milestone".

Officials at HM Courts Service say they have turned around a stalled and failing £447m IT project for a national case management system for magistrates’ courts – a scheme that is 16 years late and costs nearly three times more than expected.

HM Courts Service has revealed the main lessons learned from its turn-around of the £447m Libra project to supply a national standard system for magistrates’ courts.