Tony Collins's IT Projects Blog

Whitehall officials have allowed only two weeks for people to apply for two top IT jobs in government – each offering salaries of at least £200,000.

The jobs were advertised on 13 April and the deadlines have passed. Some of those who were interested in the adverts say that two weeks is not enough time to prepare for applications that require comments to be made on a list of difficult questions.

Connecting for Health, which runs much of the NHS’s £12.4bn National Programme for IT [NPfIT], is expected to be criticised in a government-funded report into "early-adopters" of online health records.

A year-long study, the results of which are due to be published next week, is also expected to highlight criticisms of the government by some executives at NHS Connecting for Health [CfH].

The government wanted CfH to implement online health records quickly because of the high political profile of the scheme. This was despite the difficulties gaining support from clinicians, achieving the necessary changes within NHS organisations, and the technology being unproven.

Comment and analysis

A study published this week into the summary care record – a pivotal part of the £12.4bn NHS’s National Programme for IT [NPfIT] – raises questions about the underlying assumptions behind the scheme, and highlights flaws in the organisation which runs it.

And Computer Weekly has learned that significant changes were made between a draft report by researchers at University College, London, and the approved final report. The final report softens or omits some of criticisms of the government and NHS Connecting for Health [CfH], which runs much of the NPfIT. Even so the final report is enlightening, comprehensive and authoritative.

The NHS's National Programme for IT [NPfIT] has taken a different direction with NHS trusts being given a choice of a range of systems from various suppliers - which they were able to do before the advent of the NPfIT in 2002.

The idea of a summary care record is a good one – it could save lives. But doctors say it should be rolled out only if it’s legal and will work – and there are doubts about both.

When read carefully, the report [2MB] published last week on the summary care record [SCR] early adopter sites by researchers at University College, London, raises questions about whether the scheme will work.

It found that primary care trusts whose boards decided to become early adopters of the SCR – which is part of the National Programme for IT [NPfIT] - have had extra staff and financial help: CfH gave between £100,000 and £200,000 to each early adopter site for "set up" costs. The early adopter programme was also buoyed by strong initial enthusiasm among NHS staff.

Yet still there have been significant problems.

So where does that leave the majority of England’s primary care trusts that won’t have the extra money and people, and perhaps won’t have the enthusiasm of the early adopters of the SCR?

Whitehall officials would like to control the language and information on the NHS’s National Programme for IT [NPfIT], but the laws of Nature are, at times, pitched against them: The Sun has begun to take an interest in the scheme.

Following on from its article on the implementation of the Care Records Service at Barts and the London NHS Trust, The Sun has reported on a potential security breach with the “Choose and Book” system – part of the NPfIT - at a GP practice at Essex; and it has an editorial under the headline “Data Dunces”.

Alan Spours, Chief Information and Knowledge Officer at NHS Northwest, has told his board that a review of the National Programme for IT [NPfIT] by Matthew Swindells is expected to give the NHS more flexibility to implement interim solutions where products from local service providers are not available or not fit for purpose.

He has also told his board that a contract reset with CSC, one of three main suppliers to the National Programme for IT, was due to be signed by 6 May 2008.

The IT head of an NHS health authority has suggested that CSC's contracts under the National Programme for IT [NPfIT] - may be extended, which would extend the programme itself.

If it happens, it could signal an intention of Whitehall officials to keep extending contracts to local service providers in the hope the NPfIT can be seen to succeed at some point.

The Identity and Passport Service [IPS] has cancelled an overly complicated replacement online passport applications system after rising costs and glitches which led to about 5,000 applications becoming stuck in the system.

The IPS told Computer Weekly that it has written of £10.9m in development costs because of the cancellation of the Electronic Passport Application system, known as EPA2.

Birmingham City Council - Europe's largest local authority with a £3bn annual turnover - has had an "approvals day" to try and clear a backlog of about 10,000 unpaid invoices from its suppliers. The invoices were "struck" in a SAP-based financial system, more than six months after going live.

The council said this week [May 2008] it had cleared a backlog of invoices which built up when it implemented its "Voyager" system in October 2007 - but its spokesman added that this led to a build-up of unpaid invoices "further along in the payments system".

The council set aside 13 May 2008 as an "Approvals Day" to clear backlogs and "identify and permanently eradicate any remaining payment issues that still exist".

A Birmingham City Council spokesperson said today (15 May 2008): "A total of 2,000 invoices were cleared as a result of Approvals Day on May 13.

Plans for the NHS's national IT scheme are feasible - but the main software is running four years behind, and may not be fully rolled out until 2015, according to a report published today [16 May 2008] by the National Audit Office.

Angela Hands, an author of the NAO report, told Computer Weekly that there is a risk the care records service - which includes plans to give 50 million people in England an electronic medical record - may not be complete even by 2015.

Computer Weekly comments on the report published today by the National Audit Office on the NHS's £12.7bn National Programme for IT [NPfIT].

This is a strong report by the NAO - factual and clear. There have been some achievements - the NPfIT has improved the profile, importance and training of IT staff in the NHS. It has made IT and its potential benefits a talking point at board level. A later add-on to the NPfIT, PACS digital x-ray technology, has been a success, making diagnoses quicker and reducing the need for unnecessary x-rays. The N3 broadband network is a success.

But the NPfIT, if flawed, cannot be sustained by PACS, the N3 network or even the extraordinary commitment of thousands of IT professionals and NHS staff. It cannot be sustained either by the strength of its unarguably well-intentioned objectives. It needed to be soundly planned and achievable. There are doubts about both. The NAO report raises questions about whether the most important part of the National Programme for IT, the plans for England-wide shared electronic medical records, will ever happen.

The NAO says the scheme is feasible, but only if fit-for-purpose software is installed - and there are doubts all trusts, especially foundation trusts, will want to install it.  Ministers are discovering that an IT-based scheme conceived at the centre cannot be imposed on a devolved NHS - a lesson that should have been learned from failure of the centrally-driven Wessex Regional Health "RISP" programme in the 1990s.

It's unfortunate for the NHS and taxpayers that the National Programme for IT was conceived in secret, without adequate consultation with the medical professionals and without enough independent challenge of assumptions. The government needs to be much more visible in the way it approves big projects - and more open about the progress or otherwise of those schemes.

We're believe strongly that if ministers and Whitehall officials knew at the time they first discussed big IT-based change programmes that all would be revealed about how their biggest IT-based change projects were going, they would think twice before they launched a scheme that was unachievable.

Links:

NAO report says the NPfIT is feasible but four years late

The Times has an editorial on the National Programme for IT [NPfIT] and the report of the National Audit Office on the scheme - The NHS: a question of trust - The health service can still be properly computerised

Links:

The Times on the NPfIT

National Audit Office report on the NPfIT - 4 years late but feasible

Comment on National Audit Office on the NPfIT

Richard Bacon, a member of the House of Commons' Public Accounts Committee, says the NHS's National Programme for IT [NPfIT] is in crisis. The Public Accounts Committee is expected to meet next month to question civil servants on the report of the National Audit Office on the NPfIT.

We interviewed Angela Hands and Laura Brackwell who are among the co-authors of a report by the National Audit Office on the NHS's National Programme for IT [NPfIT]

The Department of Health in its reaction to a report by the National Audit Office on the National Programme for IT [NPfIT] gave no hint it would do anything differently if it were to launch the scheme again - which suggests that senior advisers in Whitehall and ministers have learned little from the programme's problems.

The NAO report cautioned against a "focus on achievements rather than what remains to be done". Despite this, the Department's statement focuses on achievements and not what remains to be done.

These are excerpts from today's report [16 May 2008] by the National Audit Office on the NHS's National Programme for I.T

Much has been published by Connecting for Health on the achievements so far of the NPfIT. The excerpts here highlight some of the important lessons to be learned from the challenges of implementing the NPfIT.

A system upgrade means that this blog will be unavailable tomorrow (Saturday 17 May 2008) from 9am to around noon.

An online forum, The Stirrer, which is popular with employees of Birmingham City Council, does what it says on the tin.

It's being used by staff to air views and give information about problems with a SAP-based financial system, Voyager. There have been hundreds of posts about the Voyager system. Contributors have said they cannot express their concerns directly to their managers without affecting their jobs or promotional prospects.

When I investigated an IT project at Haringey council [which was nothing to do with SAP] I was surprised at how easy it was for ruling councillors to keep information from the electorate and even other councillors. So it's understandable that an online forum such as The Stirrer is being used as an outlet for views and information that may otherwise remain hidden.

Companies with the highest proportion of women in senior management have better return on equity and total returns to shareholders, according to the President of IT suppliers' association Intellect.

Sky's legal case against EDS - which has already lasted seven months - is expected to continue for at least another two months, and a judgement is unlikely much before Christmas (assuming there isn't a settlement).

A fellow blogger for Computer Weekly, Philip Virgo, has an excellent post today [22 May 2008] entitled "Why do we never learn and keep replicating failure?"

Three points in particular struck me about central government projects such as the NHS's National Programme for IT [NPfIT].

This is a longer version of an article on ComputerWeekly.com

A former senior officer who helped write rules for RAF accident inquiries has spoken publicly for the first time about his concerns over what caused the crash of a Chinook helicopter 14 years ago which killed the aircrew and 25 VIPs.

Retired Air Commodore Derek Hine says there is too much evidence of software problems on the type of Chinook which crashed to convince him that the pilots were definitely to blame.

Hine's comments come as the Defence Secretary Des Browne considers a lengthy file on the circumstances surrounding the crash of Chinook ZD576 on the Mull of Kintyre in June 1994.

The dossier contains new evidence which campaigners hope will lead to minsters setting aside the verdict of gross negligence against the pilots Fl Lieutenants Rick Cook and Jonathan Tapper.