Tony Collins's IT Projects Blogtag:www.computerweekly.com,2008:/blogs/tony_collins//122008-05-15T12:49:00ZAgainst the Current: Exploring challenges involved in IT-based projectsMovable Type 4.1-enCouncil's unpaid invoices 6 months after SAP go-livetag:www.computerweekly.com,2008:/blogs/tony_collins//12.304662008-05-15T11:14:00Z2008-05-15T12:49:00ZBirmingham 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...Tony
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.
Glyn Evans, told Computer Weekly that specific problems had been foreseen but "what we didn't take into account was the cumulative effect".
More recently staff have claimed that employees were assigned the wrong roles in the system - and when they rejected misdirected invoices these were later returned to them by the system. The staff say all they can do is register a support call - but they continue to complain that the responses to their queries are slow.
In February 2008 Computer Weekly reported that the Birmingham authority had 18,000 unpaid invoices and that bailiffs hade visited the council. Some suppliers withdrew goods and services, and some staff used their own money to buy food for a children's care home. The council had told Computer Weekly that it expected to clear its backlogs of unpaid invoices by the end of February 2008.
The council's IT transformation programme, which included the SAP project, was among the winners of the Cabinet Office's E-Government Awards. Gordon Brown praised the awards winners in January 2008.
Details of Approvals Day are disclosed in an internal e-mail to staff which was leaked to a website popular with council workers, The Stirrer.
The email says the aim of Approvals Day is to clear work-lists of outstanding invoices in the [SAP] Voyager system.
It says: "There has been on average 10,000 stuck in Directorate approval work-lists for over a month with no real progress seen in this reducing top and settling at a lower level. Action plans are being put together for a three-month push to resolve all the obstacles for a sustained improvement."
The email adds that Approvals Day should lead to a reduction in complaints from suppliers about non-payment of their invoices. It says:
"The 13th May 2008 will be a day when all Directorates are asked to give priority to clearing [invoice] Approval Worklists. To help staff to clear backlogs and deal with queries on complicated unpaid invoices, fewer new invoices than normal will be entered into SAP work-lists on 13 May.
"The main delays recently have been around complex queries and there is a need to clear worklists to be able to bring these to the surface and address them."
But the email warns its staff that mass rejections of invoices to achieve empty work-lists is not acceptable. "Unusually high levels of rejections will be investigated," says the email.
A 100-strong team of IT professionals implemented system. They were split between permanent council employees and people on secondment from a joint venture company that Birmingham set up with Capita in 2006. The joint venture, Service Birmingham, has a 10-year contract worth £470m to run the council's IT function.
PricewaterhouseCoopers and Serco also helped with SAP implementation work at the council. About 500 council staff were transferred to the joint venture.
Links:
Birmingham Council's SAP system - local MP remains defensiveSAP to Help Birmingham City Council to Achieve Savings of £1bn Over 10 YearsThe Stirrer - popular website for Birmingham Council employeesBirmingham City Council bills unpaid as SAP project faltersBirmingham council signs UK's largest local government software contract]]>
Identity and Passport Service cancels £11m web passport systemtag:www.computerweekly.com,2008:/blogs/tony_collins//12.303292008-05-13T08:24:00Z2008-05-13T08:25:14ZThe 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...Tony
Electronic Passport Application system, known as EPA2. ]]>
jammed in the system, there were "quirks in the software", and performance slowed to the point where a backlog of 5,000 applications built up. The delays put holidays of some applicants at risk. The IPS withdrew EPA2 while staff worked on its re-launch.
But IPS says the costs of a simplified system and an inability to recover the investment before new systems become available in 2011 meant that any further spending on EPA2 could not be justified.
In the absence of the system, the IPS has reverted to using the older EPA1. Compared to EPA2, if it were functioning correctly, EPA1 has no facility for paying online, is much slower because applications can take up to four weeks, and it requires paperwork with applicants to be exchanged in the post.
The IPS has also owned up to what went wrong on two other major IT projects last year. But unusually for any government department, the IPS has published the lessons.
Bernard Herdan, its Executive Director for Service Planning and Delivery, has told Computer Weekly he wants others working on major IT-based projects and programmes to avoid similar mistakes.
This month the IPS completes the roll-out nationwide of IT systems for 68 offices it has set up to interview first-time applicants for passports – the so-called Authentication By Interview project.
Herdan said that the IPS was over-optimistic about how quickly the IT could be rolled out and 600 new staff recruited to interview applicants. The start of the rollout was delayed by about six months – and there were difficulties synchronising the hiring of staff with the rollout of IT to support them.
The IPS hired too many people too soon – but their start dates were delayed because the IT was not ready and some decided not to take up the job. When the IPS began recruiting again this took longer than expected because security checks on new personnel became more stringent – so existing staff had to cover for the recruits to avoid a waste of money from empty offices and unused IT systems.
But IPS had successes with three large projects last year – and learned lessons from the parts of Authentication By Interview which went well, in particular the testing of new processes by having staff use, in live operations, paper instead of IT systems.
The IPS began the annual reporting of lessons from its major IT-based projects and programmes in 2007 after a call by Computer Weekly that it, and other departments, should do so. We had made the challenge on BBC R4 – which Herdan accepted on air.
The openness and experience of IPS on major IT-based projects has earned the IPS the respect of other departments – in 2007 it won a civil service award for the Best Project and Programme Management across government.
Herdan said in 2007 he'd welcome it if other government departments published the lessons from its key projects. But so far none has. HM Revenue and Customs flatly rejected the idea when it was suggested to Paul Gray, its then chairman, by MP Richard Bacon, a member of the Public Accounts Committee. Bacon campaigns for less secrecy over government IT projects.
On EPA2 a spokesman for the IPS said that £10.9m in development costs over 2006-07 and 2007-08 has been written off. He said:
“It was indicated last year that IPS would be seeking to simplify the EPA2 system and that once it was in a position to re-launch EPA2, its implementation would have to be accommodated within the other planned business/system changes IPS had planned for 2007.
“The costs of the simplified system, and IPS's inability to recover its investment before new systems became available meant that further investment was not justified.
“After careful consideration and evaluation of technical and commercial considerations the IPS Management Board decided to cancel the project. IPS is satisfied that this is the right decision and rather than plough on and potentially invest further in transitional and support costs, agreed it was better to stop and seek to acquire a modern on line channel. This will now form part of the projects and contracts procured through the NIS [National Identity Scheme’s] Strategic Supplier Framework.
"Currently IPS is solely using EPA1 and this will continue until 2011 when it will be replaced by a modern online channel.”
Comment:
Nothing astonishes us more than frankness, common sense and plain dealing.
This is why we're taken aback when officials at IPS discuss openly what mistakes they've made. It makes us think that IPS knows what it is doing.
And when HM Revenue and Customs refuses to discuss openly its mistakes it gives us a feeling it is burdened with the complexity of its operations and ageing IT systems. This may be an incorrect impression - but it's the message it sends to MPs and the media.
Doubtless the IPS will continue to make mistakes. But publishing details of them means the mistakes are a useful, and even a positive, experience - if others learn from them. We congratulate the IPS on its openness.
Links:
Identity and Passport Service – report on key projects in 2007Lessons learned from failure of online passport application system EPA2Passport troubles bode ill for ID Cards200 questions to get your passportPassport fees – Public Accounts Committee reportPassport scheme branded a waste of moneyNational Identity scheme has no business case IPS wants ID Card service pilots]]>
CSC's £3bn NPfIT contracts to be extended?tag:www.computerweekly.com,2008:/blogs/tony_collins//12.302812008-05-13T05:30:00Z2008-05-13T05:37:34ZThe 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...Tony
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.
Lorenzo" software product until 2016.
CSC has about £3bn worth of NPFIT contracts. It's the local service provider to NHS trusts in England except the south and London. Like Fujitsu in the south, CSC is negotiating a "contract re-set" in which it's expected to obtain more money from the Department of Health.
A spokesman for NHS Connecting for Health said: "The contract end date has not been amended. However commercial discussions remain on going and we would not wish to comment further until these are successfully concluded."
A spokeswoman for CSC made a similar comment.
Links:
Front-runner to buy CSC regards NPfIT as loss making Plans for Lorenzo slipFujitsu may quit National Programme for IT NHS drops out of NHS contract - CSC takes over]]>
Swindells NPfIT review - more flexibility for NHS IT buyerstag:www.computerweekly.com,2008:/blogs/tony_collins//12.301762008-05-13T05:28:00Z2008-05-13T05:37:32ZAlan 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...Tony
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. ]]>
Morecambe Bay was scheduled to deploy the first release of IBM Health's Lorenzo (R1) [from iSoft] on 16 June 2008 in its role as an early adopter. If the trust maintained this date it would be the first to deploy Lorenzo in the country.
- The new approach to Lorenzo required a revision to the new contract and a Memorandum of Understanding which was agreed in early March. A revised contract between NHS Connecting for Health and CSC was expected to be signed by 6 May 2008. "The new contract includes several improvements required by the NHS, including scope to create inter-operability between Lorenzo and existing GP systems."
- On a review of the NPfIT by Matthew Swindells, Spours said:
"In respect of NPfIT [the review by Matthew Swindells] it is intended to recommend changes that will improve delivery to the NHS and make the programme more sensitive to the changing needs of the NHS. The Swindells Review is expected to give the NHS more flexibility to implement interim solutions where the local service provider offerings are either not available or not fit for purpose."
Last week NHS Connecting for Health announced a list of suppliers that trusts may be able to buy from - though they may have to use their own budgets rather than receive subsidies from Connecting for Health for systems from NPfIT's local service providers, CSC, BT and Fujitsu.
CfH says that a contract "re-set" with CSC has not yet been signed.
Links:
NHS - Does Lorenzo mean the end of GP electronic patient records?Lorenzo due in June 2008Some NPfIT “major issues” - did the PM get a full briefing in 2007?CSC re-negotiating delivery of LorenzoNHS and Fujitsu to sign memordandum of understanding Lorenzo's problems continue]]>
The Sun reports on potential security flaw in NPfIT Choose and Booktag:www.computerweekly.com,2008:/blogs/tony_collins//12.302792008-05-12T12:02:10Z2008-05-12T13:42:04ZWhitehall 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....Tony
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”.]]>
article said:
“The £12bn NHS computer system lay in tatters last night — as it emerged crooks may have accessed patient records. A security card flaw has left the system open to abuse for two years. Sensitive medical details, addresses and National Insurance numbers of every patient in the country could have been seen by anyone in a GP surgery or hospital without using the special swipe card.
“And the information could have been sold to ID theft gangs. Department of Health chiefs have been alerted to the flaw in the controversial Choose and Book system… a GP in Hornchurch, Essex, found he could log on to the system without inserting his "smart card" into the reader device. He immediately reported the error to the head office in Leeds.”
A source told The Sun: “Managers are really panicking about this because the implications are huge." The Department of Health was quoted as saying that the "hardware fault" was fixed and had caused "no breach of patient confidentiality."
This morning, 12 May 2008. NHS Connecting for Health, which runs much of the National Programme for IT, said:
“We are aware of a local hardware fault experienced in a GP practice. It caused no breach of patient confidentiality and is being thoroughly investigated to ensure that this cannot happen again.”
Officials argue that that a failure occurred at a GP practice in Essex because a local hardware fault was combined with recommended security procedures not being followed. They confirm that a contact in the smartcard reader failed. So if the GP did not log out of the computer the Choose and Book system could continue to be used without the need for the smartcard and passcode.
Officials point out that the GP should have logged out of the computer. But can they rely on busy GPs always logging off? I’ve put this to officials and am waiting for a response:
Security awareness not being perfect in all parts of the NHS it is apparently not uncommon practice to log in with a smartcard and passcode, and then leave others to use the PC. If this had happened on this occasion – and the smartcard holder had logged in, used the passcode, then left the PC – it appears anyone could have used it.
Links:
Potential security breach at GP practice in Essex – article in The SunBarts NPfIT go-live ends up in The SunAll eyes on NPfIT go-liveIs the summary care record plan feasible? UCL reportSecurity warning as NHS staff view celebrity recordSmartcard sharingIs NHS CfH in a good position to oversee the NPfIT? Smartcard sharing - Stuart King's blogAre Security Requirements and Care Delivery Naturally at Odds with One Another?South Warwickshire clinicians sharing smartcards
]]>
Is NPfIT summary care record plan feasible? UCL reporttag:www.computerweekly.com,2008:/blogs/tony_collins//12.301742008-05-12T10:38:00Z2008-05-12T10:41:09ZThe 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...Tony
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?]]>
clunky and "still has significant bugs"; data on patients often isn’t in a fit state to be uploaded - some participants in the UCL study described data quality in some GP practices as "dreadful" although improving; some GPs have concerns about the security of the SCR system and they don’t like uploading confidential data on their patients to a national database without their patients knowing enough to make an informed decision on whether to opt in or out of the scheme.
A year after the go-lives began should there still be significant bugs? Given that many changes have yet to be made to the SCR, will the significant bugs diminish or increase?
There are also doubts about whether all NHS staff will use an SCR even if every patient’s allergies and medications were uploaded. The UCL evaluation found that some NHS staff were too busy to access the SCR.
There’s a further difficulty: patients were promised in a leaflet that receptionists would not be able to access their SCR. At Bolton there are plans to give receptionists the ability to print out records from the SCR system because this fits in with working practices.
When patients learn that non-medical staff may have access to a national database that contains some of their sensitive medical records, most will care not a jot. But some may be more likely to opt out of having an SCR.
Even some NHS staff at the early adopter sites decided to opt out. The UCL evaluation found that “several participants [in the study] who were NHS staff had decided not to have a SCR themselves to prevent access by 'nosey' colleagues”.
If many people opt out of the SCR it’s unlikely to be used by doctors.
NHS CfH replies that fewer than one per cent of patients will opt out. In the early adopter sites only between 0.5% and 0.97% have opted out.
But CfH is comparing the numbers who've opted out with a total population that, in the main, hasn't heard of the SCR. What would be the opt-out rate among the SCR-aware? The UCL report produced evidence that the more people knew about the SCR the greater the potential for them to opt out.
The report said, for example, that "much of the individual resistance within GP practices [to the SCR] has come not from IT-ignorant ‘laggards’ but from Caldicott Guardians who are generally the most information-literate members of staff and certainly the formal custodians of the practice’s data ..."
At the early adopter sites awareness of the SCR remained very low, despite a public information campaign. The UCL report said: "It is clear that many individuals in the early adopter sites remain unaware of the SCR programme."
As most people don't know anything about the SCR it's arguably misleading to compare the actual opt-out rate with a largely unaware public.
GP Paul Thornton who has read the UCL report says it reinforces his concern that it’s illegal for patients’ confidential medical details to be uploaded to a national database without their knowledge.
He said of the UCL report: “This authoritative, detailed critique supports concerns that the CfH [Connecting for Health] proposals are not lawful. The researchers have shown that patient awareness and understanding in the “early adopter” areas remains uninformed. Doctors can no longer assume that the common law requirements for implied consent for the release of information are met.
"On the contrary, we now have to assume that implied consent is unlikely to be valid. It is essential that the BMA reviews the lawfulness of the proposals, in conjunction with the professional defence bodies, before any further patient data is transferred to CfH systems.”
CfH is entitled to say that patients should be aware of what’s happening at the early adopter sites because it and primary care trusts have organised local information campaigns, mass mailings to households, and the topic has been covered on radio, local television, and in local newspapers. There have also been information buses in town centres and plasma screens installed in some GP surgeries to show the benefits of the summary care record.
But the fact remains that, despite the efforts of CfH and the primary care trusts, the initials "SCR" mean nothing to most people in the early adopter areas. So it may be illegal to upload their medical details to a national database.
Ross Anderson of Cambridge University's Computer Laboratory, makes the valid point that the UCL report in general does not ask the most important question: “Are the right systems being built?” Rather it asks “Are they being sold in the right way?”
But the SCR has such a high political profile that it’s likely to continue much as before. And it will possibly take years to fizzle out - as so many national NHS IT schemes have before. After the next general election it may be dropped – and with senior officials and ministers barely noticing the UCL report.
Should any more money be spent on the SCR as it is? Probably it's a waste of public money. It's a good idea - but a good idea isn't enough to sustain a large public investment. The scheme should have been thought through properly years ago. You don't build the foundations for a housing estate and then design the houses. Which helps to explain why politics, when combined with large, risky, complicated IT projects, is a toxic mix.
Links
Full report of University College, London, of summary care record early adopter sitesNHS Connecting for Health welcomes University College London report on summary care record early adopter sitesPolitical pressure on NHS trusts to use immature databaseNo qualifications needed to view summary care records Users say SCR is too complexUCL researchers publish SCR evaluation Ministerial taskforce on summary care recordDr Paul Thornton's evidence to the Health Committee ]]>
NPfIT - back to choice of suppliers for NHS trusts? tag:www.computerweekly.com,2008:/blogs/tony_collins//12.299752008-05-07T10:40:00Z2008-05-07T10:49:34ZThe 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...Tony
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.
Additional Supply Capability and Capacity(ASCC). The suppliers will supply systems to national standards and may end up competing with the three local service providers, CSC, Fujitsu and BT, who were given £6.2bn worth of contracts to supply NHS trusts in 2003 and 2004.
After the NPfIT was announced in 2002, NHS trusts were, in effect, stopped from exercising choice over their IT systems. Procurements by coalitions of trusts which formed to buy systems regionally were also stopped. Instead the Department of Health signed contracts with a small group of suppliers with the aim of ruthlessly standardising on two main software suppliers, iSoft and IDX (replaced by Cerner) for the NHS in England. But some trusts are going their own way and it has been found that iSoft and Cerner do not offer all that is needed.
Now the ASCC gives NHS trusts a choice again - but if they choose a supplier from the framework list they may have to pay for the systems from their own budgets without any special central funding. If they buy from a local service provider their purchase will be subsidised by central funds.
The choice of systems under the framework deal includes patient administration systems - which have been supplied in the main by local service providers.
The framework deal means that trusts may be able to buy systems from a catalogue, by way of mini-competitions, without having to go through a formal EC tendering process.
NHS trusts have for years wanted a choice of systems - but the framework contracts raise questions about how much has been achieved by a National Programme for IT. The existence of the framework contracts will enable the government to respond to a forthcoming report by the National Audit Office on the NPfIT.
Links
The ASCC suppliers - NHS Connecting for Health website E-health Insider report on the award of the ASCC contracts
Appointed ASCC Suppliers
Lot 2 - Clinical Information Technology
Service Category 2.1 – Patient Administration System (PAS)
National
AGFA Healthcare (UK) Ltd
Atos Origin
British Telecom PLC
Cerner Ltd
CSE-Servelec Ltd
Fujitsu Services Ltd
iSoft PLC
Logica CMG UK Ltd
Perot Systems Europe Ltd
Siemens PLC
TATA Consultancy Services Ltd
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
Agilisys Holdings Ltd
ALERT Life Sciences Computing, SA
ATKOsoft S.A
Cambio Healthcare Systems Ltd
Capula Healthcare Ltd
Epic Systems Corporation
Intersystems Corporation
System C Healthcare PLC
Service Category 2.2 – Community Service Services
National
Atos Origin
British Telecom PLC
CSE-Servelec Ltd
Fujitsu Services Ltd
iSoft PLC
Logica CMG UK Ltd
Perot Systems Europe Ltd
Siemens PLC
Steria Ltd (Formerly known as Xansa (UK) Ltd)
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
Adastra Software Ltd
ALERT Life Sciences Computing, SA
ASC Computer Software Ltd (Formerly known as Ascribe PLC)
Capula Healthcare Ltd
CSW Group Ltd
Egton Medical Information Systems Ltd
Intersystems Corporation
Stalis Ltd
Service Category 2.3 – Mental Health
National
Atos Origin
British Telecom PLC
CSE-Servelec Ltd
Fujitsu Services Ltd
iSoft PLC
Logica CMG UK Ltd
Perot Systems Europe Ltd
Siemens PLC
Steria Ltd (Formerly known as Xansa (UK) Ltd)
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
Adastra Software Ltd
ALERT Life Sciences Computing, SA
ASC Computer Software Ltd (Formerly known as Ascribe PLC)
Capula Healthcare Ltd
CSW Group Ltd
Intersystems Corporation
Strand Technology Limited
Service Category 2.4 –Maternity
National
Atos Origin
British Telecom PLC
Fujitsu Services Ltd
iSoft PLC
Perot Systems Europe Ltd
Siemens PLC
TATA Consultancy Services Ltd
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
ALERT Life Sciences Computing, SA
ASC Computer Software Ltd (Formerly known as Ascribe PLC)
Epic Systems Corporation
Euroking Miracle Ltd
HD Clinical Ltd
Intersystems Corporation
PA Consulting Services Ltd
Stalis Ltd
System C Healthcare PLC
Service Category 2.5 – Dental
National
Category not awarded as insufficient successful Bidders
Specialist SME
ALERT Life Sciences Computing, SA
Egton Medical Information Systems Ltd
Practiceworks Ltd – (Formerly known as Kodak Dental Systems Ltd)
Software of Excellence United Kingdom Ltd
Service Category 2.6 – Ambulances
National
Atos Origin
British Telecom PLC
Fujitsu Services Ltd
iSoft PLC
TATA Consultancy Services Ltd
The CSC Computer Sciences Ltd
Specialist SME
Intersystems Corporation
Plain Healthcare
System C Healthcare PLC
Service Category 2.7 – Prison Health
National
Atos Origin
British Telecom PLC
FileTek UK Ltd
Fujitsu Services Ltd
iSoft PLC
Perot Systems Europe Ltd
Steria Ltd (Formerly known as Xansa (UK) Ltd)
Specialist SME
3C Healthcare Partnership Ltd
ALERT Life Sciences Computing, SA
CSW Group Ltd
Egton Medical Information Systems Ltd
Intersystems Corporation
Plain Healthcare
Service Category 2.8 – Hospice Care
National
Atos Origin
British Telecom PLC
FileTek UK Ltd
Fujitsu Services Ltd
iSoft PLC
Perot Systems Europe Ltd
Steria Ltd (Formerly known as Xansa (UK) Ltd)
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
Adastra Software Ltd
ALERT Life Sciences Computing, SA
ATKOsoft S.A
CSW Group Ltd
Service Category 2.9 – Child Health Services
National
Atos Origin
British Telecom PLC
CSE-Servelec Ltd
Fujitsu Services Ltd
iSoft PLC
Logica CMG UK Ltd
McKesson Information Solutions UK Ltd
Perot Systems Europe Ltd
Siemens PLC
Steria Ltd (Formerly known as Xansa (UK) Ltd)
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
ALERT Life Sciences Computing, SA
ASC Computer Software Ltd (Formerly known as Ascribe PLC)
CSW Group Ltd
Egton Medical Information Systems Ltd
Epic Systems Corporation
Service Category 2.10 – Urgent Care
National
AGFA Healthcare (UK) Ltd
Atos Origin
British Telecom PLC
Cerner Ltd
FileTek UK Ltd
Fujitsu Services Ltd
iSoft PLC
Logica CMG UK Ltd
Perot Systems Europe Ltd
Siemens PLC
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
Adastra Software Ltd
ALERT Life Sciences Computing, SA
ASC Computer Software Ltd (Formerly known as Ascribe PLC)
Capula Healthcare Ltd
Epic Systems Corporation
Intersystems Corporation
Plain Healthcare
Stalis Ltd
System C Healthcare PLC
Service Category 2.11 – Theatres
National
AGFA Healthcare (UK) Ltd
Atos Origin
British Telecom PLC
Cerner Ltd
Fujitsu Services Ltd
iSoft PLC
Logica CMG UK Ltd
McKesson Information Solutions UK Ltd
Perot Systems Europe Ltd
Siemens PLC
The CSC Computer Sciences Ltd
Specialist SME
ALERT Life Sciences Computing, SA
Capula Healthcare Ltd
Epic Systems Corporation
Intersystems Corporation
Stalis Ltd
System C Healthcare PLC
Trisoft Limited
Service Category 2.12 – Order Communications and Results Reporting
National
AGFA Healthcare (UK) Ltd
Atos Origin
British Telecom PLC
Cerner Ltd
CSE-Servelec Ltd
FileTek UK Ltd
Fujitsu Services Ltd
iSoft PLC
Logica CMG UK Ltd
Perot Systems Europe Ltd
Siemens PLC
Steria Ltd (Formerly known as Xansa (UK) Ltd)
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
ALERT Life Sciences Computing, SA
ATKOsoft S.A
Cambio Healthcare Systems Ltd
Capula Healthcare Ltd
Clinisys Solutions Ltd
CSW Group Ltd
Egton Medical Information Systems Ltd
Epic Systems Corporation
Intersystems Corporation
Plumtree Group Ltd
System C Healthcare PLC
Technidata UK Ltd
Service Category 2.13 – Diagnostic Systems – Pathology and Laboratory
National
Atos Origin
British Telecom PLC
Cerner Ltd
FileTek UK Ltd
Fujitsu Services Ltd
iSoft PLC
Logica CMG UK Ltd
Perot Systems Europe Ltd
Siemens PLC
TATA Consultancy Services Ltd
Specialist SME
Clinisys Solutions Ltd
Epic Systems Corporation
Intersystems Corporation
Sunquest Information Systems (International) Ltd (formerly MISYS Information Systems (International) Ltd)
Technidata UK Ltd
Service Category 2.14 – ePrescribing Systems
National
Atos Origin
British Telecom PLC
Cerner Ltd
CSE-Servelec Ltd
Fujitsu Services Ltd
iSoft PLC
Perot Systems Europe Ltd
Siemens PLC
Steria Ltd (Formerly known as Xansa (UK) Ltd)
TATA Consultancy Services Ltd
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
ALERT Life Sciences Computing, SA
ATKOsoft S.A
Cambio Healthcare Systems Ltd
CSW Group Ltd
Egton Medical Information Systems Ltd
Epic Systems Corporation
Intersystems Corporation
Jac Computer Services Ltd
System C Healthcare PLC
Service Category 2.15 – Pharmacy Stock Control
National
Atos Origin
British Telecom PLC
Cerner Ltd
Electronic Data Systems Ltd (EDS)
FileTek UK Ltd
Fujitsu Services Ltd
iSoft PLC
Perot Systems Europe Ltd
Siemens PLC
TATA Consultancy Services Ltd
Specialist SME
3C Healthcare Partnership Ltd
ALERT Life Sciences Computing, SA
ASC Computer Software Ltd (Formerly known as Ascribe PLC)
Epic Systems Corporation
Intersystems Corporation
Jac Computer Services Ltd
System C Healthcare PLC
Service Category 2.16 – GP Surgery Services
National
British Telecom PLC
Fujitsu Services Ltd
iSoft PLC
Perot Systems Europe Ltd
Specialist SME
ALERT Life Sciences Computing, SA
Egton Medical Information Systems Ltd
Epic Systems Corporation
Service Category 2.17 – Social Care
National
Atos Origin
British Telecom PLC
Capgemini UK Plc
CSE-Servelec Ltd
Fujitsu Services Ltd
Logica CMG UK Ltd
Perot Systems Europe Ltd
Siemens PLC
Steria Ltd (Formerly known as Xansa (UK) Ltd)
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
Corelogic Ltd
CSW Group Ltd
OLM Group Ltd
System C Healthcare PLC
Service Category 2.18 – Screening and Surveillance
National
Atos Origin
British Telecom PLC
Cerner Ltd
CSE-Servelec Ltd
Fujitsu Services Ltd
iSoft PLC
McKesson Information Solutions UK Ltd
Perot Systems Europe Ltd
Siemens PLC
Steria Ltd (Formerly known as Xansa (UK) Ltd)
Specialist SME
ALERT Life Sciences Computing, SA
ASC Computer Software Ltd (Formerly known as Ascribe PLC)
Capula Healthcare Ltd
CSW Group Ltd
Digital Healthcare Ltd
Egton Medical Information Systems Ltd
Epic Systems Corporation
Euroking Miracle Ltd
PA Consulting Services Ltd
Sowerby Centre for Health Informatics at Newcastle Ltd
Service Category 2.19 – Integrated Care pathway and Care Planning
National
AGFA Healthcare (UK) Ltd
Atos Origin
British Telecom PLC
Cerner Ltd
CSE-Servelec Ltd
Fujitsu Services Ltd
iSoft PLC
Siemens PLC
Steria Ltd (Formerly known as Xansa (UK) Ltd)
Specialist SME
ALERT Life Sciences Computing, SA
ASC Computer Software Ltd (Formerly known as Ascribe PLC)
Capula Healthcare Ltd
CSW Group Ltd
Epic Systems Corporation
Map of Medicine Ltd (Formerly known as Informa UK Ltd)
OLM Group Ltd
System C Healthcare PLC
Service Category 2.20 – Decision Support
National
AGFA Healthcare (UK) Ltd
Atos Origin
British Telecom PLC
Cerner Ltd
CSE-Servelec Ltd
FileTek UK Ltd
Fujitsu Services Ltd
iSoft PLC
Perot Systems Europe Ltd
Siemens PLC
Steria Ltd (Formerly known as Xansa (UK) Ltd)
TATA Consultancy Services Ltd
Specialist SME
Adastra Software Ltd
ALERT Life Sciences Computing, SA
Capula Healthcare Ltd
CAS Services Ltd (Formerly known as Clinical Solutions Ltd)
CSW Group Ltd
Egton Medical Information Systems Ltd
Epic Systems Corporation
Infermed Ltd
Map of Medicine Ltd (Formerly known as Informa UK Ltd)
Plain Healthcare
Sowerby Centre for Health Informatics at Newcastle Ltd
Stalis Ltd
Service Category 2.21 – Diagnostic Systems- Radiology and Digital Imaging
National
AGFA Healthcare (UK) Ltd
Atos Origin
British Telecom PLC
Carestream Health UK Ltd (formerly Kodak Health Ltd)
Cerner Ltd
Fujitsu Services Ltd
iSoft PLC
Siemens PLC
Specialist SME
Agilisys Holdings Ltd
CSW Group Ltd
Digital Healthcare Ltd
Epic Systems Corporation
Insignia Medical Systems Ltd
Intersystems Corporation
Sowerby Centre for Health Informatics at Newcastle Ltd
Sunquest Information Systems (International) Ltd (formerly MISYS Information Systems (International) Ltd)
Service Category 2.22 – Coronary Heart Disease
National
Atos Origin
British Telecom PLC
FileTek UK Ltd
Fujitsu Services Ltd
iSoft PLC
McKesson Information Solutions UK Ltd
Perot Systems Europe Ltd
Steria Ltd (Formerly known as Xansa (UK) Ltd)
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
ALERT Life Sciences Computing, SA
ATKOsoft S.A
Capula Healthcare Ltd
CSW Group Ltd
Egton Medical Information Systems Ltd
Epic Systems Corporation
HD Clinical Ltd
Service Category 2.23 – Diabetes
National
Atos Origin
British Telecom PLC
CSE-Servelec Ltd
FileTek UK Ltd
Fujitsu Services Ltd
iSoft PLC
McKesson Information Solutions UK Ltd
Perot Systems Europe Ltd
Siemens PLC
Specialist Computer Centres PLC (SCC)
Steria Ltd (Formerly known as Xansa (UK) Ltd)
Specialist SME
3C Healthcare Partnership Ltd
ALERT Life Sciences Computing, SA
ASC Computer Software Ltd (Formerly known as Ascribe PLC)
Capula Healthcare Ltd
CSW Group Ltd
Digital Healthcare Ltd
Egton Medical Information Systems Ltd
Epic Systems Corporation
Stalis Ltd
System C Healthcare PLC
Service Category 2.24 – Oncology Services
National
Atos Origin
British Telecom PLC
FileTek UK Ltd
Fujitsu Services Ltd
iSoft PLC
Perot Systems Europe Ltd
Siemens PLC
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
ALERT Life Sciences Computing, SA
Epic Systems Corporation
System C Healthcare PLC
Service Category 2.25 – Ophthalmology
National
Fujitsu Services Ltd
Perot Systems Europe Ltd
Siemens PLC
TATA Consultancy Services Ltd
Specialist SME
3C Healthcare Partnership Ltd
ALERT Life Sciences Computing, SA
ASC Computer Software Ltd (Formerly known as Ascribe PLC)
ATKOsoft S.A
Digital Healthcare Ltd
Epic Systems Corporation
OLM Group Ltd
Service Category 2.26 – Renal Services
National
British Telecom PLC
FileTek UK Ltd
Perot Systems Europe Ltd
Siemens PLC
Specialist SME
Capula Healthcare Ltd
Clinical Computing PLC
Epic Systems Corporation
Mediqal Health Informatics Ltd
Service Category 2.27 – Health Care Professionals Services
National
Atos Origin
British Telecom PLC
Cerner Ltd
CSE-Servelec Ltd
Fujitsu Services Ltd
iSoft PLC
Logica CMG UK Ltd
Perot Systems Europe Ltd
School of Medicine, Swansea University
Siemens PLC
Steria Ltd (Formerly known as Xansa (UK) Ltd)
Specialist SME
3C Healthcare Partnership Ltd
ALERT Life Sciences Computing, SA
ATKOsoft S.A
Capula Healthcare Ltd
CSW Group Ltd
Egton Medical Information Systems Ltd
Epic Systems Corporation
OLM Group Ltd
Service Category 2.28 – Clinical Integration / Systems Integration Service
National
AGFA Healthcare (UK) Ltd
Atos Origin
British Telecom PLC
Capgemini UK Plc
Cerner Ltd
Electronic Data Systems Ltd (EDS)
Fujitsu Services Ltd
Logica CMG UK Ltd
McKesson Information Solutions UK Ltd
Siemens PLC
Specialist Computer Centres Plc (SCC)
Steria Ltd (Formerly known as Xansa (UK) Ltd)
TATA Consultancy Services Ltd
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
Agilisys Holdings Ltd
ALERT Life Sciences Computing, SA
CSW Group Ltd
Digital Healthcare Ltd
E.novation UK Limited
Epic Systems Corporation
HD Clinical Ltd
Intersystems Corporation
Methods Consulting Ltd
OLM Group Ltd
System C Healthcare PLC
Service Category 2.29 – Infection Control Services
National
AGFA Healthcare (UK) Ltd
Atos Origin
FileTek UK Ltd
Fujitsu Services Ltd
iSoft PLC
Perot Systems Europe Ltd
Specialist Computer Centres PLC (SCC)
Steria Ltd (Formerly known as Xansa (UK) Ltd)
TATA Consultancy Services Ltd
Specialist SME
3C Healthcare Partnership Ltd
CAS Services Ltd (Formerly known as Clinical Solutions Ltd)
Clinisys Solutions Ltd
CSW Group Ltd
E.novation UK Limited
Epic Systems Corporation
OLM Group Ltd
Plumtree Group Ltd
Service Category 2.30 – Clinical Document Management Services
National
3M Health Care Ltd
AGFA Healthcare (UK) Ltd
Atos Origin
British Telecom PLC
Cerner Ltd
Fujitsu Services Ltd
Logica CMG UK Ltd
Siemens PLC
Specialist Computer Centres PLC (SCC)
TATA Consultancy Services Ltd
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
EDM Group Ltd
Egton Medical Information Systems Ltd
Epic Systems Corporation
HD Clinical Ltd
Plumtree Group Ltd
Sowerby Centre for Health Informatics at Newcastle Ltd
Service Category 2.31 – Respiratory Care Services
National
Atos Origin
British Telecom PLC
FileTek UK Ltd
Perot Systems Europe Ltd
Steria Ltd (Formerly known as Xansa (UK) Ltd)
Specialist SME
ALERT Life Sciences Computing, SA
CSW Group Ltd
Egton Medical Information Systems Ltd
Epic Systems Corporation
HD Clinical Ltd
System C Healthcare PLC
Service Category 2.32 – Elderly Care Services
National
Atos Origin
British Telecom PLC
CSE-Servelec Ltd
Fujitsu Services Ltd
iSoft PLC
Logica CMG UK Ltd
McKesson Information Solutions UK Ltd
Siemens PLC
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
ALERT Life Sciences Computing, SA
CSW Group Ltd
OLM Group Ltd
System C Healthcare PLC
Service Category 2.33 – Endoscopy Services Further competitions will be competed under a consolidated National SME list for this category.
National
AGFA Healthcare (UK) Ltd
FileTek UK Ltd
iSoft PLC
Perot Systems Europe Ltd
School of Medicine, Swansea University
Siemens PLC
The CSC Computer Sciences Ltd
Specialist SME
ASC Computer Software Ltd (Formerly known as Ascribe PLC)
Epic Systems Corporation
Service Category 2.34 – Audiology Services
National
Category not awarded as insufficient successful Bidders
Specialist SME
ALERT Life Sciences Computing, SA
E.novation UK Limited
Epic Systems Corporation
Service Category 2.35 – Critical Care Services Further competitions will be competed under a consolidated National SME list for this category.
National
Atos Origin
British Telecom PLC
Cerner Ltd
FileTek UK Ltd
Fujitsu Services Ltd
iSoft PLC
Perot Systems Europe Ltd
Specialist SME
Epic Systems Corporation
Service Category 2.36 – Step-in and Step-out Services
To be considered for appointment to the Lot 2 Step-In/Step-Out Service Category, a Supplier must have been appointed to at least one other Service Category within Lot 2.
National
British Telecom PLC
Electronic Data Systems Ltd (EDS)
FileTek UK Ltd
Siemens PLC
TATA Consultancy Services Ltd
The CSC Computer Sciences Ltd
Specialist SME
Agilisys Holdings Ltd
EDM Group Ltd
Egton Medical Information Systems Ltd
Methods Consulting Ltd
OLM Group Ltd
4.2 - Lot 2 Consultancy Services
To be considered for appointment to the Lot 3 Part B Consultancy Services in respect of Lot 2, a Supplier must have been appointed to at least one other Service Category within Lot 2.
National
3M Health Care Ltd
AGFA Healthcare (UK) Ltd
Atos Origin
British Telecom PLC
Capgemini UK Plc
Electronic Data Systems Ltd (EDS)
Fujitsu Services Ltd
Logica CMG UK Ltd
McKesson Information Solutions UK Ltd
Perot Systems Europe Ltd
School of Medicine, Swansea University
Siemens PLC
Specialist Computer Centres PLC (SCC)
TATA Consultancy Services Ltd
The CSC Computer Sciences Ltd
Specialist SME
3C Healthcare Partnership Ltd
Adastra Software Ltd
ALERT Life Sciences Computing, SA
CSW Group Ltd
E.novation UK Limited
Epic Systems Corporation
Euroking Miracle Ltd
Insignia Medical Systems Ltd
Map of Medicine Ltd (Formerly known as Informa UK Ltd) Ltd
Mediqal Health Informatics Ltd
Methods Consulting Ltd
OLM Group Ltd
PA Consulting Services Ltd
Sowerby Centre for Health Informatics at Newcastle Ltd
System C Healthcare PLC
]]>
Is CfH in a good position to oversee the NPfIT?tag:www.computerweekly.com,2008:/blogs/tony_collins//12.299542008-05-07T09:41:00Z2008-05-07T09:43:18ZComment 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...Tony
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.
study by researchers at University College, London, finished on 30 April 2008 and was paid for by CfH. Researchers spent 1,500 hours studying the working practices and cultures of staff at CfH and at early adopter sites.
Among the study’s most serious criticisms in the study are matters that some in Whitehall will find peripheral, perhaps even unimportant: that Connecting for Health is trying to control the language of the summary care record programme– and that it has a “controlling approach to the release of information”.
So what?
The control of language and information raises questions about whether Connecting for Health has become too ideologically enmeshed with the NPfIT to want the power of private board of directors to stop, curtail or order a genuinely independent review of a programme that may be failing. Indeed the 1,500-strong CfH owes its existence, in the main, to the NPfIT.
The control of language and information about a project is a common factor in several IT disasters Computer Weekly has investigated, such as the failure of the Performing Right Online Membership system at the Performing Right Society (now the MCPS-PRS Alliance) and the failure of the Analytical Services Statistical Information System at the Department for Work and Pensions.
When large and complex programmes start to fail an early casualty is clear information about its progress: Ian Watmore, formerly government CIO, has described it aptly as “radio silence”.
Those involved in the programme because overly sensitive to the language used in official or internal reports on the progress of the project; and indirect, ambiguous and eclipsing language is preferred to harsh clarity: serious problems are depicted as in the past or transient, soon to be overcome, and probably have been, by the time the report is finished – even through the problems have existed for months, and years in the case of the NPfIT.
A degree of control of information was manifest at the outset of the evaluation of the summary care record by researchers at University College, London. They were asked to study the technology and the progress with the summary care record – but believed themselves excluded from questioning the programme itself.
This is what researchers said in the draft and final reports:
“At the outset of this evaluation, CFH made clear to us that we had been contracted to evaluate “an Early Adopter phase, not a pilot”, and that our findings would be used to “inform the wider roll-out of the programme” (hence, implicitly, that it was not our role to seek to reverse the original high-level policy decision to fund the programme).
"Nevertheless, the main question which many stakeholders wanted us to answer was 'Should large amounts of public money have been put into the Summary Care Record programme in the first place?'."
In their draft report only the researchers say they were asked specifically not become embroiled in political issues – which some would regard as the most important parts of any programme that may be in trouble or failing.
They said:
“… we were asked to evaluate the implementation of the Summary Care Record as a technology and avoid getting embroiled in political issues. But the political context proved impossible to ignore, since it formed the backdrop for key decisions, both local and national.”
The researchers at University College, London, went on to produce excellent reports, though the draft used more direct language and was clearer than the final version; and though the report was prompted by a recommendation of a ministerial taskforce CfH deserves credit for commissioning and funding it, and agreeing to publish it.
Even so the control of information as highlighted by the UCL report is a worrying sign. And it may also have wasted money and particularly the time of NHS staff and officials: a letter to patients on the benefits of the summary care record went through 93 versions before being sent out; DVDs were produced on summary care records which, the UCL report said, were greeted with amusement by a focus group as “unrealistic” and “propaganda”; and large plasma screens were bought for GPs who took part in the early-adopter programme, also to show the benefits of the summary care record.
Indeed the report’s researchers lumped together – for the first time in an official report related to the NPfIT – those who hold extreme views in favour of the programme with those who hold dogmatic views against it. They said:
“An early finding of this evaluation was that those who felt strongly about the summary care record - champions and change agents on the one hand; lobbyists and conscientious objectors on the other - had a tendency to frame issues in terms of simplistic and morally absolute dualisms, and to cite selected ‘facts’ in support of their position. Furthermore, our interpretation was that these people unconsciously sought to blame a host of problems on what they characterised, disparagingly, as the ‘other side’ … This mutual demonization … has to a large extent overshadowed sensible debate.”
The evaluation suggests caution. In response CfH's statement seems to suggest it will continue as quickly as possible. But is it in an objective position to judge the NPfIT? How objective is the government when making decisions on the future of the NPfIT on which £4bn has been spent so far?
When those who took part in the study at primary care trusts were asked towards the end of this evaluation year what single change they would wish to make in the summary care programme, the most common response was “[CFH should] just give us the money and let us get on with it”.
In separate entries I’ll mention some of the changes in the draft and final reports, and the main points they make.
Links:
Report of Evaluation of Summary Care Record Early Adopter Programme The report of University College, London, of the summary care record early-adopter sitesUrgent review of Summary Care Record consent model recommended - and useful comments]]>
Whitehall pushed immature technology on NHS – government-funded reporttag:www.computerweekly.com,2008:/blogs/tony_collins//12.298132008-05-04T08:00:00Z2008-05-03T23:27:50ZConnecting 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...Tony
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.
Bolton, Bury, South Birmingham and Dorset.
The report is expected to be published next Tuesday. It is expected to show the lengths to which some health officials were prepared to go to convey the right message to the public on the summary care record programme. A mass mailing letter to explain the benefits of the summary care record to patients went through 93 versions before it was sent.
Patients who took part in early trials were given the chance to opt out of having their medical details on a national database. But health officials paid for GP surgeries to have large plasma screens in their waiting rooms to show the benefits of the summary care record.
In what researchers considered an Orwellian scene, health officials equipped one GP surgery’s waiting room to show a PowerPoint presentation on a continuous loop to describe the benefits of the summary care records to patients. A GP at the practice said it had no control over the content of the plasma display which was “apparently ours for life”.
The researchers found that CfH had an internal organisation set up to document and disseminate the benefits from the summary care record but had no equivalent department to do the same on “dis-benefits” and risks of the project.
Whitehall officials collected information from NHS trusts about their progress and problems rolling out the summary care records. But knowledge failed to circulate efficiently. Staff at primary care trusts said they had not learnt much from other early-adopter sites.
CfH is itself a victim of pressure from the government to meet tight timescales and accelerate progress under the NPfIT.
The report is likely to say that politicians will need to recognise that it is impossible for CfH to go beyond the technology and help the NHS to make the necessary changes in the NHS while also adhering strictly to predefined goals and milestones.
The Department of Health is recruiting two executives - a CIO, and a Director of Programme and System Delivery to run the NPfIT - on salaries of at least £200,000 each. The new CIO will have an annual budget of £1.6bn.
Patients who were interviewed for the study broadly understood the potential benefits of the summary care record but questioned whether the scheme was a worthwhile use of public money.
CfH made no comment.
Links
Ministerial taskforce on summary care record - reportMore GPs to introduce NHS summary care recordThe summary care record in Bradford and AiredaleSouth Birmingham and the summary care record ]]>
Top Whitehall 200k IT jobs – hopefuls given only 2 weeks to applytag:www.computerweekly.com,2008:/blogs/tony_collins//12.297332008-05-01T15:15:00Z2008-05-01T16:20:16ZWhitehall 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...Tony
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.
Director General, Chief Information Officer, Department of Health, who will have direct responsibility for about 1,700 staff, about 180 of whom are in the Information Services Group and 1,500 are at NHS Connecting for Health
- Director of Programme and System Delivery who will report to the CIO and be accountable for managing NHS Connecting for Health, the implementation arm of the National Programme for IT.
The CIO’s total annual budget is £1.65bn.
For the CIO’s job the biggest hurdle is, arguably, a requirement that candidates prove they have board-level experience in an organisation commensurate with size and complexity of this role. How many jobs are there of the size and complexity of Director General of NHS IT?
The NHS employs more than one million people, has an annual budget of £90bn and has an IT programme – the NPfIT – which is so complex some say it’s unachievable.
The list of requirements shows how difficult it is for candidates to prepare a CIO application in two weeks.
They must convince recruitment consultants and the Department of Health of their:
- Vision for informatics, where the achievement of better patient outcomes and ongoing reform is supported by efficient, effective and secure information systems
- Ability to use IT to reduce the burden on, front line staff, ensure managers and policy makers have the timely, relevant and accurate data they require to make important decisions, and provide flexibility to deal with future change and innovation in the way that health care is delivered
- Ability to keep NHS IT secrets, particularly when they’ve left. The department is making candidates aware that they will have to sign the Official Secrets Act which covers every aspect of their work during and after employment. The post is open only to EC nationals, members of the Commonwealth, the European Economic Area (EEA), Swiss nationals and certain non-EEA family members.
- Experience of managing information-led change, married with excellent corporate leadership and policy skill.
The new CIO will also be expected to:
- Manage relationships across government
- Ensure that the Department of Health participates fully in the development of cross government information and technology policy, and that ministers and ministerial teams are “appropriately” briefed
- Ensure (as far as possible) that all decisions are made with due consideration of informatics
- Develop the informatics strategy for social care to support national planning and quality assurance, the integration of services between social care and the NHS, and closer working between social services departments
Chosen candidates will be invited to an interview with Patrick Johnson and Tim Cook from Russell Reynolds Associates in London. Those shortlisted will be asked to meet an occupational psychologist. Final interviews are likely to take place on 24 June.
Indicative Timetable
Advertisement in Sunday Times 13 April
Closing date 28 April
Long list Meeting 6 May
Short List Meeting 4 June
Informal meetings and psychometrics testing 9 and 16 June
Interviews 24 June
Computer Weekly put it to the Department of Health that two weeks for applications to top IT jobs in government seemed to be rushed. We said the apparent rush could imply that it has already chosen someone – which would mean the adverts are only going through the motions.
This was its short reply:
"The DH has employed Russell Reynolds Associates to search for applicants alongside the advert. This search began before the advert was published".
Links:
Whitehall advertises for top NHS IT jobHealth IT is too big for one boss: NHS needs two at £200,000 eachThe Summary Care Record - what has gone wrong?Top ten Richard Granger quotesThree chief information officers get pay packets that are among the biggest in Whitehall ]]>
Fujitsu makes revised offer on NPfIT contracttag:www.computerweekly.com,2008:/blogs/tony_collins//12.295942008-04-30T10:42:00Z2008-04-30T11:48:22ZSeveral people in the NHS say that health officials and Fujitsu have returned to the negotiating table after talks had stalled over a “contract reset” over the supplier’s £896m deal for installing Cerner’s Millennium systems in the south of England....Tony
Sir Ian Carruthers, who is a former acting Chief Executive of the NHS, a senior responsible owner of the NPfIT and now Chief Executive of the South West Strategic Health Authority
- a European director of Fujitsu
- A director from Fujitsu’s headquarters in Japan
As a result Fujitsu has made significant concessions – a revised financial offer – and the NHS would have to pay tens of millions of pounds, not hundreds of millions, to keep Fujitsu in the National Programme for IT [NPfIT]. The figures being discussed are not dissimilar to the £55m extra paid to BT as part of its contract reset.]]>
Fujitsu stall again.
The problem for Fujitsu is that its contract on the NPfIT could probably be absorbed by BT. But a deal with Fujitsu would still involve the NHS [taxpayers] in paying extra money; and it’s not clear if some of the risks which suppliers took on as part of the original contract - risks which the former NHS IT head Richard Granger fought hard to transfer to suppliers – would come back to the NHS.
It’s understood that if Fujitsu withdrew from the NPfIT it could cost the company up to £340m. It’s also being said that whereas NHS South East Coast and NHS South Central were willing to handle going it alone with Cerner, without Fujitsu’s help, NHS South West was not.
If the NHS accepts Fujitsu’s offer the two sides will work under a memorandum of understanding for the time being.
Links
Fujitsu and the NHS - bound by obsolete contracts Sir Ian Carruthers - the NPfIT's fifth senior responsible ownerHave NPfIT talks in the south stalled?Fujitsu and NHS to sign NPfIT MoU]]>
World-class? - please notag:www.computerweekly.com,2008:/blogs/tony_collins//12.295112008-04-30T09:00:00Z2008-04-30T11:49:11ZA health magazine has this week called on its readers to submit "world-class" questions. HM Revenue and Customs wants to prove it has a world-class data security environment after the bad publicity over its apparently losing two CDs with the...Tony
world-class data security environment after the bad publicity over its apparently losing two CDs with the unencrypted details of 25 million people on them. Ministers refer to the NHS as world-class; and they want the National Programme for IT to be world-class. Gordon Brown has backed a "world-class" medical research centre in St Pancreas.
The number 10 website says Gordon Brown wants a "world-class" standard of education. In January 2008 the UK was said to be delivering "world-class e-Government"- which could mean it surpasses the quality of online public services in Papua New Guinea. Or perhaps not.
So how measurable is world-class?
Do Eskimos have world-class igloos, Canadians world-class mountains, the French world-class strikes and the Chinese world-class methods of crowd control in Tibet? Perhaps Robert Mugabe regarded his electoral system as world-class until recently.
The term is meaningless, or misleading. One could envisage a ferry company, a new airline or a rail company using the euphemism "world-class" to describe the standards of travel commensurate with the lowest fares - cattle-class in all but name. A taxi driver could drop you somewhere unexpected in return for a world-class fare.
I'll put some egregious examples of the phrase, as used in the IT industry, on this blog. This is a tolerable use of the phrase. And this. But the general rule is: steer clear of platitudes, jargon and clichés like the plague.]]>
What does it mean to be a world-class business?
What does world-class distribution mean?What does world-class procurement look like? Meaningless: the phrase "thought leadership" The Department of Health - world-class commissioningHM Revenue and Customs, the missing CDs scandal and world-class nonsenseThe world-class Chorus and Orchestra of Welsh National Opera, supported by Classic FM
]]>
290 patient safety incidents reported under NPfIT schemetag:www.computerweekly.com,2008:/blogs/tony_collins//12.292792008-04-25T11:49:00Z2008-04-28T12:14:34ZNearly 300 incidents have put patients at risk since 2005 when health officials began systematic recording of safety matters under the NHS’s National Programme for IT [NPfIT]. The incidents are evidence that new IT systems in the health service can...Tony
launched by ministers in 2002 without any formal structure for identifying incidents in which the safety of patients was put at risk by errors arising from installations of new national systems. ]]>
radiology information systems and picture archiving and communication systems (PACS) which allow digital x-ray images to be stored, retrieved and distributed to computer screens.
Last year the partner of a patient who died in hospital complained to the General Medical Council because she says x-rays on a PACS system were mixed up. The partner has told Computer Weekly that she is waiting for a date for a judicial review over whether there should be a fresh inquest.
It’s not known if this was one of the 290 incidents which put the safety of patients at risk, some details of which were disclosed this week at HC2008, the annual healthcare IT conference at Harrogate which is organised by the British Computer Society.
Maureen Baker, national lead for clinical safety at NHS Connecting for Health, said at HC2008 that there has been a big improvement in mechanisms for reporting incidents and dealing with them since 2005 – though the NPfIT was launched in 2002 and £6.2bn worth of IT contracts were in place by January 2004.
Baker said that incidents are reported when there is the potential for a patient or patients being harmed.
She said: “We have had just under 300 incidents in two and half years. They cover just about every area that CfH has activity in. Probably the largest number relate to PACS issues almost certainly because PACS has the largest footprint of any of the systems. But we are able, we think, to detect when something goes wrong in any of the systems and quickly pick that up, address it and make it safe.”
One incident involved two NHS trusts which had connected PACS systems but both used similar ID numbers to store and retrieve the images. It was discovered that some numbers were duplicated so at times a correct number would retrieve the wrong x-ray image.
There have also been incidents of drugs “mis-mapping” – which could lead to the wrong drugs being given, or potentially causing a clash of medication.
Baker said: “Of the incidents we have dealt with we are not aware of a patient actually being harmed. It is very much the potential of being harmed. We looked to see if anyone has been harmed. We have not identified yet that that has been the case.”
But she said that when IT-related projects go wrong it can have a serious effect on patients. Information from one patient may go into another’s notes.
Baker said: “So many things go wrong for patients when the wrong information gets released to them: someone else’s blood test results in your notes could have very serious consequences for you, and the other patient as well.”
If x-rays are mixed up, NHS specialists may, at worst, act on incorrect information, diagnose someone else’s problem, or clear someone who has something wrong with them.
Of the incident in which there was confusion over the numbers under which x-ray images were stored, Baker said: “When it was picked up, when they realised they were getting images from another trust, [we asked] how long had this been happening and how many patients had it affected?”
Baker and her team helped to fix the problem by ensuring the correct images and unique numbers were assigned to the correct patients. She said problems such as this stem of the lack of any mandatory use of the NHS number. “If the trusts had been using the NHS number it would not have happened,” she said.
DNV's independent review of safety and the NPfIT was commissioned by Aidan Halligan, the then joint senior responsible owner of the national programme.
Since then DNV has carried out a fresh review of the mechanisms in place to protect patients from mistakes after troubled go-lives has found there have been important improvements but still some gaps in safety arrangements.
DNV's review has not been released. But Computer Weekly has learned that it disclosed that talks were underway to agree a contract change notice with local service providers to the NPfIT which would formally include safety of patients in the requirements of the programme.
The report also expressed concerns about a lack of clarity between NHS Connecting for Health and trusts over how they worked together on patient safety issues. There was also a lack of clarity on roles and accountabilities between parties over patient safety.
And there was a view among local service providers that although they owned some of the risks on the safety of patients, this would not be the case if NHS staff, nurses or clinicians used systems in a way which was outside the boundaries of the design.
**
Since posting this a spokesperson for NHS CFH has volunteered this comment:
"We have no evidence of any patient being harmed as a result of these patient safety incidents in the past two and a half years of the National Programme for IT. These incidents which could, for example, impact on dosage or frequency of medication if not picked up, need to be put in context of the thousands of users of the system who generate around 15 million transactions via the NPfIT in one week.
"NPFIT has been a central player in developing international standards of safety for the manufacture and use of clinical IT systems and expects these standards to be formally adopted as a European Directive later this year for healthcare providers.
"We actively encourage users to report any potential safety incidents and we pick these up to ensure that similar incidents are not repeated in other areas. This information is also used to make further improvements across the programme.
"We have trained over 400 staff on the Clinical Accreditation Training Scheme which also includes over 200 clinicians who are actively involved in the management of incidents."
**
Maureen Baker- highlights of her talk to HC2008. She is Connecting for Health’s National Lead for Clinical Safety and has been a GP and Director of Primary Care at the National Patient Safety Agency.
She said: “At one point Aidan Halligan was joint senior responsible owner for the National Programme for IT. He at that point asked the National Patient Safety Agency to conduct a high level risk assessment of the national programme. NPSA also had a professional risk adviser as a member of its board. He was the person who conducted the risk assessment on behalf of NPSA and the Department [of Health]. This was almost four years ago…. [The review was carried out by Mark Boult of DNV Consulting.]
“...He [Boult] found that the programme was not talking about safety as a benefit.” She said the priority for the NPfIT was seen to be modernising the NHS. But most people - citizen, clinician, or IT professional - wanted the NPfIT to deliver better safer care for patients, especially given the amount of money, time and effort that was being invested in it.
“There had been very little formal risk assessment at that stage. IT has the ability to eliminate medication errors through illegibility as an example. However there is an opportunity to introduce new risks that weren’t there before. If you don’t undertake a structured programme of risk assessment you are losing the opportunity to identity possible new risks that might be introduced.”
She said that Boult’s report concluded that the NPfIT was not addressing safety in a structured, proactive manner and that other safety-critical industries would.
Baker said: “So this was a fairly hard-hitting report and conclusion. Fortunately it had the effect of galvanising senior management to realise that they needed to address safety as a very distinct issue and start to take work forward to make sure these concerns were addressed.”
Suppliers of systems were then compelled to consider what could go wrong which might result in harm to patients.
“When that report was received NHS Connecting for Health came to the NPSA [National Patient Safety Agency] to say: how can we work together to address these concerns?"
Baker added: “Our safety management approach started to be in place in 2005, so it has been running for just over three years.” But 2005 was a year after £6.2bn worth of contracts were signed between the Department of Health and service providers including BT, CSC, Accenture and Fujitsu.
Baker said: “The effort is to make the products as safe as design and forethought will allow. However in any field of human endeavour things can go wrong and another fundamental safety principle is to accept that sometimes things will go wrong and when that happens you have to be able to identify that and take swift action.
“So we have a safety incident management process. When we are notified of an incident where there is potential for patients being harmed, this is passed to duty clinical safety officer and duty safety engineer.
“We run a 24/7 duty to rota to deal with safety incidents. Our aim is to assess the incident jointly from safety engineering and clinical perspective and make sure within 24 hours. Make safe means that we will take away the opportunity for harm, up and including switching the system off.”
There have been 290 incidents in two and half years, she said. “They cover just about every area in which Connecting for Health has activity in.” Probably the largest number relate to PACS because it has the largest footprint of any system, she said.
Baker was critical of the lax approach to the NHS number – an approach which endangers patients.
“We’ve had NHS numbers for best part of 10 years but they are still not used routinely in every unit or every hospital or across the NHS.
“You need a unique number to ensure the matching up of the right results, the right notes, and especially when information is transmitted electronically across different sectors the potential for that to go to the wrong place becomes quite large.
“One of the factors minimising information going into the wrong notes is consistent use of the NHS number. We are trying to get the NHS mandated across the NHS. NHS number sounds like patient notes and filing but it’s actually it’s crucially important for patient safety.
“So many things go wrong for patients when the wrong information gets released to them: someone else’s blood test results in your notes could have very serious consequences for you, and the other patient as well.”
She said that NHS Connecting for Health has made big improvements in the management of safety. “There are still things we need to do – there are still gaps – but we have made considerable progress on what was essentially a standing start.” NHS CfH’s work today is “world-leading” on safety and IT.
When answering questions after her talk Baker conceded that there are newly-emerging areas of patient risk within the NPfIT.
In the audience, GP Mary Hawking asked:
“Who is responsible for looking at the safety implications of redesign of clinical systems?”
Hawking said that a single record system is being developed under the NPfIT in which a number of organisations and individuals are contributing and “clinical governance does not yet appear to have been established”.
She added that recorded in a detailed care record such as Lorenzo – a product to be introduced in the north of England – will be prescriptions made out by hospitals, GPs, and by independent prescribers in community care.
“If the community matron changes the management of heart failure she is going to have to alter the prescription previously prescribed by secondary care or the GP”, which could leave the patient is “at risk of receiving inappropriate medication”. Hawking asked: “Who is looking at the implications at the NHS CfH level?”
Baker replied: “You have correctly identified a potential hazard. It’s important it has been addressed appropriately. The concern is being formally addressed and there’s a proposal for work on this…All of us are going to rely on professional communities to throw up such concerns. There’s a more generic problem: if they sit a pitfall ahead, how do they bring that to our attention?”
Links:
NHS CfH says that patient safety work has progressedIt’s about people, not just technologyIs government trying to control information on problems after go-lives of National Programme for IT [NPfIT] systems?Maureen BakerMajor incidents hit NHS IT systemsFears over patient record system at NuffieldLessons from troubled go live of Care Records Service at Nuffield Orthopaedic Centre - letter from the National Audit OfficeNational Patient Safety Agency ]]>
Some of the good and bad at HC2008 - a summing uptag:www.computerweekly.com,2008:/blogs/tony_collins//12.291552008-04-23T13:57:00Z2008-04-23T14:03:00ZComment: My highly subjective overview of some of the good and bad at HC2008, the annual Healthcare Computing conference in Harrogate.....Tony
HC2008, the annual Healthcare Computing conference in Harrogate..]]>
Glyn Hayes and Denise Barnett.
The Good:
The questions from the floor – including those from GP Mary Hawking – who brought the visions of some speakers back to earthly reality.
And thanks to Matthew Swindells, the Department of Health’s departing, acting chief information officer, who said some inspirational things that were also grounded in reality. It’s a pity he’s leaving.
This is some of what he said:
“We need to take our obligation to train people seriously. At the Royal Surrey [County Hospital, where he was chief executive] the only thing they will remember about me is that I was the guy who used to go portering once a month, doing a real job.
“That sense of our staff being disconnected from the grand vision is paralysing for the NHS when it is trying to drive change. When I was a porter I discovered that porters at the Royal Surrey had to come back to [base] every 20 minutes because the batteries on their radio went flat, and it had been like that for five years. £5,000 later the technology supported them in doing their jobs rather than was a pain in the neck.
“It takes a degree of honesty and engagement to say that our staff need technology to help them do their jobs because many of their jobs are onerous, boring and many come to work to earn enough money to get on with of the rest of their lives; and if we dump IT on them which is simply rubbish then all we do is devalue them as contributors to a better NHS.”
He also spoke about how to engage clinicians and staff (apart from delivering technology they want). He said:
“We should remember when we deliver technology they [NHS staff] need to understand why this helps patients, not why it helps finance managers. If we can get that right, if we can describe that coherent story about making peoples’ lives better, then we will be able to take our staff with us. If it’s just another thing we tell them to do because we are management, and we can, then we won’t take them with us.”
Links:
Another leading figure in NHS IT and the NPfIT quitsHC2008 - the lighter side of Healthcare Computing event in HarrogateNew top NHS jobs as Richard Granger leavesSwindells to go private with Tribal Review of NHS ITRichard Jeavons to quit NPfIT
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Whitehall advertises for NHS CIO tag:www.computerweekly.com,2008:/blogs/tony_collins//12.290722008-04-22T15:49:00Z2008-04-22T18:19:12ZThe Department of Health has advertised for an NHS chief information officer. Headhunters have been recruited and interviews will take place in a couple of months. Matthew Swindells, acting NHS CIO, told the HC2008 annual healthcare IT conference at Harrogate:...Tony
The Department of Health has advertised for an NHS chief information officer. Headhunters have been recruited and interviews will take place in a couple of months.
Matthew Swindells, acting NHS CIO, told the HC2008 annual healthcare IT conference at Harrogate: "This is an absolutely crucial position, linking the policy to the strategy, to the informatics. If we can drive that from the top then other things become a lot easier for everybody."
Meanwhile the Department of Health has appointed its latest interim head of IT in the NHS, Professor Sir Bruce Keogh, NHS Medical Director. He has been appointed interim Director General for Informatics. His temporary appointment follows the resignation of Swindells who is joining consultancy Tribal.
Lord Darzi on the future of the NHS . Keogh has worked on both reviews.
Keogh said: “As the first NHS Medical Director, my clear priorities are to drive improvements in clinical quality and safety in the services we provide for our patients. It is absolutely clear to me that this can only be achieved by accelerating the development and uptake of reliable, local and national information systems which will make the jobs of manager and clinicians easier and enable them to focus on improving clinical quality.”
The Department of Health says that Gordon Hextall, who's Chief Operating Officer at NHS Connecting for Health, which runs part of the NPfIT, is now "interim Director of Informatics", adding this to his role as interim Director of Programme and System Delivery.
The three-day HC2008 conference is organised by the Health Informatics Forum of the British Computer Society.
Comment:
In the past few months, senior health IT executives have seemed to stay in post little longer than machine-gunners who were assigned to the trenches in the First World War. It's not because of the person but the programme.
Is it becoming so labyrinthine as to be unmanageable? The NPfIT needs a robustly independent review. It should be carried out by those who have no association with the NHS, an idea which ministers find abhorrent.
One of the greatest achievements of Gwyneth Dunwoody, the late, exemplary chair of the House of Commons' Transport Committee, was that she and her committee harassed the government to hold an independent review of the much-delayed Swanwick air traffic control system. The result was a report by Arthur D Little, a consultancy which was appointed by open competitive tender.
Arthur D Little's was the most robustly independent report we have seen on any government IT project. And this is what the NPfIT needs. It has needed it for years. Until the government has an independent report, the NPfIT will, we believe, continue to struggle like a pilot who's getting conflicting readings from his key instruments. Which is a pity because the programme will continue to soak up billions of pounds while the country continues to wait for paper records to be replaced by dependable electronic ones - which nobody denies is in the interests of patients.
Links:
Wanless questions whether NHS IT programme should continue without a full auditWiki of leading academics who arew calling for an independent review of the NPfITOpen letter to Gordon Brown [2006]The NPfIT: act in haste, repent at leisure]]>