What is the difference between NHS NPfIT and the DWP IT Strategy for the Universal Credit?

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Today (Thursday) sees the release of the written evidence submitted to the PASC enquiry. Tommorrow (Friday) will see the release of the National Audit Office Landscape Review of Infomation and Communications Technology in Government to today. I have much bedtime reading and will confine myself to a little riddle. 

What is the difference between the IT plans to support the "vision" of a universal patient record (based on accurate information available at the point and time of need) and the IT plans to support the equally attractive "vision" of a universal credit (based on accurate information available at the point and time of need)? 

On Valentines Day I blogged on the meeting of the Public Accounts Committee at which the die was cast for the "Vision" of the National Plan for IT to go ahead with no business plan. Ian Brown has since put the minutes of that meeting on his blog . The words used to describe the "relatively modest" computer systems that would be needed to support the Universal Credit , based on upgrading HMRC's PAYE systems, bear an uncanny resemblence to those used to describe the computer systems the would be need to support a nationally available patient record, based on linking and upgrading existing hospital and GP systems. 

Most of the "vision" of the "universally available patient record" could probably have been delivered by now, at a fraction of the cost, by following the professional best practice in linking and building on the systems that already existed in 1998, developing common standards for inter-operability where they did not already exist. But the politicians lost patience, as they do, and went for rip and replace.

The current IT strategy for the Universal Credit is for a massive "delayed big bang" system to be delivered after the next election - thus maximising expectation and minimising the risk of  short-term political damage - including during the run up to that election. Meanwhile the inefficiency, waste, fraud, corruption and, above all, waste and suffering caused by current processes look set to fester, beneath some expensive sticking plasters.

Those suggesting incremental approaches, using bottom up projects within a strategic framework, to deliver short term savings and benefits while building towards long term reform, are being sent away with fles in their ears, lest they damage negotiations with the DWPs "strategic partners". 

On big differnce is that the "vision" for the Universal Credit has been much better researched than that for a universal patient record.

But the IT strategy for delivering that vision has not.

There is one other big difference.

The National Plan for IT was based on a massive procurement exercise for new outsource contracts. To save procurement time and cost, the DWP systems are due to be delivered under existing framework contracts. I will leave others to comment on the consequences.

The big similarity is the lack of professional peer review, whether to check the realism of what is being proposed, or to suggest cheaper, lower cost, lower risk ways of using ICT to help deliver the "vision".     

Whne reading the morass of data and opinions on failed IT systems coming out today and tomorrow we should try to remember the main reason for failure. 

Political agreement on an attractive vision is commonly used to over-ride professional inputs on how to deliver that vision at affordable cost (time, people, suffering, risk as well £££s).  

Few politicians show the wisdom of King Canute - in the face of an army of consultants who claim to be able to stop the tide coming in. They continue to believe that a big enough project, checked and managed by sufficient experts can deliver the impossible. And the courtiers of today are no wiser or braver than those of King Canute.

Also remember the chapter on "High Finance" or "The Point of vanishing interest" in Parkinson's Law. His comparison is the decisions to approve a Nuclear Reactor and a Bicycle Shed - but the dilemma faced by Mr Brickworth, the only man on the board who understands the questions that should be asked, is all too apposite. The Wikipaedia entry on "Parkinson's Law of Triviality" is much less informative than the original - but you must buy you own copy. 

 

 

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About this Entry

This page contains a single entry by Philip Virgo published on February 16, 2011 5:39 PM.

What is the case (business or clinical) for a "universal patient record"? was the previous entry in this blog.

Put PFI Contracts On-line for Public Scrutiny is the next entry in this blog.

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