NPfIT systems not so resilient

On Monday 2 June 2008 an NHS trust IT manager was so irritated by a lack of access to the Personal Demographics Service – a part of the National Programme for IT [NPfIT]- that he sent an email to this IT Projects blog.

NHS Connecting for Health says of the Personal Demographics Service (PDS) that it is an “essential element of the NHS Care Records Service which will underpin the creation of an electronic care record for every registered NHS patient in England by 2010”.

The IT manager said in his email: “I assume you already know that the BT supplied Spine [on which runs the Personal Demographics Service] has been down all day …”

The manger’s organisation needed minute-by-minute access to the Clinical Spine Application for patient demographics.

The Clinical Spine Application will be the primary application for viewing the NPfIT Summary Care Record.

This week in the House of Commons, at a hearing of the Public Accounts Committee,  a representative of NHS CfH made the point that the resilience of national systems was a primary justification for having [billions of pounds worth of] contracts with local service providers.

The CfH representative told public accounts MPs on 16 June 2008:
 
“One of the values of using a common system of good quality is because it is going to be resilient in terms of disaster recovery built in so that hospitals that are open 24 hours 7 days a week can be assured of 99.9% availability – downtime of 45 minutes in a 31-day period…”

This assurance is not easy to reconcile with the experience of the IT manager who was left without access to the data spine’s Personal Demographics Service for nearly an entire working day – a busy Monday.

The PDS is a mandatory gateway to some national NPfIT applications. It’s not the first time NHS staff have been unable to access national systems. When CSC’s Maidstone data centre crashed in 2006, up to 80 trusts were unable to access NPfIT systems for several days.

On the failure on 2 June 2008, NHS Connecting for Health was willing to answer some – but not all – of my questions.

I asked how long the Personal Demographics Service was unavailable; how trusts can rely on the Spine if there’s a danger it will go down for hours at a time, and whether BT will pay any penalties?

The CfH spokesman said:

“The NHS National Spine was upgraded over the weekend of 30 May/1 June. The new system was put into live operation following the successful completion of extensive testing.  In the course of this testing period, a small number of sites experienced problems, all of which were resolved over the weekend.
 
“During the course of Monday morning some issues also arose with the Personal Demographics Service.  These problems were investigated by NHS CFH and BT, the supplier of the Spine service, and have now also been resolved. These issues did not impact on clinical safety.”

Although the answer said that problems with the Personal Demographics Service arose on Monday morning, it did not say how long they lasted. Potentially thousands of NHS sites could have been affected. I put more questions to CfH.

The next day its spokeswoman replied:

“Monday’s problems were experienced following an extensive and complex upgrade to the NHS National Spine. Users experienced intermittent failures of the PDS service from 8am, and full service was restored at 4.30pm. 

“During this period other key NHS CFH services continued as normal.  For example, 14,000 Choose and Book referrals were processed successfully.

“As recorded in the most recent National Audit Office report, all Spine services – including the PDS – consistently report between 99 and 100% availability.”

She added: “If applicable, any penalties will be determined in due course.”

The reply was helpful – though the IT manager said that he was unable to access the PDS – at all – for much of that Monday.

Could CfH put the figure of 14,000 referrals on Choose and Book into context, I asked. How many referrals would there have been, typically, during the same period if the system had been fully available?

The reply was that “acquiring this information is likely to take some time”. That was two weeks ago and I’ve heard nothing more.

Comment:

I was left wondered whether, if national systems are not resilient, whether it’s so necessary to have billions of pounds of local service provider contracts.

It’s a pertinent question to ask at a time when CfH is considering whether to replace Fujitsu as the local service provider to NHS trusts across the south of England. Many in the NHS would prefer that Fujitsu were not replaced. We support them. 

Links:

Spine problems force trusts to switch off Care Records Service – E-Health Insider

Fujitsu says that the NHS’s NPfIT terms were unaffordable

NHS head is content about rejecting NPfIT review

UK Dept of Health – a prescription for disaster?

NPfIT progress so far – Gordon Hextall of CfH writing for E-Health Insider

The meeting which started NPfIT

Academics air concerns over NPfIT

Government snubs key recommendations of Public Accounts Committee on NPfIT  

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