Signs of a big IT-based scheme in trouble

A new era of official openness over on the NHS’s National Programme for IT [NPfIT] began on 26 January 2007. On that date David Nicholson, Chief Executive of the NHS, spent a day listening to criticisms of the NPfIT and to proposals for putting the programme on the straight and narrow.

The event was called “The National Programme for Information Technology in the NHS: Facing the Issues, making progress.” The audience of about 80 was individually invited. It included representatives from royal colleges, NHS trusts, the British Medical Association, the NHS Confederation, and suppliers to the NPfIT, BT, Fujitsu and CSC.

Some of the comments made by delegates that day were particularly important. One said safety lessons from implementations were “not being “systematically disseminated”. Several delegates agreed that, for the programme to move forward, there needed to be an official admission of the strategic and local mistakes [not likely]. There was also agreement that the programme’s objectives needed to be reprioritised.

And a white board was shown of eight challenges facing the NPfIT.

A theme of the first of Nicholson’s two speeches was the need for more openness over the programme. He spoke of the “bunker mentality” of the national programme and how it responds to criticism in a “very defensive way”.

To unveil a plaque that marked the new era of openness, Nicholson allowed a known critic of the programme to make a short speech. Then the audience divided into groups, table by table, to discuss the various challenges facing the NPfIT and proposed actions. The comments of delegates on each table were then summarised by representatives of Connecting for Health, an agency that runs the NPfIT.

On my table the representative from Connecting for Health was a genuine and committed supporter of the programme. He nodded enthusiastically when something was said in support of the programme and held his head low in disapprobation when criticisms began to flow. When it came to summing up the comments of delegates at his table, he cited only the mildest of the criticisms.

But what struck me as incongruous, on a day to mark a new era of openness, were the “Briefing Notes” given to each of the representatives from Connecting for Health for managing the one-day event. Each was marked at the top:

Restricted Management – Briefing Notes

This unnecessary secrecy will feed the suspicions of quite a number of delegates that day that the proceedings were stage managed. Indeed Nicholson concluded the day by saying he had heard no evidence that justified the commissioning of an independent review of the NPfIT.

But the minds of those who mattered were closed to that evidence. And today, four months later, they are still closed.


Computer Weekly’s reporters have investigated numerous IT-based projects over the past 20 years that have failed to meet expectations, and defensiveness and secrecy are among the common factors. It’s hard to be open on a programme in trouble, So where does that leave the NPfIT? Now and again some light gets through. But, in general, we have seen no more evidence of defensiveness and secrecy than on the NPfIT.