The following is a longer version of the article in Computer Weekly.
A senior executive at services supplier Fujitsu, a primary supplier to the NHS’s £12.4bn National Programme for IT (NPfIT), has questioned whether key aspects of the scheme are working – or are going to work.
The comments of Andrew Rollerson, healthcare consultancy practice lead at Fujitsu, gained general acceptance at a conference last week entitled “Successful implementation of NPfIT 2007”.
Twenty-three senior academics and, separately, the British Computer Society, have also raised fundamental concerns about the scheme.
Rollerson, who is responsible for the delivery of Fujitsu’s healthcare professional services, said there was a “gradual coming apart of what we are doing on the ground because we are desperate to get something in and make it work, versus what the programme really ought to be trying to achieve”.
He added, “The more pressure we come under, both as suppliers and on the NHS side, the more we are reverting to a very sort of narrowly focused IT-oriented behaviour. This is not a good sign for the programme.”
A main aim of the programme – now in its fifth year – is to provide electronic health records for 50 million people that can be shared. This part of the programme is running two years behind schedule, and there are concerns about whether it is possible to achieve fully joined up systems given the size and complexity of the NHS.
Rollerson questioned whether standard project and programme management techniques needed to be rethought given the enormity of the programme.
He said, “What we are trying to do is run an enormous programme with the techniques that we are absolutely familiar with for running small projects. And it isn’t working. And it isn’t going to work.” He added that unless “we do some serious thinking about that – about the challenges of scale and how you scale up to an appropriate size then I think we are out on a limb.”
Rollerson’s criticisms were not directed specifically at Connecting for Health, which is running the IT part of the programme, but at what he saw as a lack of vision and focus related to the wider changes within the NHS that are needed to make best use of new technology.
He said that Connecting for Health was, in effect, a national IT department. “There is a belief that the National Programme is somehow going to propel transformation in the NHS simply by delivering an IT system. Nothing could be further from the truth. A vacuum, a chasm, is opening up. It was always there.”
There are concerns about whether the systems being delivered by suppliers will meet the priorities of the NHS, which have changed since the programme was announced in 2002. Trust boards are now, for example, under greater pressure to show precisely how money is spent, which requires IT support.
Rollerson said there was a danger that suppliers would end up delivering “a camel, and not the racehorse that we might try to produce”.
Fujitsu is one of three companies that are local service providers to the NPfIT. It has an £896m contract to supply systems in the South of England.
In slides to the conference, Rollerson said that:
– Short term challenges have distracted us from the goal
– The business goalposts have moved but not the contractual ones
– The Programme has not been structured for a dynamic environment
– The challenges of scale and scaling have still not been faced
Responding to Computer Weekly’s reporting of Rollerson’s speech, Ian Lamb, NHS account director at Fujitsu Services, said, “This is a significant misrepresentation of a presentation made in support of the National Programme. We refute any inference that has been drawn to the effect that Fujitsu in any way questions the success of the National Programme.”
A Department of Health spokesman said, “David Nicholson, the chief executive of the NHS, has clearly said that he is fully committed to the National Programme for IT as it is a necessary part of a modern health service, fit for the 21st century. He sees this as one of his key strategic priorities as it is key to the successful delivery of patient-centred care.”
Connecting for Health declined to comment.
In response to inquiries from national newspapers which followed up Computer Weekly’s article Fujitsu issued this statement:
Fujitsu statement regarding Computer Weekly
12th February 2007
Andrew Rollerson, whilst employed by Fujitsu, is neither a senior executive nor working on the NHS/NHS Connecting for Health Account – which he made clear at the conference. In particular he has no detailed view or knowledge of the various programmes being delivered by Fujitsu for NHS Connecting for Health.
The content of his slides may have been ill-considered but his associated presentation was in support of the National Programme.
His presentation was to encourage debate around a robust defence of the programme. His comments have been taken out of context and abridged to misrepresent what was actually said.
Meanwhile Fujitsu continues to work very effectively with NHS Connecting for Health, Strategic Health Authority and Trust colleagues to deliver the NHS CRS, PACS and other programmes.
This weekend over 250 people from NHS Connecting for Health, the Strategic Health Authority, Trusts and Fujitsu, took part in the go-live of the NHS CRS system at the Mid Hampshire Deployment Family (consisting of three sites: Winchester and Eastleigh Healthcare NHS Trust, part of the Hampshire Partnership Trust and a part of Hampshire Primary Care Trust).
The new system (Cerner Millennium Release 0) includes a new Patient Administration System (PAS), a new computer system for A&E, and components of the maternity and theatre support systems. Blood and Radiology tests are also now being ordered electronically.
Andrew Rollerson was a speaker at a conference on the NHS’s National Programme for IT. The conference’s title was “4th Annual Successful Implementation of NPfIT 2007”. He is described in the conference literature as:
“Healthcare Consultancy Practice Lead for Fujitsu Service. Andrew is responsible for the development and delivery of Fujitsu’s healthcare-oriented professional services. These services cover the whole spectrum of organisational change from strategic transformation and alignment of major projects with organisational goals, to implementation of business controls and changes to organisational processes and structure. Andrew has almost thirty years’ experience in business and information technology, most of those in a management or business advisory role. The emphasis of his consulting career has been IT-enabled change, and he has accumulated significant experience in the setting up and managing of large programmes.”
The Times, Daily Telegraph and Daily Mail have followed up our coverage. The Telegraph has published Rollerson’s slides and The Times has an editorial on the subject. The Times is here, the Telegraph here, and the Daily Mail here.