NHS IT project: divided we fall?

Private angst among senior executives that spills over into the public domain is a compelling spectacle.

Private angst among senior executives that spills over into the public domain is a compelling spectacle.

It provides a sharp stab of plain-speaking reality to counterpoint the well-rehearsed, finely-nuanced formal utterances that are usually offered by way of updates on the progress of high-profile IT projects.

So it is with a grim fascination that anyone with an interest in the government's modernisation of the NHS will this week read in Computer Weekly (page 18) the details of exchanges between two of the senior civil servants in charge of the world's largest civil IT project.

The disclosures in a series of leaked e-mails relate to one of the principal planks of the project - the Choose and Book system - and the risks it poses to the wider success of the national IT programme.

In the e-mails Richard Granger, who is responsible for the delivery of the IT systems, expresses concern to his colleague Margaret Edwards, the Department of Health's director for access and patient choice, about making changes to the specifications of Choose and Book. He warns, "Choose and Book's £20m IT build contract is now in grave danger of derailing (not just destabilising) a £6.2bn programme."

It remains uncertain whether the situation is as grave as Granger declares in his e-mail. It may be that his comments have been borne out of genuine concern to curb a colleague's well-intentioned demands for changes to the build contract when she may not realise the knock-on effect on the rest of the national programme and the cost.

The tension implicit in the e-mails may also provide an insight into a fundamental issue at the heart of the national programme - namely the failure of government to make one executive fully accountable for its success or failure.

Granger is charged with the delivery of the systems. John Bacon, the project's overall senior responsible owner, is mainly responsible for ensuring the acceptance and take up of the systems by the medical end-users.

Such a division of roles and responsibilities is dangerous. No IT project can be deemed a success if the systems that are delivered - no matter how innovative and robust - are not accepted by the majority of its users.

Ultimately, this is one of the major problems facing the national programme for IT.

And no amount of angst expressed by senior civil servants is going to improve the likelihood that the systems being delivered will not end up being disliked and ultimately sidelined by its users.

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