Doomed from the start: considering development risk
Hell for a developer is ...
Comment "Hell" for a developer is working on a project that is doomed to failure from the start. No matter how ill-conceived the business case and unreasonable the external constraints, the hapless developer still has a good chance of collecting the blame. And even if he escapes the massacre of the innocents (following on from the promotion of the guilty), the odour of failure clings to all involved.
But even worse is the feeling of working hard and professionally on something that is ultimately pointless. Why this train of thought should have led me onto a consideration of the NHS (National Health Service) National Programme for IT (NPfIT; see also NHS CfH; Connecting for Health is the DH agency responsible for delivery of NPfIT) I'm not sure, but this project does seem to exemplify one with high scores in all the risk categories I'd review before starting a project:
• It's a very large project, and the Government's record with large projects certainly isn't better than anyone else's.
• It involves massive changes to existing systems.
• It cuts across organisational boundaries (hospitals and GP surgeries, and uses outsourced services).
• It has legal/regulatory issues - doctors are responsible for the governance of patient records, and the Data Protection Act applies to much of the information.
• It is a highly visible project, raising considerable press interest.
• Top management (in this case, probably even our Prime Minister) is taking a lively and, possibly, ill-informed interest.
• It has safety-critical aspects.
• Resources are limited and, in theory, tightly controlled.
• It involves new technologies.
• Few of those involved can have much experience with similar projects - US healthcare is very different and the NHS is an unusually large operation, even in a global context.
An important first stage in any project is risk assessment, looking not only at project risk (the risk of the project failing) but also the operational and business risks the project will have to address (often, and somewhat misleadingly, called "non-functional requirements". Far better to embark on a high risk project with your eyes open, and some risk mitigation strategies and contingency plans, than with the "positive attitude" (aka hysterical optimism) so beloved of many of my past employers.
So, are there unconsidered risks with the NPfIT NHS project? Well, as I write this it looks as if there may have been, as a written answer in Parliament has disclosed that only £234 million (of the £6.2bn estimated for the project), under 5 per cent of the contracts outstanding, has been paid by CfH over 2 years in. This implies that the project as a whole may be slipping, and may introduce further risk, if suppliers aren't being paid enough to service their contracts properly.
Moreover, the installation of the new technologies is not proceeding as smoothly as one would like, I read, with service reliability and availability problems plaguing connections to the NHS spine over Christmas and the New Year. However, as CfH says, "The upgrade release to the NHS Care Record Service over the weekend of December 17 and 18, 2005, was the largest and most complex to date." But should that really mean that we must expect problems?
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