NHS IT: what went wrong, what will go wrong
We draw up a handy list of excuses for civil servants
This week Fujitsu pulled out of the £12.7bn National Programme for IT - the government's enormous project to introduce national patient records for NHS patients leaving BT, CSC and iSoft still involved.
How bad must things be for a company to walk away from just under £1bn of government money? And why are we writing yet another story about a government IT project heading inexorably for the rocks taking billions of pounds of taxpayers' money with it? This has happened so many times, and no doubt will again. We all know what the lessons are but for some reason government and civil servants seem unable to listen to even the simplest lessons from past failures.
When the project was started we were told that the use of several contractors meant that competition would drive down prices and the civil service would keep control of costs.
Now that there are only two contractors left for the south of England they can effectively dictate terms to Connecting for Health - the body charged with running the scheme.
One of the core problems of government IT projects - that no one individual is ever in charge - was supposed to be solved by the appointment of Richard Granger as director general. He left at the end of January, ground down and exhausted according to some.
So was the project doomed from the start or was a decently specified project kyboshed by greedy contractors and incompetent civil servants?
Simon Williams, director of independent consultancy DMW Group, said: "The idea of controlling risk by using several suppliers sounds good but with a shrinking list of suppliers it doesn't work. They should have started small - run a project in one or two small regions with one hospital and two or three GP surgeries in each. Run a prototype project, prove the functionality and show the staff the benefits of it - it is a simple and well trodden route for big projects." The project also failed to consult doctors and nurses who would be using the system, he said.
Williams added that having proved a small scale project works it can, if necessary, be handed over to a bigger supplier to roll-out nationally, once the functionality has been proved.
Martyn Hart, chairman of the National Outsourcing Association, was unsurprised at the problems and questioned whether there was even a need for a national programme. He said Granger gave a talk to the NOA several years ago and the audience was asked afterwards if they thought it would succeed - not a lot of hands went up.
Hart said: "If I live in south London how many times will I need my health records to be sent somewhere else? How many times does that really happen? And even if it does happen then data exchange is old hat - you need some agreement on formats and standards not necessarily a nationwide system."
@ Odius Grunt
"I guess it comes down to whether we want the NHS/Government to control our health data or should they just give up and sell us all to The Beast(s).."
Scuse me just one second but why should the Govt control *my* health data? I've been adivsed I cannot opt out of it - the Govt ignoring it's own laws I see. With that sort of breathtaking arrogance it's hardly surprising that people are going to walk away from such a project.
I'm contracting for...
...the 2018 National Human RFID Tagging Project.
1. Lodge tender
2. Sit back..
3. Get contract
5. Profit !!
re: It's just really really hard
Yes, it is really really hard. OFCOURSE! As many of the commentators already have pointed out. People are not necessarily stupid - but arrogant! You have to ask yourself the question: WHY IS IT HARD? The answer is not only "because of complexity". There is a very important factor hiding behind concepts as "stakeholder buy-in". OK, so people involved in the development might not actually be stupid - but in many ways I do not feel sorry for those professionals who are engaging in efforts to develop systems for "users" (other professionals) who - do not want their system! Yes it is hard, really really hard - to work in an environment where you insist to treat users as ignorant and incompetent - because it is obvious that you yourself know what is best for them in their professional role - which you obviously do not have to do yourself.
I sincerely hope that these kind of abusive project continue to fail, and also continue to be just that - "really really hard". Hopefully one day people will just give up on their patronising efforts to implement systems over the heads of those professionals who are supposed to use future "wonderful" IT systems.
did i miss the part
Where you get to decide who controls, corrects, and has access to YOUR information? If, as R says: My motor insurance becomes invalid if my psychiatric clinics are irregular...what if your insurance becomes invalid because whoever keyed in the information got your records mixed up with a govtard at #10 and you (like those on the pinko TSA list) can't ever get it fixed?
@ Shabble - Got it in one!
"My suspicion (going by observations of how NuLabour works) is that Blair/Brown want to create a system that effectively micromanages the whole of the NHS. A single recording structure that tracks everything from drugs prescription costs to heart transplant failure rates would be very useful to a control-freakish central government."
Indeed, which is why defining standards and leaving the records themselves in the hands of clinicians or (shock horror, something the DoH has fought against since Lloyd George) patients, just won't do.
Look up the Secondary Uses Service
- a transparent misnomer, since it immediately comes clear once you read it that 'Secondary Use' is the primary bureaucratic motivator for the whole damn thing.