Do you have a view on the NHS IT Programme?

I’ve not been sleeping too well lately – probably, you will say, due to too much Christmas fare and festivities. So I have had time to mull over two IT-related things that happened to me before Christmas – over and above my normal technology-related responsibilities, that is.

The first thing came totally out of the blue and was rather surprising.  I noticed a tweet about Mike Lynch of Autonomy, who is one of my heroes in technology.  I followed it and found that Mike – with total justification, I think – had been chosen as “Most Influential Individual in UK IT” by

As you do, I started flicking through the rest of the list – and stumbled across a rather fetching picture of yours truly at number 15.  It is fashionable to affect disdain about awards, but I must confess I was rather pleased and I emailed the family to tell them. (Well, your children do wonder what you actually do at work all day…)

Seriously, I am not sure what it means to be listed one place ahead of the UK CEO of Google – and only two below Sir Tim Berners-Lee himself – but it certainly made me smile!

Furthermore, I was struck by how many public sector IT figures were there in the list above me – Joe Harley and Ian Watmore included.   I was delighted to see this, since Joe and Ian and their colleagues in Government and Local Government IT are making a real impact for good in UK society and economy.   But it did start me thinking about the importance of UK public sector technology and just how important and challenging it is.

I was on a plane earlier this month and, settling into my seat home to UK, I opened The Times to see the headline “Exclusive: NHS computer fiasco still costing billions”.  Opening the double-page spread, I read “Software firm is banking in getting £2bn extra for its failed system” and “Project blighted from the start by bad decisions”.

So I have a confession to make that will cause me to be demoted 50 places in the IT Chart:  I was appointed, way back at its start, to be the “Private Sector Non-Executive Director” on the Board of the NHS IT Programme.

It very quickly became apparent, however, that the so-called “Board” was nothing of the sort; that the Civil Service in those days had no idea what a Non-Exec was or how to use one sensibly; and that the loosely-confederated elements of the NHS at the time were in no sense set up to deliver the “biggest IT project in the World”.   So I quickly resigned.  No-one noticed.  You could describe it as a good call, I guess…

But this is a national issue of epic proportions.  Let’s face it, we would all benefit from a Health Service that used technology more effectively.  It has indeed delivered a broadband network that works, the spine for data, GP records transfer and digital X-rays – but not the core electronic records system.  Spend is apparently £6.4bn with a projected total of £11.4bn.   How can you spend all that?

One illustration of the current situation: shortly before Christmas, a relative of mine was taken ill on a Thursday where she works and was sent to the local hospital where many painful tests were carried out, but the cause not discovered…

She then travelled home to London where she was still ill and overnight Saturday went into the hospital that was functioning as the emergency centre. Again, many similar tests were carried out.  And again her problem was not diagnosed fully and she was sent home in pain. Therefore, on the Monday she was sent by her GP to her local hospital, where – yes, you’ve guessed it, the same tests were again painfully (and expensively) carried out.

And on none of these occasions did the doctors have the benefit of seeing and considering the results of the other medics’ tests. So all that ECG data, all those x-ray, ultrasound scan and blood tests results sat useless in paper folders in hospitals miles apart, waiting to be filed away unanalysed, some time in the New Year…

A more powerful case for an electronic records system in the NHS you could hardly construct, from everyone’s point of view – patients, doctors, nurses (and taxpayers).

My point in writing this is that we all – as IT professionals in the UK – should have a point of view on the NHS IT Programme

Not because we should blame individuals: goodness knows, we have all faced major programme challenges (and before anyone says it – yes, T5 Opening at BA) but because we should learn from all of this. And, let’s face it, like my relative, we all have a strong stake in this working.  So here goes…

I personally think that the NHS IT Programme went wrong for all the usual reasons that IT projects jump the rails:

  • the users were not bought into understanding exactly why they needed it
  • there were multiple interest groups who felt excluded from a centralised project that could not enforce its decisions
  • the supplier contracts were win/lose not win/win, which is fatal when you are entering unknown territory
  • the IT teams seem to have over-promised and under-delivered
  • no-one told the people at the TOP (PM, Secretary of State etc) the realities of large-scale new development AND integration, and
  • the top people (as is sometimes the case in the UK) did not fully understand technology, or recognise how hard what they were trying to do really was.

My view is that the UK in 2002 was probably incapable of delivering something so large, so cutting-edge, so integrated and simply so difficult as the NHS IT Programme (which is why when the headhunters came calling I declined to put my hat in the ring).

I will stop there, and simply observe that Joe, Ian and their many excellent public-sector colleagues have, since then, successfully delivered many major public sector IT programmes that are all too rarely celebrated.  So it is good that they have been recognized within our industry.

And anyone doing a large project knows that none of this is easy.

About paulcoby
I am CIO at the John Lewis Partnership in the UK. I was Chair of SITA - the airline solutions company owned by the Air Transport Community - for 11 years. I am also on the Boards of Clydesdale and Yorkshire Bank and Pets at Home. Previously I was Head of BA Services and for 10 years CIO at British Airways. I am interested in Roman and Military History. The views expressed are entirely my own not my employers.

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