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April 2019
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NPfIT ' put us out of its misery

The recent resignation of Christine Connelly as the Department of Health’s Chief Information Officer (CIO) should not have come as a surprise. Anyone who has followed the progress of £11.4-billion Nation Programme for IT transformation (NPfIT) will be acutely aware of quotes including -no grounds for confidence , -not value for money , -far below expectations, -a damage limitation exercise that leapt from the pages of the National Audit Office’s report into this ill-starred IT colossus.

It’s not as if we haven’t seen it coming. This is the third time the NAO has looked at this project and found it wanting and almost since its inception back in 2002, there has been a steady stream of bad news.

Within a year of commissioning, the deadline was slipping; two years in and a key clinician quit blaming a lack of engagement and that same year BT, one of the four major suppliers, was hit with its first fine for missing a deadline. By 2006, the NAO revealed the programme was running at least two years behind schedule with costs likely to hit £12.4bn; and at the end of 2007 Richard Granger, brought in the year before to lead the project, quit.

The following year, weeks after news from the NAO that further delays meant the project would not be completed until 2014/15 Fujitsu was fired from its £900m role. Last year, BT agreed a deal to install fewer systems for not much less money and the government admitted that the goal of electronic records for 55m patients was not going to be achieved as the scope of the project was cut again.

The recent NAO report, triggered by MP Richard Bacon, is quite rightly damning and must make the powers that be face up to what many in IT have been saying for years â€- the programme is a joke and government should consider taking the hit and abandon it all together. Meanwhile his parliamentary colleague Margaret Hodge, chair of the Public Accounts Committee, publicly raises the question of who should carry the can. A side show that will be interesting to follow but will not make a jot of difference to the outcome: a wasted opportunity and a disgusting waste of taxpayers’ money.

Implementing one of the world’s largest IT projects was never going to be easy, but basic mistakes have repeatedly been made. The focus has always been on the technical delivery of the IT, not managing the change and the multitude of stakeholders. As a result, the problems that came out of the lack of management, supplier accountability, the failure to proactively communicate, along with cultural challenges, have been allowed to persist and combined have brought the project to the brink. All could and should have been addressed long ago, but there was no one to do it.

In the private sector, any programme worth even a fraction of this one would have employed proven project and programme management expertise to sit on top, to oversee such an important transformation and manage all the stakeholders.

Given the complexity of this programme it was crucial to have independent programme management with industry experience of large scale transformation – who were not involved in the technical/operational delivery and who could execute the plan and drive progress. Instead, the suppliers were advising government and therefore had control of both the programme and operational delivery.

In addition, an independent firm responsible for delivery of the whole programme would have put considerably more emphasis on a robust and overarching framework for managing stakeholders, change and culture, engaging users such as the clinicians early on. From this, a sound communications and engagement strategy would have flowed, a prerequisite on any successful programme.

Lastly, the way the centralised procurement for NPfIT was undertaken also begs significant question. While a noble intent, it was a mistake to put a commercial value on the programme before specific requirements were finalised. You can’t quantify a cost without knowing what you’re buying. This has only resulted in downstream problems in executing technical delivery together with damaging supplier partner relationships with the client. So, almost £3bn later, we’re left in the position where the taxpayer is still footing the bill, but receives far less than was promised in return.

Ms Hodge’s desire to bring to account those responsible for this national failure is laudable. Sadly, there are too many to name and they are in the end only bit players. It is also worth keeping in mind that no country has found it easy to create an electronic patient record, but that is no excuse for the state of NPfIT.

Delivering a programme five months late is unacceptable, but running five years behind has to be a first. And, rather worryingly, there is still little in the way of accountability for its far reaching failures.

Marc Cetkowski is head of government and public sector at PIPC, a global project management consultancy responsible for some of the world’s highest profile business and IT transformations.

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