Thursday, 19 January 2012

A Look Back Three Years

it is now three years since we started blogging about NHS IT and CSC and it is probably timely to look back at what was said at the time and see how matters have developed. Just look at this extract from Sunday, 8 February 2009

Let's look at some basic facts about NHS to see there is anything there that explains why the IT Strategy has gone very wrong.
1. It is the largest single IT project anywhere in the world.
And still is.
2. It is charting new waters and just like Starship Enterprise, goes where no one has gone before.
This never arrived.

All the above tells us that this is going to be high risk, high spend, slow and very difficult. Yet as the single biggest project in the UK government the NHS IT is not reviewed regularly at any depth by the Cabinet.
Thus our political leaders have let us down.

without a wholesale restructuring of NHS it looks like a recipe for failure .....

They (The Conservatives) also have the problem that Andrew Lansley MP, Shadow Health Secretary, has had a charisma bypass and is almost invisible to the public. What does he stand for? What will he do to improve matters when in power? Is he just waiting for Labour to fail and is keeping quiet because he has so little to add, confining himself to unambitious tinkering at the edges of NHS. This week his flagship programme to change NHS has been put on hold.

This package iSoft was originally designed to work within the precincts of a health practise and by all accounts worked quite well. The problem is  the solutions providers, CSC and others, to base their solution on this product. ..... unfortunately as anyone with experience in IT will tell you, taking a small scale system and stretching it to a wider geography, across multiple locations, with hundreds, if not thousands, more users, is doomed to failure. As has happened.
 In essence scaling iSoft up to mega health region size is rather like taking a tug boat design and turning it into an aircraft carrier. It might float but will it be fit for war?

.... there has been the problem that many of the iSoft founding management left as fast as they could once they cashed in the share options based on an inflated share price due to iSoft being part of NHS IT. Some of this management have been investigated for corruption.

The technical solution to all this is supposed to be Lorenzo. What odds am I offered that this will work on time too? How about 100-1? What a pity that no one took up this bet.

But surely the systems integrators with the NHS contracts can make it work? Unfortunately they have found out they have bitten off more than they can chew. As mentioned before Accenture a world class systems integrator has cut and run. Others will almost certainly follow soon. Indeed, Hitachi subsequently did just that.

Where does this all leave us? It leaves us with £18bln spent on IT that won't work or won't be used because the client has decided to buy elsewhere, and with NHS trusts who are going to commission their own solutions. This is now the case.

.. it would be cheaper to give each of NHS's 1,500,000 employees £10,000 each to buy their own IT to help do their job better, and leave £3bln spare for central work.

Further reading to show there are solutions to the NHS problem and that this blog is constructive can be found here or just by browing earlier postings:

No comments: