The "IT Upgrade" for the UK National Health Service that isn't

In this weekend's BBC and Financial Times sites, there's the latest on the disaster in the making otherwise known as the "IT Upgrade" for the National Health Service (NHS). The numbers are staggering. The Financial Times reports that the project is not only two years overdue on completion, but the costs have swollen from £6.2 billion to nearly £20 billion. And here's the phrase that pays from Lord Warner, the health minister who is overseeing this travesty:

The extra money did not mean the programme would cost more than expected, he said, but instead reflected the full expense of switching existing IT spending from outdated systems to the new ones. (Financial Times)

and

The delays to the electronic care record, which mean it may not be in place until early 2008, come in part because of delays in providing the software, which is being developed by iSoft and other companies. (Financial Times)

So, the schedule was under-scoped by years, and the true cost of the implementation was just sort of left out of the original plans?

And while the electronic records systems (aka, the customer database) is now over two years late, the same group has been rolling out and promoting the appointment system to GPs, with equally disastrous results. According to a survey by BBC's Radio 4, 85% of the GPs questioned said there should be "an independent review of the entire scheme by technical experts to check its basic viability." That's not having the same people who implemented it taking a look and saying that it looks fine to them. Even more telling regarding the appointment system--of the 80% of GPs who have access to the system, half said they either don't use it or rarely use it (BBC).

And the response on this? From Dr Simon Eccles, who's overseeing the project: "Our view is that we are already under enormous scrutiny, political financial and otherwise. We would be happy with further scrutiny, providing we don't delay the project further while answering yet more questions to explain why the project is delayed." (BBC)

Oh my--nothing like a veiled threat to make your customers feel like they are in the loop. Or maybe no a veiled threat, but a hope that the whole mess can be rationalized away by pointing to all the scrutiny that happened when the customers took a look around and decided that things weren't right.

Hands up, anyone who's thinking that the fox is indeed guarding the henhouse. Here we have a project that is overdue, over budget, without decent oversight, and the reaction of those responsible are to hand-wave around the numbers, and hold their client group hostage against any possible remedy.

So, what to do? The biggest problem is that there is a lot of money invested in this project as it is--if you decide to pull out, something has to be done about those funds. I'm not an expert on accountancy in the public sector in the UK, but I'll guess that depreciation of capitalized items may not be an option. In fact, when I see a statement like "full expense of..." that tells me that there's little to no capitalized funding going on. In one way, that's good--you don't have to play the depreciation tango with Finance. On the other hand, you get to take the hit all at once, and someone is going to be asking questions about all that money. And all that money is on the wrong side of the balance sheet. Even taking into account the difference between a British billion (100 million) and a US billion (1,000 million), that's like Bruce Chizen telling his shareholders that Adobe lost all of their sales revenue for the next two years in a botched IT expenditure. If you were a shareholder, which the residents of the UK *are* in the case of the NHS, wouldn't you be asking for a really good explanation of exactly what happened? And then voting the one in charge of the disaster out of office?

In any case, I'd be asking how all of this managed to spin out of control. Very rarely does a project of this size suddenly find itself over budget, late, and with unhappy customers. It had to get there somehow. This speaks for why a project of this size needs to have someone who knows about the technology, and in this case, the technology is customer databases, and someone who can act as independent oversight to the project. It's not evident that there were milestones for this project, nor were there "out of bounds" or "go/no-go" definitions and tracking available. In fact, I'd hazard a guess that there was a very helpful person with an MPP (Microsoft Project) files, happily showing progress in the coding until at some point the code needed to show up for some form of user acceptance. And that's when they found out that it didn't fit together in one large piece. In fact, it likely didn't fit together at all. And at that point, they saw how much they had invested in the project, and made the decision to throw money at it, as well as keep a forward momentum, with promises made that it all was just around the corner.

But that corner never came, and they had to release *something*. And that something was the scheduling software. And the reaction to that software led to questions, and those questions led to the realization that things were, indeed, two years behind and massively over budget.

And now they have to deal with it.

Comments

[Andrew Zielinski]

Laurie,
Would you know who the major IT product and services suppliers are? Scoping tends to be a two-way communication between the customer and supplier(s) and I'm curious as to who is involved.