Thursday, September 22, 2011

NPfIT Programme goes "PfffT"

More on the travails of the UK's moribund National Programme for IT in the NHS.

It's officially gone "PffffT"...

NHS told to abandon delayed IT project
Denis Campbell, health correspondent
The Guardian, Wednesday 21 September 2011

£12.7bn computer scheme to create patient record system is to be scrapped after years of delays

The NHS has spent billions of pounds on a computerised patient record and booking system, which has never worked properly.

An ambitious multibillion pound programme to create a computerised patient record system across the entire NHS is being scrapped, ministers have decided.

The £12.7bn National Programme for IT is being ended after years of delays, technical difficulties, contractual disputes and rising costs.

And failure to read and comprehend sites like "Contemporary Issues in Medical Informatics: Common Examples of Healthcare Information Technology Difficulties" (extant since ca. 1999) and this very blog...

Health secretary Andrew Lansley, Cabinet Office minister Francis Maude and NHS chief executive Sir David Nicholson have decided it is better to discontinue the programme rather than put even more money into it. The axe may be wielded , with ministers likely to criticise the last Labour government for initiating the project but doing too little to ensure it delivered its objectives.

An announcement has been expected for months after the National Audit Office cast serious doubt on the wisdom of ploughing further money into the scheme and David Cameron told MPs in May that he was considering that advice. Whitehall sources confirmed the decision had been made because of coalition cost-cutting and the ongoing problems.

"It was meant to be a very helpful thing for NHS staff and patients but instead has become this amazingly top-heavy, hideously expensive programme. The problem is, it didn't deliver", said a Department of Health source.

We, of course, in the United States will learn from all this and our "National Program for IT in the HHS" will go splendidly...

"It was too ambitious, the technology kept changing, and loads and loads of money has been put into it. It's wasted a lot of money that should have been spent on nurses and improving patient care, and not on big international IT companies."

Perhaps they do read Healthcare Renewal after all, because I've written exactly that in numerous posts...

The move comes after ministers received fresh advice from the Cabinet Office's major projects authority, which assesses the value for money of major public spending schemes. It concluded "there can be no confidence that the programme has delivered or can be delivered as originally conceived", recommending ministers "dismember the programme and reconstitute it under new management and organisation arrangements".

How about with leaders with domain-specific expertise, too, as I wrote at my Aug. 2010 post "Are computers in medicine narcotic? Why did the National Programme for IT fail?" At that post I sadly observed that:

... [NPfIT] also failed because of collective ignorance of these domains [e.g., healthcare informatics, social informatics, etc. - ed.] among its leaders, and among those who chose the leaders. For instance, as I wrote here:

The Department of Health has announced the two long-awaited senior management appointments for the National Programme for IT ... The Department announced in February that it was recruiting the two positions as part of a revised governance structure for handling informatics in the Department of Health.

Christine Connelly will be the first Chief Information Officer for Health and will focus on developing and delivering the Department's overall information strategy and integrating leadership across the NHS and associated bodies including NHS Connecting for Health and the NHS Information Centre for Health and Social Care.
Christine Connelly was previously Chief Information Officer at Cadbury Schweppes with direct control of all IT operations and projects. She also spent over 20 years at BP where her roles included Chief of Staff for Gas, Power and Renewables, and Head of IT for both the upstream and downstream business.

Martin Bellamy will be the Director of Programme and System Delivery. He will lead NHS Connecting for Health and focus on enhancing partnerships with and within the NHS. Martin Bellamy has worked for the Department for Work and Pensions since 2003. His main role has been as CIO of the Pension Service.

Excuse me. Cadbury Schweppes (candy and drink?) The Pension Service? As national leaders for healthcare IT?

Instead of sobriety, attitudes about health IT seem to universally be "sure, the experts think you shouldn’t ride a bicycle into the eye of a hurricane, but we have our own theories." (See here and here.)

The domain of health IT needs a very stiff period of detox and rock-solid sobriety before it can achieve the (non-revolutionary) benefits of which it is capable.

Riding bicycles into eyes of hurricanes, I'm sorry to say, really is not a good idea.

Back to the current Guardian article:

Its highly critical verdict said: "The project has not delivered in line with the original intent as targets on dates, functionality, usage and levels of benefit have been delayed and reduced. It is not possible to identify a documented business case for the whole of the programme. Unless the work is refocused, it is hard to see how the perception can ever be shifted from the faults of the past and allowed to progress effectively to support the delivery of effective healthcare."

That is a stark assessment. I think we in the U.S. remain deluded as to the true complexity of a scheme for national health IT, using today's systems.

Health minister Simon Burns, who is responsible for the NHS, said recently: "The nationally imposed system is neither necessary nor appropriate to deliver this. We will allow hospitals to use and develop the IT they already have and add to their environment either by integrating systems purchased through the existing national contracts or elsewhere."

Providers of NHS care such as hospitals and GP surgeries will now be told to strike IT deals locally and regionally to get the best programmes they can afford.

Common sense regarding the need for some degree of local control in healthcare, in a country with socialized medicine yet.

It is still unclear how much money the government has agreed to pay contractors in recent negotiations over cancellation fees for scrapping the project.

Let's just say, the amount will not be peanuts.

Lansley told the the Daily Mail: "Labour's IT programme let down the NHS and wasted taxpayers' money by imposing a top-down IT system on the local NHS, which didn't fit their needs.

"We will be moving to an innovative new system driven by local decision-making. This is the only way to make sure we get value for money from IT systems that better meet the needs of a modernised NHS." Serious doubts about the project's future were confirmed this year when the cross-party House of Commons public accounts committee said it was "unworkable" and that, despite huge investment, had failed to deliver.

Sadly, I knew and predicted this years ago. And I'm not even British, although I have spoken to many G-prefixed ham radio operators over the years.

This is one prediction I am not happy to see come true.

You can guess the next prediction of mine that I hope also doesn't occur.

-- SS


Live IT or live with IT said...

Well well. And to think the US government has released its first update on the money we handed out. Half a billion and counting, see:

Anonymous said...

This comes as no surprise. What is astonishing is that the US Congress and POTUS ignore the obvious: HIT is a scam by the vendors to take care from the patients to enrich themselves.

HIT directed care is enormously dangerous.

All you have to do is ask the family of the dead patients from UPMC and the guy who got hepatitis in an EMR associated botched kidney transplant.

Anonymous said...

Doing some quick and dirty math: Based on a per person cost we find this project would cost about $115bn in the US. (Population X exchange rate.)

While I am sure many in the IT industry are salivating at this prospect, and many in government will say we are putting money into the hands of workers, I am equally sure we cannot afford this amount on a project that does not work and endangers lives.

Steve Lucas