NPfIT ' put
us out of its misery
Marc Cetkowski PIPC
Government & Public Sector Journal, July 2011
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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