World’s largest programme cutting quality corners?

Delivery to Time, Cost and Quality are three standard measures for projects and programmes. It looks like they are all at risk for the world’s largest civil IT programme. The ambitious National Programme for IT (NPfIT) underway in the UK’s National Health Service is running years behind the original schedule and the budget has been regularly inflated, with each passing year.  But I have recently seen at first hand that the quality of the programme is suspect in an area that I publicly raised quality concerns about – back in 2004.

My experience may seem trivial at first glance. However, on closer examination of the issues, serious quality concerns are raised. Here is my experience of my local GP’s (doctors’ surgery) transition to the new Connecting for Health service: 

• The surgery had been using an [emis] website for a number of years.
•  NPfIT imposed an obligation to migrate to the new system.
•  The old system was withdrawn and no online service for patients.
•  It took about 6 weeks to implement the new system.
•  All previous patient registrations for the emis system were null and void.
•  Patients have to register for the new system.
•  I collected my new registration letter, replete with username and initial password.
•  The standard registration letter, however, omitted a fairly key piece of information: the URL of the GP website is blank.
•  A quick telephone call to the surgery requesting the website address elicited the response: “what do you mean?”
•  I explained that I needed the website address to complete my registration.
•  The receptionist put me on hold and then advised me “to search on the web for the surgery name”
•  I pointed out that this was most unlikely to give me the proper address and that there is clearly a fault in the configuration of the software.
•  I then had to wait for a call-back from the surgery manager so that I could explain to him what is wrong with his system!

 My Conclusions?

1. The cut-over from existing online service to the new system is far from seamless (indeed more like Disconnecting for Health)
2. The  quality of implementation is suspect (the surgery name is likely to be a simple but fundamental configuration element)
3. The training of the GP surgery staff is inadequate, if two receptionists in consultation cannot recite the surgery website address

Likely cause of the problems? 

I remember very clearly [former NPfIT supremo] Richard Granger stating [in Autumn 2004] that the time over-runs in NpfIT were not going to be a problem because they would be able to shorten the programme’s time provision for GP training. On 1st October 2004  I wrote about the danger of this cavalier attitude in an article for Computer Weekly 

My concerns were well founded because four years later the evidence is there. Clearly there are inadequacies in the quality of implementation and the training provided for GP staff. 

The NHS programme is costing hard-pressed UK taxpayers billions of pounds more than orginally forecast and we deserve effective information systems, properly implemented.

My question to the Health Secretary is straightforward: how good is the quality of work in the NPfIT roll-out?  Perhaps we need to see the programme statistics for re-work and fault calls so that stakeholders (including patients and taxpayers) can have confidence that an effective quality assurance and improvement plan is maintained.

Possibly related posts:

• world’s largest iT project – more poison pills for Health Service?
• Implementation problems to cost hospital £4M?
• Annual cost of project failure in EU: 142 billion euro
• Research claims only 30% of enterprise systems “adequate”
• one step forward, four steps back?