Wednesday, August 03, 2011

This Is Looking Like A Very Sad Story Indeed. Are We Learning Enough From What Has Happened?

The following appeared yesterday.

NHS pulls the plug on its £11bn IT system

After nine years and with billions already spent, doomed computer system is abandoned

By Oliver Wright, Whitehall Editor
Wednesday, 3 August 2011

A plan to create the world's largest single civilian computer system linking all parts of the National Health Service is to be abandoned by the Government after running up billions of pounds in bills. Ministers are expected to announce next month that they are scrapping a central part of the much-delayed and hugely controversial 10-year National Programme for IT.

Instead, local health trusts and hospitals will be allowed to develop or buy individual computer systems to suit their needs – with a much smaller central server capable of "interrogating" them to provide centralised information on patient care. News of the Government's plans comes as a damning report from a cross-party committee of MPs concludes that the £11.4bn programme had proved "beyond the capacity of the Department of Health to deliver".

The Commons Public Accounts Committee (PAC) said that, while the intention of creating a centralised database of electronic patient records was a "worthwhile aim", a huge amount of money had been wasted.

"The department has been unable to demonstrate what benefits have been delivered from the £2.7bn spent on the project so far," Margaret Hodge, chair of the PAC, said. "It should now urgently review whether it is worth continuing with the remaining elements of the care-records system. The £4.3bn which the department expects to spend might be better used to buy systems that are proven to work, that are good value for money and which deliver demonstrable benefits to the NHS." A further £4.4bn was expected to be spent on other areas of the vast IT project.

The nine-year-old NHS computer project – the biggest civilian IT scheme ever attempted – has been in disarray since it missed its first deadlines in 2007. The project has been beset by changing specifications, technical challenges and clashes with suppliers, which has left it years behind schedule and way over cost.

Accenture, the largest contractor involved, walked out on contracts worth £2bn in 2006, writing off hundreds of millions of pounds in the process. Months earlier, the US supplier IDX, contracted to provide software in and around London, had also withdrawn from the project, making a $450m (£275m) provision against future losses from the two contracts.

The PAC said part of the problem had been weak leadership in the department. "The department could have avoided some of the pitfalls and waste if they had consulted at the start of the process with health professionals," it said.

Heaps more here:

http://www.independent.co.uk/life-style/health-and-families/health-news/nhs-pulls-the-plug-on-its-11bn-it-system-2330906.html

NHS should consider abandoning £7bn IT project

The Department of Health should consider abandoning a disastrous £7billion project to computerise all patients’ medical records, according to a powerful group of MPs.

6:15AM BST 03 Aug 2011

The Public Accounts Committee says that although £2.7bn of taxpayers’ money has already gone on the scheme, it is unclear what the benefits have been and so ministers should think about whether the rest of the cash could be better spent elsewhere.

Although the intention was to create a single network that would allow NHS staff across England to access any patients’ details, the report says this will not happen now and the country has been left with a “patchwork” of costly and fragmented IT systems whose future is uncertain because of reforms to the health service.

The chief executive of the NHS, Sir David Nicholson, also comes in for criticism for failing to oversee the project properly while civil servants provided “late, inconsistent and contradictory” information to the MPs’ inquiry.

Margaret Hodge, the committee’s chairman, said: “The Department of Health is not going to achieve its original aim of a fully integrated care records system across the NHS. Trying to create a one-size-fits-all system in the NHS was a massive risk and has proven to be unworkable.

“The Department has been unable to demonstrate what benefits have been delivered from the £2.7 billion spent on the project so far.

“It should now urgently review whether it is worth continuing with the remaining elements of the care records system. The £4.3 billion which the Department expects to spend might be better used to buy systems that are proven to work, that are good value for money and which deliver demonstrable benefits to the NHS.”

The integrated electronic care records system is a central part of Labour’s £11bn National Programme for IT in the NHS, which was set up in 2002 and faced repeated criticism since then over its cost and technical problems, most recently from the National Audit Office.

In a report published on Wednesday, the MPs say the intention to allow rapid sharing of patients’ records was “worthwhile” but the Department of Health has been unable to make it work.

They claim that creating a single system was always a “massive risk” especially as clinicians were not asked for suggestions on its operation.

Again a lot more here:

http://www.telegraph.co.uk/health/healthnews/8677275/NHS-should-consider-abandoning-7bn-IT-project.html

There is a lot to carefully digest here, but it seems the warning for what is planned with the PCEHR needs to be very carefully thought trough.

That many of the companies who were involved in what now seems to be a pretty questionable enterprise in the UK are now apparently wanting to be involved in the PCEHR would have to demand, at the very least, some very careful due diligence as to what was done, what was learnt and how things would go better in Australia.

It seems clear that while some of the peripheral work for the UK NHS has gone well that the key failure has indeed been with the Shared EHR.

I wonder just how full the DoHA/NEHTA understanding is of what caused these problems is? Having one or two people join NEHTA who were involved may not be enough. Who can know. Maybe a published review from NEHTA on the ‘lesson learnt’ and the risk mitigation proposed with the PCEHR might be a useful first step to reassure clinicians and consumers.

David.

3 comments:

Anonymous said...

It's quite amazing that we are making carbon copy mistakes and all the warning signs are there that we will also fail, but the worse it gets the more defensive Doha and Nehta become.

Its hard for anyone to say that our programs are different when Nehta Mk 1 & 2 and several versions of HealthConnect have delivered nothing in 10 years. I know they claim to have delivered things but that's rubbish. There are no standards/Specifications or software applications, developed by Nehta, actually out there working. I think its well overdue for someone with some common sense to pull the pin on Nehta.

Anonymous said...

"Instead, local health trusts and hospitals will be allowed to develop or buy individual computer systems to suit their needs – with a much smaller central server capable of "interrogating" them to provide centralised information on patient care. "
What they are replacing it with sounds more like the Australian PCEHR Concept of Operations - not a full SEHR, just the ability to locate and view some key health information across care settings. Perhaps they read the PCEHR concept and liked it?

Anonymous said...

Oh Dear, I think you are serious, which is the concern.
It seems the political speak has replaced the science as the language of eHealth.
We have lots of comment and advice from political lobby and interest groups but a complete lack of technical expertise and experience. The technical underpinnings have to be right and if they are they the way it works is simply policy. We have a lack of technical credibility and it’s looking like one big amateur hour production where there were big ideas, but no talent, rehearsals or backstage preparation. Brought to you by the “Rudd-Gillard Production team”, other big hits include “The Bats are Burning” and “The School Hall Tapes”