UK NHS's £13 bn records project ???

BenjAii

This has been rumbling on for years now (and is now in jeopardy, probably just as well).

http://www.guardian.co.uk/society/2008/oct/29/nhs-health


So it's to cost £12.7 billion sterling, and is decribed thus;

"The future of the NHS's £12.7bn computer programme was in doubt last night after its managers acknowledged further delays in introducing a system for the electronic storage and transmission of patients' records."


So given you can buy pretty much off the shelf solutions that can scale to running the likes of sites with volumes like facebook & bebo.
---

£12.7 BILLION for a system to store patients records ???

Ignoring issues of training & implementaion - focusing purely on the software, am I right in detecting a gigantic case of Emperors new clothes here ?

£12.7 million more like.

EKRIUQ

I put that down to there's money in fear!! like the Y2K bug there was millions spent because of people's fear and anything to do with health records, companies are going to breed on fear of security over sensitive information.

I'm sure 1 billion would of been enough(LOL) but consultants security experts blah, blah blah all got involved.

CuLT

Depending on the data storage required (which I can imagine would be significant) I could see something like that running into the millions anyway. National access? Software accessible to every terminal in every hospital in the country?

Ignoring issues of training & implementaion - focusing purely on the software

I think you're underestimating the value of training, hardware and implementation.

I'd be picking figures out of the air if I were to put a number on what I thought was involved in it. 12 billion sounds like a lot, subjectively, but god knows what's involved.

Webmonkey

Oh this brings back memories, little report I done on it for Software Engineering last year - why projects fail.

Course it was only an assignment but this sums up a lot:


NHS’s National Programme for IT


Name of Project: National Programme for IT (NPfIT)


Purpose of Project
The National Programme for IT was developed by the National Health Service (NHS) in England to move towards an electronic record system for patients. This system allows for the connectivity of 30,000 General practitioners to 300 hospitals throughout the country. It provides secure and audited access to the records by authorised health professionals.


Background on Company
The National Health Service is the health care system in the United Kingdom. The NHS is divided by the four constituent countries of the UK (England, Scotland, Wales and Northern Ireland). Each of these countries has their own NHS, each run similarly but managed independently.
The NHS provides most of the healthcare in England. This includes primary care such as general practitioners, in-patient care, long-term healthcare and dentistry.

The NHS needed to resolve a major difficulty they had – that was the problem of handling hundreds of thousands of patient health records and providing a convenient way for authorised personnel such as general practitioners and dentists etc to access these records.

To overcome this problem, the NHS contracted several companies to develop the NPfIT system.
Unfortunately the NHS did not predict the problems the project would encounter down the road.

The project originally began in 2004 but continued on throughout 2006 overcoming major difficulties.



Problems with the Project

Cost and Delay Problems
To begin with, the NHS encountered several problems with companies that were contracted on the NPfIT project. One of these companies was the IT Services Joint Accenture.
In December 2003, Accenture signed two major contracts to design, develop and deploy patient administration systems for the Eastern and North East regions of England.
In April 2005, Accenture announced they had problems with the NHS contract. The reason for such problems was financial. Accenture announced that the company would make a loss of between $110m and $150m for the year and that these losses would continue into 2005. These losses are a result of the costs incurred in building the infrastructure for the system. The cost of the infrastructure was significantly above estimates.
This financial problem lead to a large delay of the project.


Lack of Communication
The British Medical Journal conducted some research on the project. According to the research, some employees involved in the implementation of the system are feeling cut out from the program.
A group of researchers from the London School of Hygiene and Tropical Medicine interviewed 23 senior clinical and non-clinical staff that were attempting to implement the program in numerous hospitals. The conclusion they arrived at was that there was a big lack of communication between staff and NPfIT officials and that this was leading to confusion and was threatening the success of the project.


Further Delays
BT was contracted by the NHS to design, deliver and manage a national-record database and transactional messaging service.
In October 2005, reports claimed that BT was up to 12 months behind on one of the major areas of the contract with NHS.


Patient Safety Concerns
In March 2006, the NPfIT project came under attacks following reports that its implementation in one hospital created serious problems and compromised patient safety.
Oxford's Nuffield Orthopedic Centre moved to the new patient record system but it claimed to have encountered major difficulties which lead to major concern for patient’s safety. The problems that occurred were the possibility for patients to be lost in the system and operational difficulties that created a backlog of appointments.
The fact that records of a patient could be lost is a serious one that would definitely compromise a patient’s safety.


Technical Failures
In the period of 4 months during mid 2006, the NHS’s NPfIT project was hit by over 110 technical glitches. These failures affected dozens of UK Hospitals. Some of the failures involved X-Ray programs, online appointment systems. Some of the more serious glitches left staff unable to access main computer systems.



The Reason the Project is a Failure:

Poor User Input and Bad Communication
Every project should have a great deal of input from users/stakeholders of a system or the project is almost guaranteed to be a failure by missing important key requirements.

Users and stakeholders of the NPfIT project, such as senior clerical and non-clerical staff did not have fair input to the project. This can lead to problems such as missing requirements, poor usability etc.


Poor Cost and Schedule Estimation
Clearly for a project to be a success, a good estimate of the overall cost and schedule of the project should be carried out.
The NPfIT project estimated these figures extremely badly. The project was originally expected to cost £2.3 billion over three years but in June 2006 the total cost was estimated by the National Audit Office to be £12.4 billion over 10 years.


Poor Planning
The NHS did not plan the project well at all. They picked IT contractors that were not fit for the job. Some of the contractors were even dropped which lead to a lot of money going to waste.


Lack of Testing
Clearly the system was not tested enough as it encounter a lot of major technical glitches. A system should not be put in place without adequate testing, especially in such a serious area as the health system.



Implications the Project had on the NHS
Clearly the main implication this project had on NHS was financially related. The system went away above budget, resulting in less funds for other important parts of the NHS. For example, staff involved with the NPfIT project were angered by the fact that the plans for the IT program have taken priority over local, existing IT systems for radiology and pathology, which are in dire need of upgrading and replacing.

The NHS have developed a bad reputation from this system. The general public lost confidence on the ability for NHS to plan projects and the fact that due to system problems, patients lost trust in NHS looking after their health records.



References
The NHS:
http://en.wikipedia.org/wiki/National_Health_Service

The NPfIT:
http://en.wikipedia.org/wiki/National_Programme_for_IT

NHS Incidents:
http://www.computerweekly.com/Articles/2006/09/19/218552/major-incidents-hit-nhs-national-systems.htm

Accenture Contract Problems:
http://www.cbronline.com/article_news.asp?guid=0D53BC26-C82C-4ABE-B08D-4E704E0530E4

Lack of Communication:
http://www.cbronline.com/article_news.asp?guid=C9FC2209-D8CF-4032-A072-6A440EDA5523

Patient Safety Concerns:
http://www.cbronline.com/article_news.asp?guid=86B6E781-B239-4365-90C4-47B795E635DB

Technical Failures:
http://www.cbronline.com/article_news.asp?guid=06A9BC28-58A2-4781-922C-968C14673FAE