PAC criticises NPfIT delivery

Tags: A Government Information iS NPfIT PAC

14 Sep 2009

The Public Accounts Committee has criticised the government for not using appropriate governance arrangements or available project management skills when delivering the National Programme for IT in the NHS.

It stresses that the public sector needs to build up “internal expertise” in these skills, and not “abdicate responsibility” to external contractors.

The House of Commons committee, responsible for overseeing public spending, says: “Failure to put in place the right management skills and governance affected the delivery of projects reviewed by the Committee including the National Programme for IT in the NHS (NPfIT).

The PAC says in a new report, ‘Learning and Innovation in government’: “It is a positive sign that more expertise is being brought into the government, but internal expertise needs to be built up too.

"Things go wrong where unsuitably skilled staff are brought in to run a contractual relationship, or where they abdicate responsibility to private sector contractors.”

It continues: “There is no substitute for building up the learning and experience of in-house managers so that they can manage projects and the risks associated with them, and get the best from external contractors.”

The report also calls for a “well-informed understanding” of risk, as well as “transparent” monitoring of progress so that failing projects can be halted early.

“Numerous reports from this committee have highlighted that government can repeat mistakes and fail to learn from the past,” it says.

The report highlights that the economic downturn, ageing population and climate change, mean that the public sector’s ability to learn from past experiences and to innovate are more important than ever.

“Experimentation is necessary, but with public money at stake, government needs to be able to halt ineffective activities quickly and learn lessons from them.”

The committee, chaired by MP Edward Leigh, acknowledges that the Office of Government Commerce’s (OGC) Gateway Reviews are one of the ways of capturing lessons for others to learn. But the report notes that projects subject to the gateway reviews are still subject to problems.

The PAC report adds: “Government has also paid insufficient attention to analysing the lessons from the reviews. A lack of good management information is still a hindrance in some cases, and inhibits understanding the impact of innovation.”

The report calls for the reviews to be published and shared more widely across government and for the data from previously completed reviews to be analysed systematically in order to identify lessons which should be shared more widely.

Link

Learning and Innovation in government

Jon Hoeksma

Readers Comments

thank you Sir Edward...

14 Sep 09 16:42

...I also am in favour or building an understanding of risk in the NHS and expertise in managing contracts using a knowledgeable skills base...

and for the record I am also in favour of both motherhood AND apple pie

More money required

15 Sep 09 08:58

Well better project management skills in the NHS are required.

So lets put aside a big pot of money for training, by the way who would train them as these skills do not exist inside the NHS.

I got it go to the private sector as they have tons of PM skills and employ new PMs, just pay them £80,000 pa and bobs your uncle problem solved!

Rot at the top

17 Sep 09 20:45

As one of the internal NHS people with quite a bit of IT procurement, and NHS knowledge (and to know how to thin PRINCE to a bearable methodology), I can vouch that we were trampled and sidelined from the very beginning.

The rot started at the top with the appointment of a management consultant to overcomplicate, and to push the mantra that everything external, and designed by private companies or management consultants was good, and anything internal was legacy not worth a jot.

Funny which systems, despite chronic underinvestment from awaiting the NPfIT mirage, have been keeping the NHS system going all this while. Had the government invested in its own NHS expertise, we'd have delivered the Clinical Five long ago. Certainly in my area, this was well on track in 2002 until sensible procurements were stopped.

Make a decision and stick to it!

18 Sep 09 08:24

I was always taught that once you had made a decision you saw it through? The problem with informatics for the NHS is that frequent changes of direction (or external forces) causes wild swings of activity. For example - what will public choice in changing GPs do to the prioritisation of GP systems? Will GPs claim 'restraint of trade' if they cannot get records shared with hospitals fast enough (and of the appropriate quality) to support the patients who moved to them for a better service?? The PAC may observe another 'wobble' in the direction of NPfIT if this is the case; unless those in the service are listened to and involved in any potential changes.

If you can keep a sailing boat on a relatively straigt course in gusty weather, why cannot some of that sensitivity rub off on informatics initiatives??

What happened to the NPfIT Programme Management team?

18 Sep 09 09:58

If you look back to the precise date of the Wednesday of HC2003, colleagues will recall that after a 5 month open procurement a large WORLD-CLASS programme management company (name withheld on purpose) was awarded a major contract to programme manage the NPfIT. The OJEC adverts had openly stated that the vision for the role was that the contracted programme manager would be JOINED AT THE HIP with the NPfIT programme office, applying its WW expertise in managing large complex projects by partnering with RG and his team on all matters. Within only a few months it was clear that that would not be the case. The contracted company would not in any way be charged with helping to lead the creation of the NPfIT's business case, its purpose, its vision, and a establishing high-performance MODERN management team charged with its delivery -- all of which are essential to delivering large projects, be they national railways or civil IT projects! After 6 months most of the contractor's key executives were removed at the programme office's request, and the contractor adopted the role the NPfIT wanted -- monitor projects with fancy project charts, diagrammes, plans, and documents -- but no provision of world-class management and leadership. So, what happened to that role? It was re-contracted to a second player 3 years later, how did they get on? If you look into the details of who filled that role, its real terms and purpose, and what issues and problems they had in fulfilling it, perhaps the managment lessons of this failed programme will be crystallised. But, who is to do that review? EHI, the PAC? Such a review needs to be done, openly, to understand what we mean by 'better programme management'; the lessons are there we just need to be bolder on exposing what really happened, from March 2003 to today.