Government: we've learned from our IT mistakes

The government has learned from its past mistakes in implementing large-scale IT projects, according to the minister responsible for the enormous Connecting For Health programme.

Lord Warner was speaking on Friday after the release of a National Audit Office (NAO) into the NHS IT project’s progress. Calling the report "extraordinarily positive", Warner said the government and the NHS had "learned from public IT projects that have not gone well".

"[Connecting For Health] is on budget and it has made substantial progress," Warner claimed, adding that the project was motivated by patient safety rather than "because we think it is clever to do it".

Governmental IT projects have a patchy history of keeping within budgets and timeframes.

One of the worst was the tax credits fiasco, where tax credit recipients received over £2bn in overpayments. Contractors EDS eventually paid a settlement of over £70m to the Inland Revenue last year.

Another was the IT system for the Child Support Agency (also supplied by EDS), which went £29m over budget and suffered record transfer problems, leading to the resignation of the agency’s head, Doug Smith.

The Inland Revenue’s national insurance computer system cost more than double the original budget, and the Rural Payments Agency’s Single Payment System (SPS) has also recently hit problems, with thousands of farmers experiencing significant delays in receiving vital funding.

A major issue of concern surrounding Connecting For Health — which the world's largest civilian IT project — has been its ability to stay within budget.

The estimated cost of the project has gone up from an initial estimate of £6.2bn to £12.6bn, but project director Richard Granger attributed the extra costs to factors including data conversion, legacy systems upgrades and user training, as well as contract extensions and "additions to scope".

Warner was also at pains to point out that much of the additional expenditure would be absorbed by the existing IT budgets of local NHS Trusts.

"I would stake my reputation on the fact that in the long term this project will pay for itself," Warner said.

A major stumbling block for major governmental IT projects has traditionally been staff participation, and Connecting For Health is no different, as demonstrated in the NAO’s report and claims by senior medical staff that they have not been sufficiently consulted on.

The report identified "significant concerns amongst some staff" and Lord Warner conceded on Friday that "we should have worked harder at the beginning on staff engagement". 

He said that a "genuine problem with a project as big as this" was that staff had to "see it as a working system that is relevant to them". This meant difficulties where a certain Trust might be on the tail-end of the gradual national rollout, and staff there might be wondering why the implementation was so slow.

Mike Pringle, a national clinical lead for GPs, said there was "no single message for the whole country", and the Department for Health had to be "very careful to manage expectations and get the timing right".

Following yesterday’s allegations over the timescale promised to the NHS by software subcontractors iSoft, Granger also admitted that some "contractors do have difficulties", and said there was a "balance to be struck" between penalising contractors for poor delivery and letting them get on with the job.

"The interaction between iSoft and [primary contractors] Accenture and CSC is a matter for them," said Warner, who added: "What we have done is manage taxpayers’ money tightly".

Lord Warner also gave an assurance that he had "not a flicker of doubt" that patients’ records would be fully computerised by the end of 2010 and claimed that, with such a "sophisticated structure" in place, new ways would appear to "exploit this system in ways that none of us are clever enough to think of yet".