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NHS IT: Another project over budget, late and with a functionality shortfall

Mike Simons | July 3, 2015
The public sector spending watchdog, the National Audit Office, has slammed the NHS for signing off and paying for a £40 million IT system that was not fit for purpose, that was delivered late and which still cannot provide the public service intended. The Department of Health's GP Extraction Service is more than twice over budget and with the NHS estimating it will deliver less than two years' service instead of the expected five.

The public sector spending watchdog, the National Audit Office, has slammed the NHS for signing off and paying for a £40 million IT system that was not fit for purpose, that was delivered late and which still cannot provide the public service intended. The Department of Health's GP Extraction Service is more than twice over budget and with the NHS estimating it will deliver less than two years' service instead of the expected five.

This is such a familiar central government IT saga that it hardly ranks as news, yet the NAO report which detailed this scandal contains important insights for all IT professionals on contract management, agile development and offshoring.

The General Practice Extraction Service (GPES) is an IT system designed to allow NHS organisations to extract data from all GP practice computer systems in England. The aim of the project, first launched in June 2008, was to share data that could be used to monitor quality, plan and pay for health services and help medical research.

The bare bones of the NAO findings make stark reading, even from an audit body used to cataloguing government IT failure.

The project was significantly delayed. The original business case said the service would start in 2009-10, but it took until April 2014 for Health and Social Care Information Centre (HSCIC) to provide the first GPES data extract to a customer. Many intended customers have not had data from the service.

Mistakes in the original procurement and contract management contributed to losses of public funds, through asset write-offs and settlements with suppliers.

The costs of the GPES programme increased from £14 million to £40 million during the planning and procurement stage and have risen further. The project has incurred at least £5.5 million of write-offs and delay costs. Major contributing factors were mistakes in the original procurement and in contract management which led to asset write offs and additional payments to suppliers.

Only NHS England has so far received any data from GPES. Five other major NHS agencies have not received data they need and have been forced to bypass the system to get the information they require - for example to produce clinical guidelines, monitor the side effects of medicine, carry out clinical audits and support research.

"It is unlikely that GPES in its current form can provide the NHS-wide service planned," the NAO noted.

Problems with the system began at the contract and design phase.

The NHS Information Centre (NHS IC), which commissioned the project, and Atos, the supplier, "found it difficult to agree the requirements for the system", the NAO stated.

The procurement began in April 2009, with the NHS using a fixed-price contract model with 'agile' parts. This meant the supplier and the NHS agreeing some of the detailed system needs in workshops, after the contract had been signed.

 

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