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back to article NHS IT loses key contractor

The NHS patient care record project has suffered another serious setback - key contractor Fujitsu is ending any involvement in the scheme. The National Programme for IT, NPfIT, is already four years late and over budget and losing Fujitsu is unlikely to help. Estimated costs for the whole project have risen to £12.7bn. Fujitsu …

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Doesn't bode well for ID cards.

Are they going to end getting BT to do the whole project?

I'm starting to wonder if they're ever going to finish or if this is going to become some generational project that keeps going because no-one wants to admit what a mistake it was.

Kinda like Vietnam.

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Coat

Intergrated System

So, am I the only one who thought that all this ca$h going in to NHS IT was to standardise the whole shebang and have all patient data available anywhere?. If so, then why the funk has the south had a different company developing their system?. Maybe there's some sort of diseases/illnesses that you get from eating fried chocolate bars that us southerners are unaware of, yeah, that must be it.

Yeah, the one with the target on the back.

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Coat

How to guarantee a titsup project...

...call it a National Programme or Pan Government Initiative...

(and let the suits run it because the techies are bound to mess it up by setting reasonable expectations)

Mines the pinstripe one with the Java reference in the pocket...

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Lessons need to be learnt

It sounds like IT contracting firms need to learn from Railway contracting firms.

1. Offer to supply services at massively reduced prices to undercut competitors and win contracts.

2. Once contracts are signed re-negogiate contract and take government for as much money as possible.

3. ....

4. Profit.

Or maybe it's the government that has learnt from this.

Oh sorry wrong site for that.

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Paris Hilton

Quelle Suprise.....

It's projects like this that give IT a bad name. How can you spend £12.7bn, be 4 years late since the original deadline and still not get it sorted! Pull your finger out Brown!

Paris, because I reckon if I gave her £12.7bn she could have had it all finished, and throw a decent party at the end of it!

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Pirate

BT could get the work...

...and maybe pass the patient data on to a third party for some focused bedside marketing?

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Anonymous Coward

Time to tender a bid

I wonder if all register readers could make a better job/bid

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Happy

I start working for the NHS...

...on Monday 2nd June on this project. Things'll balance out nicely: Fujitsu leaves, and I start.

Nothing can possibly go wrong. Nothing.

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Tim

Every cloud...

Maybe the UK market will now be flooded with very cheap offers of those awesome Fujitsu convertible tablet PCs.

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Stop

BT?

Eh?

Hold on, the same BT that wants to run Phorm on our interweb thingy?

Phuck that!

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Silver badge

Getting Real.

"It is possible the two sides could end up in court over the issue."

What for..... apart from milking the system to sustain predatory, parasitic low lives that is?

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Stop

I had to laugh

Saw this on the TV news last night. The woman was saying that at £12.5 billion it was coming in on or just under budget. Weren't we initially told that this would cost £4 billion?

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Coat

Let's form a consortium

Anyone fancy a few million quid? Some of you lot are naturally good with IT so let's form a consortium and bid for a slice of the cake. How hard is it NOT to be incompetent?

I suspect it's the NHS project leaders who are mostly responsible for messing it up. Public workers should never be allowed to lead a project where the private sector are doing the leg work.

I'll get my coat... any private company accepting this job is doomed. Doomed I tell ya!

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Flame

It boggles the mind

How on earth do they manage to spend £12.7 billion and still manage to have nothing to show for it?

As a developer myself I still have absolutley no idea how you can possibly spend that sort of money and still fail to get it done!

Really, everyone involved should be fired and/or jailed for defrauding the taxpayers out of such a huge amount of money. If I robbed a hospital or government building I'd go to jail, so why dont these charlatans?

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Paris Hilton

Why the big expensive contractors only?

A friend of mine developed Out Patient software for a number of hospitals some years back. It worked, it was on-time and it didn't cost the earth. It was (last time I spoke to him) in use in a good number of hospitals. It had full 24 hour back-up and support and was run on a staff of a few people (it's probably changed by now).

He had a fight to get it into the NHS because:

a) It was inexpensive.

b) his wasn't a large company (1 person originally).

c) his system actually worked.

Interestingly, the NHS wanted to create their own system (this was several years ago) - so they tried to "copy" his system - it was a massively expensive failure.

So, yes you're correct - some Register readers could do a damn sight better - BUT they would have to have worked in the NHS, know what is needed from a "grassroots" - i.e. user - perspective, ignore specs from the NHS "empire builders" and get a commercial system up and running without interference from the self-same empire builders.

Paris - because the obscene, immense waste of OUR taxes on these project would make you weep!

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'Mathew Swindells' ???

Too many jokes, so little time.

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Alien

Re distribution of wealth

...what an awesome scheme !!

...and unlimited amount of money can be siphoned from tax payer and into the pockets of big business - and better yet, it need never end !

Almost anyone "in the trade" knows that had there been genuine commercial pressure to deliver, it would all be over by now.

how can patient records present anything more complicated than say, ebay ?

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RE: "Time to Tender a bid"

I'd be up for it - databases and infrastructure - chance to start a new way of doing the big projects away from the control of the bean counters. May even get it right for the customers rather than the consulting companies.

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Dead Vulture

CSC?

This wouldn't be the same CSC who vowed never to touch (UK) healthcare systems after the Scottish healthcare IT project blew up in their faces, would it?

Plus ce change...

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Dead Vulture

I wonder if all register readers could make a better job/bid

I'm sure we could, if we could cut through some of the crap that the management layers put in place.

I've seen half a dozen six figure projects in the last few years that I _know_ me and a few mates could have turned out in a couple of months worth of lunch hours.

But all these bids will be through Catalist so only the greedy dinosaurs can bid for them.

There is no appetite for this to change. The Public sector voting for less red tape and paperwork...yeah right.

Dead vulture because it is the closest we have to a turkey that voted for Christmas...

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And you are surprised?

Any company/government mad enough to employ the likes of Accenture/Fujitsu/IBM/BT/EDS/TCS etc etc deserves all it gets. Unfortunately, it is us, the tax payer who pays for the mistake, not the cronies who are taking backhanders left, right and centre to give these contracts out. Give the job to a proven small/medium size PROPER IT software house with professional IT guys who know how to implement systems, not business men who know how to put on a flash powerpoint presentation.

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@Hedley Lamarr (great handle!)

"can you imagine every single Barclays location (eg local bank branch, business centre, investment bank) in charge of it's own IT?"

True, but can you imagine a central Whitehall bureaucracy dictating a solution (designed without involving any actual users, natch) that will work in all these locations and without any local commitment? What's needed is a central framework architecture so that locally appropriate systems can intercommunicate, with a 'menu' of centrally purchased systems that can either be selected or you can roll your own so long as it complies with the central standards. Can I have my £12 billion now, please?

Regarding Barclays - I was once at an IBM(UK) AIX conference for their 50 largest users. 22 of them were representing differing divisions of Barclays - and none of them had ever met ...

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Anonymous Coward

Well what are the Japanese doing in this anyhow?

This is a UK project, taking UK money holding data on UK citizens.

Most UK developers consider the project trivial to implement, so why are we paying foreign companies to implement this?

Has Japan produced a really elegant Health Service record system?

I say we use this whole fiasco as a reason to scrap the NHS, it has nothing to do with the Nation anymore and is just being used to transfer funds out of the country, and act as a millstone round the necks' of the citizens of the UK.

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Unhappy

Oh lord, not another one

Being a software developer myself and having a family member who is currently in a significantly long career with the NHS I can safely say that this is the most botched project i've ever seen. When asking said family member what exactly is going on I got the general impression that they weren't really sure, and that they too agree that the entire thing is just a complete waste of money that could be spent elsewhere.

How many beds, hospital expansions and personnel does 12.5 billion represent again?

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Stop

@And you are surprised?

"mad enough to employ the likes of Accenture/Fujitsu/IBM/BT/EDS/TCS etc"

What a jerk.. take for example if the project was just to rollout 1 PC to each hospital in the UK, lets say 8,000 hospitals for sake of argument, probably loads more!??

Now how would you do that, you would have to hire engineers to install, train them, then you need stock control, change control, project management, HR for when the engineers go off sick.. finance, warehousing, distribution so they arrive in advance of the engineer, then you have to handle DOAs, hospitals closing/moving,etc. etc... the list goes on!!

So how would say a small/medium size outfit ever have the ability to handle that?? Hence why you end up with the same big name companies who have the resources to be able to do it.

Same for the software, its not like you could have written a vb frontend on an access db to handle the entire system!

You are talking rubbish and should go back to your 1 man in the basement IT outfit....

The reason it cocked up, is more likely staff within the NHS who dont want to loose their empires and therefore put spanners in the works all the way through it, no wonder the main contractors thought screw this!

The government should deploy a hit squad to sack the lot of them!!

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My NHS IT experience

After Uni I was employed as a temp by a London PCT to install a word document onto each surgery in the areas main server. This involved me walking between each surgery, stick my USB disk in CTRL+C / CTRL+V.

Once I'd done them all, they sent me back around again to do version 1.1 of the file.

Email anyone?

Cool job over the summer for me though :)

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Flame

@FlatSpot - hit the nail right on the head

"The reason it cocked up, is more likely staff within the NHS who dont want to loose their empires and therefore put spanners in the works all the way through it, no wonder the main contractors thought screw this!"

I work for one of said contractors.

And you're dead bloody right. Too many management dickheads with their brains in their backsides. Get rid of them, and we, together with our technical NHS counterparts, would have had it done by now, with just a few rollouts left to go.

This can work, and it will. It's complicated, but it's good. And it's secure. Don't bother flaming back about that unless you've seen more of the designs and code than I have. Which you probably haven't, unless I know you personally.

Same old story - too much deadwood clogging up the works. If some of these clowns (on BOTH sides of the contract, let's be fair here) knew of the things the techies have to do to contain their half-arsed decisions and unwarranted interference they'd drop dead on the spot.

Anonymous for pretty obvious reasons!

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Coat

Saw this coming from the start

I used to work for one of the "Early" adoptor sites. Basically my "boss" thought he knew all that there was about IT and best practices on networking. This is what lead him to take over another hospital that was properly VLAN'd/segmented and reconfigure it so that all "subnets" were in VLAN 1. This is the same boss that told Fujitsu and CfH/NpfIT how it was "going to be" in this hospital. I left after being there for two years because I really really hate to put my name on the bottom line of networking when its as screwed up as that... I have more pride than that.

/me grabs white lab coat so that no one realizes I work in the IT department

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Anonymous Coward

The 2 problems here are...

I don't think FlatSpot understands the big IT service providers like "Accenture/Fujitsu/IBM/BT/EDS/TCS". I reckon a medium size company could take on the project and be hugely successfull. I've lots of experience of one of them big companies and can tell you now, they pay peanuts (so the best staff leave), they have far too many managers (hugely expesive) and many still end up getting contractors to the sites anyhow. Until someone stops sending a contractor to site costing £400 to fix a peice of hardware costing £300 it'll still be madness. As for the NHS, it's just a very large database, how complex can it be compared to banks accounts, financial exchanges etc. The big problem is that civil servents dream up an idea and the Big IT companies are scared to say "That's a stupid idea and too complex - we can design this cheaper if you keep your arse out of the project!"

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Stop

Large budget, no requirements, why so surprised?

'nuff said. This is a project that should never have happened. It was simply a big splash by Tony Bleagh who decided that the key to revolutionising the NHS was to create a whole new set of IT systems. Absolute rubbish, there were nevere any proper, controlled, formal requirements and we are simply seeing the results of this now.

Cancel the whole thing before more money is wasted.

Read Private Eye if you want the full facts.

Unfortunately this is depressingly common in government IT contracts and the government only have themselves to blame - it is politics and expediency getting in the way of properly managed IT projects. Politicians want quick results and headlines; good IT systems take time, clear requirements and strong management on both sides to get successful results.

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@ amanfrommars

phuck me.. I actually understood that!!

Someone higher up touched on it: If you want to consolidate a system, don't use two different suppliers for the North and South... So simplistic, it just screams "phuck up"

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Black Helicopters

Shame

They should have asked me. I could have easily delivered a phat pile of nothing, in half the time, for a good deal less than £12bn.

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Paris Hilton

@James

spot on.

I worked for a small company like you describe. in fact the directors are former NHS staff but even that isn't enough.

BT came to sniff out their software a couple of years ago but never took the bait. shame as it could run every clinical department in the land, no problem. Instead we rope in multinational companies to write what has already been written at huge cost. WHY?

oh and btw the £12bn is the total cost not the spend so far. Richard Granger did get something right.

Paris - she has great software too

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Silver badge

NEUKlearer Understandings......for AI NeuReal Mode of Globally Available Governance

"Any company/government mad enough to employ the likes of Accenture/Fujitsu/IBM/BT/EDS/TCS etc etc deserves all it gets. Unfortunately, it is us, the tax payer who pays for the mistake, not the cronies who are taking backhanders left, right and centre to give these contracts out. Give the job to a proven small/medium size PROPER IT software house with professional IT guys who know how to implement systems, not business men who know how to put on a flash powerpoint presentation." .... By Anonymous Coward Posted Thursday 29th May 2008 11:24 GMT

The Register could QuITe easily run a Transparent Analysis/Public Showing of the Problems which have defeated Fujitsu, and if there is a Solution out there, Word of Mouth/Binary Chatter will Attract someone who can and will Share it .... and be entitled to handsome reward, by Automatic Default.

And of course, El Reg, would require Consideration Worthy of Empowerment, too.

And it would be incorrect to suggest that Funds are not there for such Speculative Joint AddVenturing whenever such massive Sums are so easily written off with Non-Performing Systems cluttering up the WwworkSpace.

And there are also any number of such Innovative Grant Funds available for such Novel Speculations too. In fact, very recently was that something which Mr Brown was pimping. One trusts in Global Operating Devices that it was not empty rhetoric/idle chatter/BSSpin

And very Democratic IT would be too, with a Server Meritocracy emerging to Build the Future, ideally not for them, but for their Children's Children, which would be QuITe far enough for Now to start Building for. Any Further would require QuITe a bit more Imagination than would be Practical to Supply.

:-) But Never say Never as it is Bound to be something Boffins are Working on.

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Gates Horns

``This can work, and it will. It's complicated, but it's good.''

What is `this' and what is `it'? Sure, consolidating health records is a perfectly do-able task, and doing it securely is not beyond the bounds of possibility (although what `securely' means when the staff aren't all cleared is an open question). But what does it deliver? 12.7bn is enough to abolish prescription charges in the NHS for twenty five years, and people harming their health by not getting all the drugs they need is not unheard of. 12.7bn is enough to perform hip replacements at private prices on everyone in the UK over sixty. 12.7bn is about five hundred pounds per working citizen.

And for what? How many people have adverse events because they visit hospital X when their records are in hospital Y, which could be cured if only their records had been available? And of those, how many would be solved by underwriting MedAlert bracelets?

The vast majority of NHS spend is in the final years of life, and people in that position visit their local hospital.

PACS: yes. Because radiology tackle isn't doing silver nitrate anymore, so the digital images have to be distributed somehow. But the rest? At best, a great solution to a non-problem. At worst, a non-solution to a non-problem.

93C3. Just remember: get 93C3 on your records.

Bill. Because he told Tony to do it.

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Pirate

Not only in the UK

If one looks at the history of major health-care IT projects world-wide, there is a depressing pattern that emerges:

1 - announcement & high hopes by the participants

2 - awarding of contract(s) to big-name IT firms

3 - delay , delays and more delays

4 - sacking of prominent figures

5 - delay , delays and more delays

6 - reorganisation and/or new blood (contractors)

7 - delay , delays and more delays

8 - disillusionment by participants on the same scale as the original announcement's hopes

9 - out comes the knives

Healthcare IT is a black hole for any aspiring senior IT manager.

Mostly what happens is that the government ends up in a series of perpetual battles with the regional health bodies and hospitals over the vision vs practical aspects of implementation. Add to the mix that the irrepressible urge to play IT professional by physicians (who should know better) and you are left in a no-win scenario.

Happens in Canada

Happens in Germany

Happens in FInland

Don't get me started on the Yanks......

Why should you folks be left out of the fun? (just kidding)

Heaven forbid if a competent and capable manager be brought on and left to do his job without egregious interference.

that's my take anyways...................................

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Q after A

Does anyone know of a goverment IT project that came in on time and on budget? could change that to any project run by a goverment department?. Boy do i wish i still worked in the IT civil service it was ssssoooo easy (well it works if you reboot it so just do that everytime).

Still think there using 3.11 in social services? better than vista though less bloat.

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Impossible job

If this job was ever completed it would be the biggest IT project brought to a conclusion in the history of the world. It was never going to happen. Putting together a specification is probably impossible, let alone fulfilling that spec.

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Anonymous Coward

Duh

Funnily, DNS, Active Directory and SQL scale rather well. Write a front end and you're done.

As for "Well what are the Japanese doing in this anyhow?", it's nothing to do with the Japanese. Fujitsu is what was left of ICL in 1990.

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Happy

Re: Q after A

Yes I do know a success. BT have delivered the DWP transformation on time and under budget ($1bn). 130,000 handets, 220,000 voice and data network ports delivered in 18 months!

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Health IT

From what little experience with IT project and health:

It does not help that medical doctors in charge consider they should have the last word on everything. They are so used to say: "Sorry, but I'm the doctor" that they have trouble accepting anybody else making decisions for them.

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Anonymous Coward

Lorenzo - Horendzo

As one of the poor sods who has to use this software in my day to day practice treating patients I am appalled at the quality of this software. We are using isoft IPM and ICM, (pre-lorenzo release). Quite frankly it is a joke. Someone above mentioned a VB front end on an access db - i wouldn't be surprised if thats what this is!

Local ammendments to the system are vertually impossible - 'hard-coded' is the stock excuse from CSC.

I would honestly prefer to go back to our old DOS blue screen PAS sysytem.

The doctors and nurses in our hospital now refer to Lorenzo as Horendzo!

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Flame

Lorenzo + CSC = problems

Some of us have been using Lorenzo for some time. Hopefully, it is supposed to gain features with time. At present though it is very poor. Far more basic than what was running on many hospitals before.

A major part of CSCs efforts seems to be concentrated on avoiding fixing problems, even denying there are any. It certainly doesn't spend much time on trying to convince IT, or medical staff of its quality. It is fiddly and slow to use and an absolute nightmare to install the client for.

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Anonymous Coward

my mate dave etc etc

Some of the comments on this thread are laughably simplistic e.g. "my mate wrote a system that could do it all" etc etc.

To help inform an understanding of just how ambitious the National Programme is it might be worth looking at a few key metrics for NPfIT:

- 650,000 clinicians, nearly all of whom feel entitled to contradict Connecting For Health and their 649,999 colleagues on what the systems should / shouldn't do

- 30,000 separate physical locations

- Hundreds of Trusts each with their own set of "unique" processes holding the expectation that their different way of working should be supported- Hundreds of local IT Directors who can and do decide to do what's best for their Trust irrespective of the impact on regional or national plans

- Hundreds of different versions / providers of systems that need to be integrated into a new standards based architecture - and thousands (if not tens of thousands) of combinations of legacy systems that have been configured / tailored locally (often with very little documentation).

- 240m appointments in Primary Care a year

- 60m+ (?) appointments in Secondary Care

- a coding structure that contains over a million different clinical terminologies that will apply to each of the 300m appointments in Primary & Secondary Care (compare this to the simplicity of even Tesco with c40,000 SKUs)

- A key (and vociferous) stakeholder group of 140,000 Doctors who will always warn you that doing something will kill patients even when this is just an argument designed to protect their shonky ways of working or protect the cosy set of working arrangements they've fooled the government into accepting and who are represented in public by spokespeople who will often say something completely different in private

When, and only when you've actually had some exposure to this can you really understand the scope of the challenge or comment with any real insight on what Connecting For Health should do / could do / has done / hasn't done.

Many of the commentators on here seem to have missed the key point that Connecting For Health pays on results. Key contractors don't get paid until they deliver - with the result that although the programme is late, CFH haven't paid for the privilege - they are reportedly c£2B underspent at present.

Finally, many of you probably haven't worked in environments where even small changes can involve consultation across hundreds of separate organisations and thousands of key stakeholders. Until you have, it's very easy to come out with all the "my mate dave in his shed" scenarios which make for entertaining reading and not much else.

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Dilbert

I think the complication here is that Fujitsu were paid by results, so very little money was actually changing hands ;-) . Meanwhile Fujitsu was paying staff and subcontractors.

The NHS then tried to change the contract. To recoup its outlays, Fujitsu played hardball on the price of the changes, so NHS cancelled. Doubtless there will be some payment under the terms of the contract, but also huge writeoffs on the Fujitsu side.

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Whats the problem?

Its a simple database server with a simple user interface, that requires security so tight it squeaks. £12.7 billion????? I'll do it for a pie and a pint.

So is the managers that have spec'ed it as a mammoth project, or the contractors who have sucked their teeth like some Del Boy mechanic and said "thats gonna cost ya". £12.7 billion buys an awful lot of hip replacements. Simple problem, simple solution, screwed up by money grabbing bastards

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Heart

Big Boys do not know how to Play

"Key contractors don't get paid until they deliver - with the result that although the programme is late, CFH haven't paid for the privilege - they are reportedly c£2B underspent at present." - Half Truth. On the main contracts that the deliverables are set against this statement is correct. Anything thats was not defined as a deliverable on the initial contract is used to recoup the costs of the contractors. Daily rates for engineers, Application Specialists and Consultants ranging from £1,500-£6,000 just for one visit. This does not include the cost of equipment that was not originaly spec'd. "Oh, you wanted a DVD burner...sorry that was not in the original spec, its going to cost you £200 for the burner". This happens all the time.

The goverment has good ways of hidding these additional costs as CFH does not pay for anything considered "extra" and the local trusts are responsible for this extra cost. Where does trust money come from? The £12 billion is probably less then the true cost and most of it is unreported.

Just a little note about big/large companies managing these contracts better then medium companies..... what tosser said this? Having worked for these big companies that pay fat salaries to contractors who do not care at all for their jobs as long as the weekly timesheets are getting signed. Then as soon as a delay occurs due to CFH/NHS cockup's, the big firm terminates the contractors to save money and then brings in new inexperience people who know jack about medical.

Most of these installation had three project managers...WTF do you need 3 Project Manager's for? Seriously what a waste of money.

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To Gordon Johnstone

Your Wrong. Your are totally, fundamentally wrong.

Anonymous Coward has it right, two comments up. Read it before saying it's a simple 'database server with a simple user interface'.

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Anonymous Coward

@ Gordon Johnstone

"Its a simple database server with a simple user interface, that requires security so tight it squeaks. £12.7 billion????? I'll do it for a pie and a pint...Simple problem, simple solution, screwed up by money grabbing bastards"

Here speaks the voice of (no) experience.

Complex problem, equally complex solution, sniped at by people who fail to understand the complexity and can't understand why a "simple" solution will just land up with patients dying.

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