back to article When IT projects go right

There is a vast difference between running a project and running one successfully, as a cursory scan of recent news shows. In the run up to the Commonwealth Games, dire predictions were rife that the event could not actually go ahead. The government initiative to generate a quarter of all the UK’s electricity over the next 10 …

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"Clear vision" in IT ...

... doesn't exist.

At least not where myopic manglement rules the roost.

That would be pretty much anywhere labeled "government", IMO ...

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Megaphone

Oh utopia

What IT is people to bloody test!

Not go, yeah it's fine, then a week after go live come back with a list of things that are wrong, which any real testing would of picked up!

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Anonymous Coward

Learning comes from making mistakes, but best fail quickly.

"Very few IT projects match NPfIT in terms of scale, of course, but even a much less significant failure is something that no one wants on their CV".

I disagree, in some cases. Projects can succeed by learning from people with a project "failure" on their CV. Such people have real experience about what went wrong - and are able to warn those embarking on a new project of the signs.

Learning can come from making mistakes. "a person who never made a mistake never tried anything new" - Einstein.

That said, it doesn't excuse the enormity of the NPfIT failure. So another wisdom would be to "fail quickly", so that a new direction can be taken. Plan contigency.

It depends on how the failure experience is presented on the CV.

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IT Angle

Interesting you bring up NPfIT

As someone who was actually quite close to the debacle...

There is (and was) a strong need to allow greater access to peoples medical records. Put shortly IT WILL SAVE LIVES.

However, there was a strong resistance from GPs in general, not because of privacy concerns, or about a perceived lack of need (indeed the SCR is replacing a chunk of the really useful functionality), but because GPs perceived the data as *theirs*.

The resistance to the centralised DB from GPs was purely down to a loss of control. Essentially the nagging worry that it would far too easy to audit a GPs work without having to come to the GP and get the potentially incriminating data, immediately left a nagging doubt at the backs of GPs minds.

The privacy concerns leveled at the DB though were utterly foolish. It was misrepresented right from the get go, and the security it actually brought in was ignored. My question to people who complained that "Anyone could see my records!". How do you currently know who sees your paper records? There is no logging (as with digital records), and the only reason they aren't stolen more often is that the nice cabinet full of drugs is usually a nicer target.

That's not to say that bits of NPfIT didn't go well, much of it didn't, but planning was less of an issue than PR. If it had been spun correctly to parliament, GPs and patients, it wouldn't have been the dead duck it was basically from the start.

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Anonymous Coward

Re: Interesting you bring up NPfIT

>but because GPs perceived the data as *theirs*

This is what really pisses me off about the NHS. Where I live if I go to the doctors and need some tests the results are mine. X-rays, blood tests, MRI scan, anything. I have a draw full of tests for all the family. My son had the MMR jabs in the UK and simply getting a doctor to confirm this was approaching impossible.

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I always though

That the major failure of the NPfIT, was not particularly IT related.

My understanding was that because the NHS didn't have common, defined, business processes across the country, it made it impossible to build a single IT system to support those, non-existent, processes.

Most people seem to forget that modern IT systems are built to support business processes, rather than the old fashioned way of creating business processes to support the IT systems. If you can't describe your business process to the IT bods, you're out of luck!

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@AC

Curious. This is an article about the reasons for failure in IT projects, and it touches only peripherally on the single most important problem. Your own very confused reply highlights precisely that problem.

Rule #1, IMHO, is to make sure that there actually is a *need* for whatever you intend to create. In other words, make sure there's a real problem, propose a solution, carry out a cost-benefit analysis. JS might argue that her second point ("...concerns the support and commitment of the different parties involved across the business, especially senior management") covers the first part of this, but GPs and nurses aren't part of the "business"; GPs, at least, are independent contractors who are nothing more than the proposed users of this system.

You (AC) state that there was a need:

"There is (and was) a strong need to allow greater access to peoples medical records. Put shortly IT WILL SAVE LIVES"

but you don't back this up. What breathtaking arrogance. Here's a simple sum: the annual primary care budget in the UK is about £125/head (that's what your GP surgery gets for *you*). This costs about £6.9B/year. The NPfIT budget was £12B. In other words, NPfIT consumed, or was intended to consume, the entire primary care budget for about 1.7 years. How many lives was NPfIT supposed to save? You've got no idea, have you? It's not your fault, of course - no-one has any idea, because they didn't bother to do the sums before committing to spending our £12B. If you ever do work out the answer, then perhaps you could also let me know how many lives would be saved by increasing that £125 budget to, say, £145.

And here's another rule. When your project crashes and burns, don't start talking bollocks at the post-mortem. Try to find out what actually did go wrong (there wasn't actually a "need", for example), or you'll have wasted all that taxpayer's money for nothing. In this case, I'm afraid that:

"However, there was a strong resistance from GPs in general, not because of privacy concerns, or about a perceived lack of need (indeed the SCR is replacing a chunk of the really useful functionality), but because GPs perceived the data as *theirs*"

qualifies as the bollocks. Back it up. I know a fair number of GPs and, without exception, their objection was *cost*.

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Clarification

You're perhaps playing a bit fast and loose with those numbers, the £12.7bn is over 10 years, it has also been reduced, it was down to at least £12.1bn by the end of the Labour Gov't and I presume it is lower still now. It is also not just being spent on the health records, for that money we get electronic x-rays (widely hailed as a triumpth), electronic prescriptions, choose and book, 1 internal mail system, NHS Spine network thing... etc etc.

Increasing the healthcare spend per person is a different argument. I presume this figure is calculated based on how much the average person requires anyway. Do people get turned away because a care provider has run out of money?

Personally, I'm quite happy money is being spent to modernise the NHS, the patient records system makes sense, it is logical that their should be a standard health record that can easily be transmitted between care providers when I move or need care whilst not being at home.

My understanding is the delays in implementation of certain elements can be put down to the fractured nature of the NHS (12 SHA's and 125 PCTS) of course with 3-500 GP consortia in charge this will improve Im sure.

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re: interesting you bring up NPfIT

With a GP in the family, I was under the impression was that the biggest source of resistance was that most GPs know they can get to their records in a reasonably efficient manner. Being 'theirs' meant that they weren't going to have to spend mornings saying to patients "Sorry, I can't access your records, something's broken that I have no control over".

There seemed to be very little faith that NPfIT would deliver a system that improved their day to day work. Certainly existing moves to introduce IT to surgeries have been painful and disruptive and NPfIT looked like it would take that to an entirely new level of inconvenience.

Blaming the end users for the failure of an IT project is very hard to defend.

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Megaphone

SCOPE!

The first thing that MUST be put in place is scope management. And nothing should be started until the project scope is locked down. If the powers that be cannot agree on scope then the project is dead in the water.

The client, the vendors, the PMO and the integrators all need to be in agreement on the exact scope and they must sign off the scope and schedule with penalties for non compliance.

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