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Neil Williams wrote: > On Mon, 07 Dec 2009 13:32:28 +0000 > Simon Waters <simon@xxxxxxxxxxxxxx> wrote: > >> Neil Williams wrote: >>> Government should stop moving the goal posts. The first reason the >>> pharmacy side of the NHS IT scheme has gone so far over budget is that >>> the entire basis of the mechanisms and protocols were abandoned and then >>> redesigned time and time again. >> Who/what was/were the driver for those changes? > > Department of Health and political expediency. Couldn't decide > initially whether to go with a push or pull model then the interface > got tangled up with other unrelated changes (unrelated at a > technological level but, sadly, not at the political level) and clashes Thing is that at the political level you get the kind of people who think it's important to be seen "doing something". Which apparently includes changing their mind frequently. Then if someone senior changes they probably want to be different from the last person in that job. > with the results of the same process going on with the other end of the > connection into other proprietary computer systems in doctor surgeries. > > NHS IT *is* a very large, very complex task. To do it right needs > a clear direction and open collaboration between all parties. Code > duplication and indecision - which have characterised the process so > far - are fatal errors. Effectivly what's needed is to make a plan then follow it through. > >> I think the government understand project management as a Prince II >> thing, and where this is followed, and done by people who understand the >> methodology, you often get reasonable project management, and thus >> reasonable software projects. >> >> Where I see it go wrong, if where work is outsourced, or where the >> project is not well understood (the current NHS system is a case in >> point, I know someone who was managing a subproject for something it >> wasn't even clear was technically possible), or the project management >> is inexperienced. All these were visible to me in the current big NHS >> project, and I only happened to know a few people who worked on bits of >> the project socially. > > Absolutely. The biggest problem was continual changes of direction > driven by political winds - fatally undermining any kind of long term > planning or even rational decision making. But no doubt plenty of "initutives". > > The end result is that although a partial system does now exist, > almost nobody uses it because it slows down the generation of data at > the prescriber end, slows down retrieval of data at the dispensing end > and produces unusable data at the payment end. That mess cost us an > estimated £10bn. > > In the 9 months since the system went live (3 years late), I've seen > less than 1% of incoming prescriptions carrying the electronic > information, of those less than 1% actually get dispensed using that > electronic information (because reproducing it by hand is 5 times > quicker than downloading) and none have been paid using that Which is by any rational standard a complete failure. It would have been better use of the money to make chocolate teapots.
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