Anatomy of a £15bn gamble- CfH's NHS IT busted flush
The new NHS computer system could be the biggest IT disaster in history, warn experts. Inside a leading hospital in Oxford, expensive new computers were humming away just before Christmas when disaster struck. The Nuffield Orthopaedic Centre was at the forefront of a multi-billion-pound revolution to modernise the entire computer system of the National Health Service — and the screens had suddenly frozen.
Medical staff looked on in disbelief as they tried to retrieve lost records. “We had only been running the system for a couple of days when it went down,” said one manager. “You would try to get a patient’s records which you knew were there and it just locked you out.”
Although the system was functioning again the next day, some patient files seemed to have disappeared completely. The trust was so alarmed that it sent a report to the National Patient Safety Agency, warning that it had posed a potential risk to patients.
The collapse of the system and further failures led to cancelled operations and a backlog of outpatient appointments. Bob Cullen, 57, a postman who had been referred for treatment by his GP last year, found himself in limbo.
“I was in agony and was on painkillers, as well as taking liquid morphine,” he said. “I was phoning up the Nuffield in so much pain that I hadn’t slept for days and they said ‘We can’t find you on the system’. This was meant to be a hospital with the latest computer systems for patient care and I somehow got lost.”
All new computer systems suffer from “bugs” and the Nuffield’s trust says the problems were merely “glitches”. But to critics of the NHS’s expensive new computer project, Connecting for Health (CfH), the incident was a portent of further trouble.
So concerned are experts that last week 23 senior academics in computer-related science called for a independent review of the project. They fear that the entire scheme is misconceived, overpriced and a waste of billions of pounds.
Last week NHS trusts were facing an estimated deficit of £800m. Staff are being laid off across the country; wards are being closed; patients are being denied potentially life-saving drugs. Yet at the same time the NHS is spending a fortune on a computer system that, critics say, is needlessly expensive.
Even CfH admitted this weekend that the cost of the scheme, now not due to be completed until 2010, could reach £15 billion. Outside experts suggest that £30 billion is more realistic.
It is the largest civilian computer project in the world, designed to transform the NHS into a beacon of electronic wizardry. But could it instead become the mother of all IT disasters while the country’s hospitals remain desperate for cash?
FOR more than 20 years it has been clear that the NHS needed to modernise its information systems to improve patient care and cut delays. The question has always been: how? The initial suggestion under Labour was pragmatic. After a series of reports between 1998 and 2002, advisers recommended an “off-the-shelf” solution which would upgrade and link existing NHS computer systems and buy readily available software.
However, on February 18, 2002 Tony Bliar, a self- confessed computer illiterate, chaired a meeting at Downing Street on the NHS and information technology. Alan Milburn, then health secretary, and his officials outlined a bold new plan to link up GPs, hospitals and patients on a much grander scale.
It envisaged a new NHS computer system designed from the top down to hold the records of 50m patients on one huge database. The prime minister was impressed. One of the main advantages, he was told, was the instant access that the scheme offered to patients’ records. A complete medical history could be pulled up on a screen at the touch of a button — from anywhere in the country.
Patients would be able to book appointments with GPs on their home computer and once in the surgery would choose their preferred hospital for an operation.
Hospital staff would have instant access to electronic records of any accident victim and x-rays would be electronically transferred from one end of the country to the other.
The scheme’s ambition and potential cost were staggering. Yet Bliar gave it the go-ahead without public consultation. The government initially allocated £2.3 billion for the project and boldly proclaimed that electronic records for every patient in the country would be online by the end of last year. The costs and the delays have been mounting ever since.
It is an example, say critics, of how the management consultants contracted to deliver such systems are only too happy to think big since it makes more lucrative work for themselves.
The man tasked with running the CfH project is Richard Granger, a Bristol University graduate and management consultant. A driven, abrasive character, he bought a Porsche as soon as he started earning “serious money”, lives in a large country house in Cumbria and was appointed on a salary of £250,000, making him one of the country’s highest-paid civil servants.
Few dispute the need to make improvements — but critics say that a centralised system will require vast computing power, raises questions of security and will be a nightmare if it goes wrong.
“In the system they are building, errors can get spread and copied across the network and nobody can do anything about it,” said Ross Anderson, professor of security engineering at Cambridge University and one of the 23 academics calling for an independent review of the project. “What they are proposing is a recipe for chaos and disaster.”
Helen Wilkinson-Makey, a 40-year-old manager from High Wycombe, Buckinghamshire, says that her experiences highlight the pitfalls. She discovered that an inputting error had led to her being wrongly logged as having received treatment at an alcohol dependency unit in 1998. The computerised record had been distributed to her strategic health authority, primary care trust and a local “shared care agency”.
http://www.timesonline.co.uk/article/0,,2087-2136718.html
Medical staff looked on in disbelief as they tried to retrieve lost records. “We had only been running the system for a couple of days when it went down,” said one manager. “You would try to get a patient’s records which you knew were there and it just locked you out.”
Although the system was functioning again the next day, some patient files seemed to have disappeared completely. The trust was so alarmed that it sent a report to the National Patient Safety Agency, warning that it had posed a potential risk to patients.
The collapse of the system and further failures led to cancelled operations and a backlog of outpatient appointments. Bob Cullen, 57, a postman who had been referred for treatment by his GP last year, found himself in limbo.
“I was in agony and was on painkillers, as well as taking liquid morphine,” he said. “I was phoning up the Nuffield in so much pain that I hadn’t slept for days and they said ‘We can’t find you on the system’. This was meant to be a hospital with the latest computer systems for patient care and I somehow got lost.”
All new computer systems suffer from “bugs” and the Nuffield’s trust says the problems were merely “glitches”. But to critics of the NHS’s expensive new computer project, Connecting for Health (CfH), the incident was a portent of further trouble.
So concerned are experts that last week 23 senior academics in computer-related science called for a independent review of the project. They fear that the entire scheme is misconceived, overpriced and a waste of billions of pounds.
Last week NHS trusts were facing an estimated deficit of £800m. Staff are being laid off across the country; wards are being closed; patients are being denied potentially life-saving drugs. Yet at the same time the NHS is spending a fortune on a computer system that, critics say, is needlessly expensive.
Even CfH admitted this weekend that the cost of the scheme, now not due to be completed until 2010, could reach £15 billion. Outside experts suggest that £30 billion is more realistic.
It is the largest civilian computer project in the world, designed to transform the NHS into a beacon of electronic wizardry. But could it instead become the mother of all IT disasters while the country’s hospitals remain desperate for cash?
FOR more than 20 years it has been clear that the NHS needed to modernise its information systems to improve patient care and cut delays. The question has always been: how? The initial suggestion under Labour was pragmatic. After a series of reports between 1998 and 2002, advisers recommended an “off-the-shelf” solution which would upgrade and link existing NHS computer systems and buy readily available software.
However, on February 18, 2002 Tony Bliar, a self- confessed computer illiterate, chaired a meeting at Downing Street on the NHS and information technology. Alan Milburn, then health secretary, and his officials outlined a bold new plan to link up GPs, hospitals and patients on a much grander scale.
It envisaged a new NHS computer system designed from the top down to hold the records of 50m patients on one huge database. The prime minister was impressed. One of the main advantages, he was told, was the instant access that the scheme offered to patients’ records. A complete medical history could be pulled up on a screen at the touch of a button — from anywhere in the country.
Patients would be able to book appointments with GPs on their home computer and once in the surgery would choose their preferred hospital for an operation.
Hospital staff would have instant access to electronic records of any accident victim and x-rays would be electronically transferred from one end of the country to the other.
The scheme’s ambition and potential cost were staggering. Yet Bliar gave it the go-ahead without public consultation. The government initially allocated £2.3 billion for the project and boldly proclaimed that electronic records for every patient in the country would be online by the end of last year. The costs and the delays have been mounting ever since.
It is an example, say critics, of how the management consultants contracted to deliver such systems are only too happy to think big since it makes more lucrative work for themselves.
The man tasked with running the CfH project is Richard Granger, a Bristol University graduate and management consultant. A driven, abrasive character, he bought a Porsche as soon as he started earning “serious money”, lives in a large country house in Cumbria and was appointed on a salary of £250,000, making him one of the country’s highest-paid civil servants.
Few dispute the need to make improvements — but critics say that a centralised system will require vast computing power, raises questions of security and will be a nightmare if it goes wrong.
“In the system they are building, errors can get spread and copied across the network and nobody can do anything about it,” said Ross Anderson, professor of security engineering at Cambridge University and one of the 23 academics calling for an independent review of the project. “What they are proposing is a recipe for chaos and disaster.”
Helen Wilkinson-Makey, a 40-year-old manager from High Wycombe, Buckinghamshire, says that her experiences highlight the pitfalls. She discovered that an inputting error had led to her being wrongly logged as having received treatment at an alcohol dependency unit in 1998. The computerised record had been distributed to her strategic health authority, primary care trust and a local “shared care agency”.
http://www.timesonline.co.uk/article/0,,2087-2136718.html
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