Friday, 9 September 2024
On 5 September the head of the UK’s National Audit Office (NAO), Gareth Davies, published an Insights article entitled ‘Here’s how to make public money work harder’. The article draws attention to the scale of the challenge the new government will face in reconciling its ambitions with a tough fiscal backdrop and suggests how NAO’s previous work could help.
The brief assessments that follow below (all drawn from public sources) reflect the budget and operational implications of the difficulties already inherent in certain UK National ICT Systems.
- Sub-postmasters’ problems caused by the Horizon retail and accounting system are widely reported. What is not so widely reported is that the existing contract with Fujitsu to run Horizon is due to conclude in March 2025. The aim was to have a replacement system, called New Business IT (NBIT), in place by that time. However, delays mean that Horizon is not likely to be fully shut down until 2030. (See Fujitsu set for further £180m deal as Post Office Horizon replacement delayed, Karl Flinders, Computer Weekly, 31 May 2024.)
– More problematic are reports that the new platform being developed in-house by the Post Office (NBIT plus the wider project known as the Strategic Platform Modernisation Programme (SPMP)) was given a red warning rating after an Infrastructure and Projects Authority (IPA) review completed in April concluded that “successful delivery of the programmes to deliver the Horizon replacement to time, cost and quality appears to be unachievable”. (See Post Office Horizon replacement project labelled ‘unachievable’ as taxpayer bill reaches £1bn, Bryan Glick, Computer Weekly, May 30, 2024.) - Concerning trade, the Single Trade Window (STW) (defined by the World Customs Organisation as: a “facility that allows parties involved in trade and transport to lodge standardised information and documents with a single entry point to fulfil all import, export, and transit-related regulatory requirements”) is a crucial part of delivering the new border target operating model (BTOM). In Part Three of its recent report ‘The UK border: Implementing an effective trade border’ the National Audit Office (NAO) assesses projects that are most relevant to delivering the new BTOM. Paragraphs 3.7 through 3.13 and Figure 10 (pp. 42-48) concern the STW.
– In its conclusions NAO states: “In our view, the programme’s objectives and timescales are overly optimistic and continue to under‑estimate the complexity of what is required” … “The March 2024 business case estimates that a 12-month delay delivering the STW could reduce the benefits realised by £866 million over 10 years (from £2.77 billion) …”. In the IPA Annual report on Major Projects 2022-23 the STW project received an Amber rating (p.65). According to the key at Annex A, Amber means ‘Successful delivery appears feasible but significant issues already exist, requiring management attention. These appear resolvable at this stage and, if addressed promptly, should not present a cost/schedule overrun’.
- Five ICT systems with a red Delivery Confidence Assessment (DCA) are identified in Figure 7 of the IPA 2022-23 Report (p.17).
- It will be recalled that The National Programme for IT in the NHS (NPfIT) was a large public sector IT programme intended to bring the NHS’ use of information technology into the twenty first century. Launched in 2002 under Prime Minister Blair, it was cancelled by the Conservative-Liberal Democrat Government in 2011.
– NAO’s report ‘Digital transformation in the NHS’ of May 2020 (paragraph 20) came to the conclusion about value for money that: “The Department and its arm’s-length bodies have ambitious plans for digital transformation, intended to enable many of the wider service changes set out in the NHS Long-Term Plan. However, the track record for digital transformation in the NHS has been poor, with the previous major national programme being closed early without achieving its objectives. Currently, £4.7 billion of national funding is delivering some national digital services and improving the digital maturity of some NHS trusts. However, the target of a ‘paperless’ NHS by 2018 has not been achieved”. [NHS Improvement] “now expects the NHS to reach a core level of digitisation by 2024, with important information routinely available to clinicians when and where they need it”.
– The British Medical Association’s December 2022 report ‘Getting IT Right: A Prescription for Safe, Modern Healthcare’ found that more than 13.5 million hours of doctors’ time was being lost each year in England due to delays resulting from ‘inadequate or malfunctioning IT systems and equipment’ – the equivalent of almost 8,000 full time doctors, or nearly £1 billion.[1]
- Four NHS programmes with an Amber DCA are mentioned in the IPA 2022-23 Report. (Annex D: List of projects with DCA history pp.56-27.)
- Added to the complexities of managing large digital projects are the increased vulnerabilities of large IT systems to ransomware cyber-attacks. After the ransomware cyber-attack against Synnovis on Monday, 3 June, 2024, NHS England – London reported on the clinical impact in its 4 July update: “Some services, such as outpatient appointments, are now operating to similar levels to before the incident but there continues to be disruption to other services”. … “so far 4,913 acute outpatient appointments and 1,391 elective procedures and have been postponed at King’s College Hospital NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust since 3 June”.
Frameworks for assessing digital change programmes: Concerning the challenges and risks of implementing digital change programmes the NAO has developed an NAO digital change framework. It examines programmes against six criteria:
-> understanding aims, ambition and risk;
-> engaging commercial partners;
-> approach to legacy systems and data;
-> using the right mix of capability;
-> choice of delivery method; and
-> effective funding mechanisms.
Internal and external digital experts are used, and fieldwork includes interviews, a technology demo and review of programme documents, including the delivery plans, contract with the delivery partner, and technical documentation.
(See NAO Report ‘The UK border: Implementing an effective trade border’, Appendix One at paragraph 23 concerning the assessment framework.)
Conclusions: a number of important ICT problems already exist that are capable of de-railing key government priorities concerning growth, trade and the NHS recovery. Early identification and the application of rigorous analysis techniques (such as the NAO’s digital change programme analysis) could help to avoid these problems becoming critical. In his article Gareth Davies says: ”I look forward to discussing our work with MPs – both newly elected and those returning to the House of Commons – in the coming weeks and months”.
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[1] A competitive tender worth up to £1.5 billion for suppliers to provide a variety of IT hardware to the NHS was published on 27 August 2024 by NHS Shared Business Services Limited (NHS SBS) together with North of England NHS Commercial Procurement Collaborative (“NOE CPC”). The tender concerns a framework contract “Tech Devices – Link 4“. The framework agreement is expected to last four years. Potential bidders need to request participation by October 2 at 12:00pm.
Disclaimer: The brief summaries in this article may not deal with every important topic or cover all important aspects of the subject matter. It is not intended, and should not be used, as a substitute for seeking appropriate advice, including legal advice, on specific questions.
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