Key lesson from the NPfIT

A US doctor Scot Silverstein, who has an expertise in clinical IT design, says of the NAO report on the NPfIT that the initials should stand for: "National Programme of Failed IT”He says on the blog Health Care Renewal:"Perhaps the NPfIT...


A US doctor Scot Silverstein, who has an expertise in clinical IT design, says of the NAO report on the NPfIT that the initials should stand for: "National Programme of Failed IT”

He says on the blog Health Care Renewal:

"Perhaps the NPfIT (National Programme for IT in the NHS) should be renamed the "National Programme of Failed IT in the NHS. No new acronym will be needed.

“For this pleasure, the UK has spent upwards of £13 billion. Of course, we as the progeny of the UK are going down the same path, surely soon to have a ‘National Program for Failed IT in the US.’ Ours will be a bit more expensive, unfortunately…

"I think it fair to say the UK has been massively fleeced and abused by its suppliers, consultants and health IT pundits.

"The people of the UK have paid for this boondoggle. They should think of it as a form of taxation without representation, an abuse of their rights.”



He may have a point. The capacity of UK taxpayers to put up with the unnecessary spending of billions of pounds is remarkable. Many in 2002 warned that the NPfIT would not work, including Robin Guenier.  He asked in an article on the NPfIT in 2002: "Why are big IT projects seen as a badge of virility?"

Nobody in government wanted to listen to critics. Ministers and civil servants - and government press officers - wanted evangelists. These comments to E-Health Insider, in response to this week's NAO report on the NPfIT, ring true:

"I was an NPfIT trainer employed directly by the NHS ...After voicing my opinions at various 'lessons learned' meetings with the Strategic Health Authority and trust level meetings it became clear that the blinkers were on and we were going to push this dead horse forward regardless in order to save face for all involved."

Another commentator said: 

"As an NHS Informatician working ... from the inception of the NPfIT programme, the alarm bells started ringing very early on when ...SHA and DH staffers closed their ears, shut off their minds and suffocated any opinion that ran contrary to the mantra that NPfIT was the holy grail..."

One of the lessons that emerges from disastrous business decisions, as recorded on the excellent BBC2 series "Business Nightmares" with Evan Davis, is that expensive new ideas should be tested, and repeatedly tested, by the harshest critics of those ideas. 

During the life of the NPfIT the opposite happened: critics of the programme were denigrated, sometimes by name, by ministers in the House of the Commons and by NPfIT speakers on the conference stage.  

At one point the Department of Health repeatedly blamed the problems of the NPfIT on journalists.

Have the lessons been learned? Does the government and civil service now recognise that informed and well-meant criticism is the most important thing on any big project or programme?   

It's unfortunate that the National Audit Office has had so many difficulties obtaining basic information about spending by NHS Connecting for Health. It's one thing for the Department to deny information to journalists and FOI applicants. It's another to defeat the efforts of government auditors. Indeed the NAO has accused the Department of a lack of transparency, which suggests the lessons have not been learned, at the DH at least.



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