3 ms·

NHS £13bn IT programme to be overhauled - good luck with that

dreemteem 16y ago
£13bn? Are these people nuts? That's more than 10% of the total NHS budget.
- user24 16y ago
  yeah, the benefits afforded by IT aren't worth 10%.
  - c1sc0 16y ago
    Actually, in many use cases & for many organisations 10-20% of budget on IT is a very reasonable ratio. As hackers we may not like it, but that's how the real world functions.
    - user24 16y ago
      I was being sarcastic. Evidently I wasn't clear enough.
- kierank 16y ago
  It's £13bn over a number of years.
nudge 16y ago
Can someone with knowledge or experience of extremely large projects such as this please explain what exactly are the costs? I cannot even begin to understand how you could ever arrive at £13bn, even if you had an army of systems engineers and buildings full of new equipment. What exactly is being paid for, and what is it billing at? (I'm not looking for an answer like "They're gouging them because they can" - although I'm sure there is some of that going on - I'm actually interested in what are the purported costs, i.e. how could it even be seen to be the correct order of magnitude of expenditure)
- mseebach 16y ago
  I don't have any particular knowledge, but this sentence from the article: Over a billion pounds was spent on the programme last year alone seems to indicate that it's an accumulated number. Also, I think it's a safe guess that a significant slice of that money is recurring license fees for many, many instances of very enterprisey software.
  - weego 16y ago
    You also have to take into account that the delivery of said systems will be undertaken by a consortium. There will be someone like accenture taking a huge slice for general management/PM and this is where the accountability comes in.
- junklight 16y ago
  So for a government project in the UK: You first of all need to go into the procurement process. This pretty much starts with the principle that you need to know whose fault it is when it all goes wrong which kind of sets the tone for everything. To be able to cope with the procurement you need quite a large and bureaucracy heavy setup to start with - the emphasis is on accountability not performance. Also the government moves very slowly - it is a very large organisation with few of the commercial pressures we in the private sector are used to - this leads to delays - which in turn lead to costs. The type of company that can cope with doing business with the government has a lot of overheads. Secondly the government side is quite hampered with rules and regulations to prevent what you might characterise as corruption. This means a lot of stuff has to be done formally and that often brings delays (and expense). (I don't want to portray this as a bad thing - corruption is bad - but it does prevent a lot of agility IMO) Thirdly the people on the government side often don't know what a successful IT project looks like and the people doing the procuring frequently won't be people who know anything about what they are buying (and the actual end users of the system will likely not be consulted until long after the procurement). To be fair to the procurers they really do try and get value for money - but way things are setup normally means that this can't be done in sensible ways. It's one of those "well you wouldn't start from here" type things - and whats worse they do keep starting from here and it keeps going wrong.
jgrahamc 16y ago
I wish these large IT projects would be done in an agile manner. Start in one hospital and one doctor's surgery and work up from there. Of course, that's politically not acceptable because what ministers need is a massive project to announce. I bet a small group of motivated people could get the work done faster, cheaper and with greater user satisfaction if they built out from a small project to the wider NHS. I happen to be in the weird position of knowing some of the people who are currently running the UK. I was at Oxford at the same time as Cameron etc. and actually know Michael Gove. I wrote time him just before the election about this very issue. Who knows if they'll listen.
- pmjordan 16y ago
  More to the point, unlike bottom-up the top-down approach tends to be a solution in search of a problem.
  - Gormo 16y ago
    And centralized financing and management of large segments of the economy tends to encourage top-down decision making. I think one of the biggest problems with modern society is that due to the scale of institutions, there are way too many layers of abstraction and aggregation between decision-makers and the decisions they make. This breaks the feedback loop, since decision-makers can only operate against generalities and not actual knowledge, and it encourages a great deal of risk aversion that prevents the exploration and variation necessary to create real solutions.
- junklight 16y ago
  So the first thing to understand is that value for money is only one of the check boxes in a procurement and the biggest one by far is accountability (which ironically just kills value for money even though I presume the accountability is to prevent money disappearing) Secondly you can not do agile things or indeed anything other than mainstream IT projects under the current procurement rules. I've tried (from both sides) So reform will have to come from the top down. The good news is that this government does seem interested in root and branch reform so keep pushing. However it is going to require dramatic new thinking in an organisation (the civil service) that is fundamentally built to resist such a thing as part of its very foundations.
singular 16y ago
The impression I've got is that the problems with the project come down to a combination of firstly, as @jgrahamc rightly points out, the fact the project has been unleashed all at once across the country rather than one surgery at a time as would be sensible, and secondly (ok, I am risking downvotes here bigtime), I think, poor programmer and management quality - I'm sure there are good programmers on the project, but overall it seems to me the quality must be pretty low. The damage one bad apple can do in software is immense and entirely out of proportion to their position, magnified if that person is higher up in the hierarchy. Additionally it seems obvious that the project has been somewhat mismanaged. I do understand the project is huge and really very complicated, and naturally a difficult problem probably more so than is immediately obvious, but it is that very fact that makes it easy for poor engineering decisions to have a big impact.
- jgrahamc 16y ago
  I agree with your on the programmer quality. I know people working on these type of projects: not the sharpest knives in the drawer.
  - arethuza 16y ago
    I bet they are charged out at over £1000 a day though.
    - junklight 16y ago
      ranges between £400 to over a grand in my experience depending on what kind of skill sets. Remember that scaling this kind of business is hard because you are selling peoples time - so for each salary you pay you can only sell it one time over. Compare and contrast with being a product company - I might spend a few weeks working on a product and then those few weeks of my salary can be sold over and over again. The scaling of so many employees also brings massive overheads. So yes - the day rates seem high but the margins can be pretty rubbish.
      - deleted 16y ago

£13bn? Are these people nuts? That's more than 10% of the total NHS budget.

user24 16y ago
yeah, the benefits afforded by IT aren't worth 10%.
- c1sc0 16y ago
  Actually, in many use cases & for many organisations 10-20% of budget on IT is a very reasonable ratio. As hackers we may not like it, but that's how the real world functions.
  - user24 16y ago
    I was being sarcastic. Evidently I wasn't clear enough.
kierank 16y ago
It's £13bn over a number of years.

nudge 16y ago

Can someone with knowledge or experience of extremely large projects such as this please explain what exactly are the costs? I cannot even begin to understand how you could ever arrive at £13bn, even if you had an army of systems engineers and buildings full of new equipment. What exactly is being paid for, and what is it billing at? (I'm not looking for an answer like "They're gouging them because they can" - although I'm sure there is some of that going on - I'm actually interested in what are the purported costs, i.e. how could it even be seen to be the correct order of magnitude of expenditure)

mseebach 16y ago
I don't have any particular knowledge, but this sentence from the article: Over a billion pounds was spent on the programme last year alone seems to indicate that it's an accumulated number. Also, I think it's a safe guess that a significant slice of that money is recurring license fees for many, many instances of very enterprisey software.
- weego 16y ago
  You also have to take into account that the delivery of said systems will be undertaken by a consortium. There will be someone like accenture taking a huge slice for general management/PM and this is where the accountability comes in.
junklight 16y ago
So for a government project in the UK: You first of all need to go into the procurement process. This pretty much starts with the principle that you need to know whose fault it is when it all goes wrong which kind of sets the tone for everything. To be able to cope with the procurement you need quite a large and bureaucracy heavy setup to start with - the emphasis is on accountability not performance. Also the government moves very slowly - it is a very large organisation with few of the commercial pressures we in the private sector are used to - this leads to delays - which in turn lead to costs. The type of company that can cope with doing business with the government has a lot of overheads. Secondly the government side is quite hampered with rules and regulations to prevent what you might characterise as corruption. This means a lot of stuff has to be done formally and that often brings delays (and expense). (I don't want to portray this as a bad thing - corruption is bad - but it does prevent a lot of agility IMO) Thirdly the people on the government side often don't know what a successful IT project looks like and the people doing the procuring frequently won't be people who know anything about what they are buying (and the actual end users of the system will likely not be consulted until long after the procurement). To be fair to the procurers they really do try and get value for money - but way things are setup normally means that this can't be done in sensible ways. It's one of those "well you wouldn't start from here" type things - and whats worse they do keep starting from here and it keeps going wrong.

jgrahamc 16y ago

I wish these large IT projects would be done in an agile manner. Start in one hospital and one doctor's surgery and work up from there. Of course, that's politically not acceptable because what ministers need is a massive project to announce. I bet a small group of motivated people could get the work done faster, cheaper and with greater user satisfaction if they built out from a small project to the wider NHS. I happen to be in the weird position of knowing some of the people who are currently running the UK. I was at Oxford at the same time as Cameron etc. and actually know Michael Gove. I wrote time him just before the election about this very issue. Who knows if they'll listen.

pmjordan 16y ago
More to the point, unlike bottom-up the top-down approach tends to be a solution in search of a problem.
- Gormo 16y ago
  And centralized financing and management of large segments of the economy tends to encourage top-down decision making. I think one of the biggest problems with modern society is that due to the scale of institutions, there are way too many layers of abstraction and aggregation between decision-makers and the decisions they make. This breaks the feedback loop, since decision-makers can only operate against generalities and not actual knowledge, and it encourages a great deal of risk aversion that prevents the exploration and variation necessary to create real solutions.
junklight 16y ago
So the first thing to understand is that value for money is only one of the check boxes in a procurement and the biggest one by far is accountability (which ironically just kills value for money even though I presume the accountability is to prevent money disappearing) Secondly you can not do agile things or indeed anything other than mainstream IT projects under the current procurement rules. I've tried (from both sides) So reform will have to come from the top down. The good news is that this government does seem interested in root and branch reform so keep pushing. However it is going to require dramatic new thinking in an organisation (the civil service) that is fundamentally built to resist such a thing as part of its very foundations.

singular 16y ago

The impression I've got is that the problems with the project come down to a combination of firstly, as @jgrahamc rightly points out, the fact the project has been unleashed all at once across the country rather than one surgery at a time as would be sensible, and secondly (ok, I am risking downvotes here bigtime), I think, poor programmer and management quality - I'm sure there are good programmers on the project, but overall it seems to me the quality must be pretty low. The damage one bad apple can do in software is immense and entirely out of proportion to their position, magnified if that person is higher up in the hierarchy. Additionally it seems obvious that the project has been somewhat mismanaged. I do understand the project is huge and really very complicated, and naturally a difficult problem probably more so than is immediately obvious, but it is that very fact that makes it easy for poor engineering decisions to have a big impact.

jgrahamc 16y ago
I agree with your on the programmer quality. I know people working on these type of projects: not the sharpest knives in the drawer.
- arethuza 16y ago
  I bet they are charged out at over £1000 a day though.
  - junklight 16y ago
    ranges between £400 to over a grand in my experience depending on what kind of skill sets. Remember that scaling this kind of business is hard because you are selling peoples time - so for each salary you pay you can only sell it one time over. Compare and contrast with being a product company - I might spend a few weeks working on a product and then those few weeks of my salary can be sold over and over again. The scaling of so many employees also brings massive overheads. So yes - the day rates seem high but the margins can be pretty rubbish.
    - deleted 16y ago