I've worked at the DOH and involved in the regional splits carried out in the late 90's that saw area's split into Trusts. The level of control Trusts and othe

I've worked at the DOH and involved in the regional splits carried out in the late 90's that saw area's split into Trusts. The level of control Trusts and other departments have is not zero and the divergence in systems and data is huge. Many legacy systems, old systems that just work and yet to tie that all together is such a massive undertaking. You could anneal all the data, but the process and systems that get that data has so much divergence that any standard is at the mercy of work-arounds and there are many. Then the whole aspect that IT support/system design was all TUPEd (employee's handed over to private companies on the grounds their pension's etc stayed the same) and you have a core system that is so outsourced that to manage that in a way that looked past the 4-5 years contract window and you can see why things just limp along. To document and look at what the systems should be and how they are is going to be a struggle with all those different hands and time factor as you get with any system. Also many systems connect to bespoke hardware that will be a limiting factor and how many lovely working fine as tools used that are connected to stand alone windows 3.11 systems and data exported via floppy in 90's excels flavours again is not zero. To control the NHS data you need firm in-house IT staff at at the DOH and due to the splitting off and outsourcing in the 90's, the problems that was before are now far larger. This is not only a problem with the NHS but so many government bodies that saw IT development/support outsourced and is a product of that as if your paid for a 4-5 year contract, your not going to plan 20 years ahead, indeed planning for 4-5 years and locking yourself in so you get another 4-5 years is what they will want to be doing, and they do as that is what they are contracted and paid for. No one person can fix this, as the level of change and work involved as greater than doing a whole setup greenfield style and this is not that, legacy costs and support are huge. How would I tackle it - for a start, in housing and restructuring the whole IT support/development. Then the data flows and identifying the most addressable/impacting area's and working slowly from there. But a project upon this scale is not your 5 year plan affair, it would be close to a lifetimes work, and to resolve it all would be a huge chunk out of 10-20 years effort. I'd expect documenting and rationalising the existing systems fully to take best part of 5 years, just to see the path forward. Sure there will be some stand out area's that could be paralleled, but the crux is that the data and systems used by the DOH/NHS are more diverse than anything I've ever experienced, or will and having worked on many migration projects of various scale and fields of work both in and out of government. This is if Sir Time took it on, a lifetime job and one in which most people would not want to commit that long too. I wish him luck but no one person could ever fix this, it would take many years just to define the problems and until that is done, you can not fix poorly defined problems and that may well become the problem itself.