NHS IT project costs

[davislove]

I read today the cost of the NHS IT project to date stands at £2.7 billion with projected completion costs likely to reach £11.4 billion!! To me, mind boggling.

Precisely WHAT does this money get spent on?? Perhaps some IT bods on here could explain?

Profligacy in the extreme?

[Corsair7]

davislove said:

I read today the cost of the NHS IT project to date stands at £2.7 billion with projected completion costs likely to reach £11.4 billion!! To me, mind boggling.

Precisely WHAT does this money get spent on?? Perhaps some IT bods on here could explain?

Profligacy in the extreme?

Change requests, mostly.

Client usually has bugger all idea what they really want when they ask for bids for tender. They then accept the lowest quote, and slowly come to realise that the contracted agreement doesnt cover the things they either 'forgot' about or didnt realsie they needed in the first place. So costs and delivery times spiral.

Its like asking a builder to quote for building a house. Builder supplies basic cost and estimates completion date. However, 2 up 2 down 'house' isnt what the client really wanted, instead, over a period of years, they change their requirements to be something akin to a high tech modern buckingham Palace. Obviosuly, original quotes and estimates are wrong.... and costs far higher.


Thing is, its just a big game played by all the IT suppliers really. They know full well that what has been asked for and what has been quoted for isnt what the client will really need, but thats how you win contracts based on cost. All the IT companies do it.

in fact, the whole industry is very much like speaking to a dodgy builder in the first place. Eventually you have to pay another builder to put right the stuff the first builder bodged up so it costs you more. However, if you chose to use the cheapest builder with the lowest quote in the first place, in some respects you get what you deserve....

[Piersman2]

I'm an IT bod, and even I struggle to comprehend how these projects continue to be awarded and managed in a manner that appears gauranteed to failure. It's not just the NHS, there's been plenty of other similar 'systems' over the years.

Mainly, to me, it seems to be that the client , in this case the NHS, does not have the knowledge in house either the do the work or write a watertight contract that can be used to control any of the big consultancy players.

So the consultancies come in, run rings around the client, fail to deliver anything and ramp the costs up based on changes that were not included in the original contract.

I've worked on many multi-million pound implementations, all private sector, and MOST of the clients have had their own people taken on board to keep the big four in check.

But even bearing this all in mind, I fail to see how someone can spend BILLIONS without having anything tangible to show for it. That is SHAMEFUL and smacks of brown envelopes and old boy network'ism to me.

[Targarama]

Surely much of the cost is sunk into consultant and contractor fees and what is really needed is a project/program management team with the remit to make things happen?

[Corsair7]

Piersman2 said:

I'm an IT bod, and even I struggle to comprehend how these projects continue to be awarded and managed in a manner that appears gauranteed to failure. It's not just the NHS, there's been plenty of other similar 'systems' over the years.

Mainly, to me, it seems to be that the client , in this case the NHS, does not have the knowledge in house either the do the work or write a watertight contract that can be used to control any of the big consultancy players.

So the consultancies come in, run rings around the client, fail to deliver anything and ramp the costs up based on changes that were not included in the original contract.

I've worked on many multi-million pound implementations, all private sector, and MOST of the clients have had their own people taken on board to keep the big four in check.

But even bearing this all in mind, I fail to see how someone can spend BILLIONS without having anything tangible to show for it. That is SHAMEFUL and smacks of brown envelopes and old boy network'ism to me.

I was told the 'big four' only really start making money on projects when they start doing 'Change requests'. All the rest is run at a loss to gain contract win.


that said, IT in the NHS is much improved from what it was, so saying that there isnt anything tangable from all this money being spent isnt fair, I think. it just doesnt reach the invisaged goal.

[julian64]

I think its money well spent, although does seem an awful lot. Not sure if being an IT bod actually give you any insight into whats going on.

[joe_90]

Equally as an IT bod, I cannot fathom how they spend so much money.. I guess when you become a registered 'government IT contractor' its just opens up the piss taking of costs to a new level.

Facebook/Google Server farms, have more complex databases etc, and will handle far far more data and far more requests per second and did not cost anywhere near 2 billion..

FFs, its the biggest piss take game in the world becoming and IT supplier to the government.

julian64 said:

I think its money well spent, although does seem an awful lot. Not sure if being an IT bod actually give you any insight into whats going on.

In what i do, yes.. yes it does. Its a royal piss take, There is no way what they have been delivered so far is anywhere near worth 2 billion pounds.

[sjg]

The likes of Facebook and Google don't have to deal with hundreds of independently managed organizations, each with their own idea of how to do things, their own data sets already, and the power to veto any changes.

For a "national" health service, organizationally the NHS is anything but.

[plasticpig]

Corsair7 said:

I was told the 'big four' only really start making money on projects when they start doing 'Change requests'. All the rest is run at a loss to gain contract win.


that said, IT in the NHS is much improved from what it was, so saying that there isnt anything tangable from all this money being spent isnt fair, I think. it just doesnt reach the invisaged goal.

Very similar to the construction industry. Many sub contractors will quote with minimal profit on on the contract and expect to make their profit in variations.

I have wondered for a while if it would be possible to use an agile development approach to such large projects rather than a formal structured approach that is used at the moment. Not sure this would fit in with how the public sector operates.

[98elise]

Corsair7 said:

davislove said:

I read today the cost of the NHS IT project to date stands at £2.7 billion with projected completion costs likely to reach £11.4 billion!! To me, mind boggling.

Precisely WHAT does this money get spent on?? Perhaps some IT bods on here could explain?

Profligacy in the extreme?

Change requests, mostly.

Client usually has bugger all idea what they really want when they ask for bids for tender. They then accept the lowest quote, and slowly come to realise that the contracted agreement doesnt cover the things they either 'forgot' about or didnt realsie they needed in the first place. So costs and delivery times spiral.

Its like asking a builder to quote for building a house. Builder supplies basic cost and estimates completion date. However, 2 up 2 down 'house' isnt what the client really wanted, instead, over a period of years, they change their requirements to be something akin to a high tech modern buckingham Palace. Obviosuly, original quotes and estimates are wrong.... and costs far higher.


Thing is, its just a big game played by all the IT suppliers really. They know full well that what has been asked for and what has been quoted for isnt what the client will really need, but thats how you win contracts based on cost. All the IT companies do it.

in fact, the whole industry is very much like speaking to a dodgy builder in the first place. Eventually you have to pay another builder to put right the stuff the first builder bodged up so it costs you more. However, if you chose to use the cheapest builder with the lowest quote in the first place, in some respects you get what you deserve....

The basic fault still lies with the client though. If you don't know what you want in the first place, the you are asking for trouble.

I can't see how it can cost so much though, its not a complex system surely?

[julian64]

joe_90 said:

Equally as an IT bod, I cannot fathom how they spend so much money.. I guess when you become a registered 'government IT contractor' its just opens up the piss taking of costs to a new level.

Facebook/Google Server farms, have more complex databases etc, and will handle far far more data and far more requests per second and did not cost anywhere near 2 billion..

FFs, its the biggest piss take game in the world becoming and IT supplier to the government.

julian64 said:

I think its money well spent, although does seem an awful lot. Not sure if being an IT bod actually give you any insight into whats going on.

In what i do, yes.. yes it does. Its a royal piss take, There is no way what they have been delivered so far is anywhere near worth 2 billion pounds.

All due respect I don't think its IT on a scale your average IT bod has much of a handle on.

Doctors in the UK have gone from filling bits of paper in a little brown envelopes to being part of probably the worlds largest sub net in about five years.

In five years every health care professional is now carrying multilevel smart card security to access every single patients medical data in this entire country. To give you an idea of that size, most patients have an average of about 3-4 gigs of data on them each!!, and that seems to be growing by about a half a gig a year and accelerating.

All referrals are now made completely electronically, and most data is passed between the various services paperless. Investigations, discussions advice and MDTs are all being shared in a country wide fashion.

Data anaylisis on perfomance, clinical targets, referral expenditure, and multsourcing of providers is all happening electronically.

The NHS net is doing all of this and at the same time has the sort of security that sony and apple would be jealous of. To my knowledge there are no instances of someone breaching the NHS net deapite the obvious size and acess problems that there are. That is some pretty spectacular achievement in itself. Imagine some celebrity with their medical details on show!

The sheer scale of whats been achieved would dwarf any business project in this country many times over, and I'm not sure how many IT projects are out there bigger in the entire world.

I have no idea how much that costs but you can't just say it has the same problems as a local business IT setup your average IT bod does, multiplied by the size. Its like the titanic of distributed computing.

Whether it was a sensible goal at the start or not is certainly something to dwell on in terms of affordability for this country. But to say the money has been spunked for something your local IT bod could have done for small change is not really true.

[joe_90]

sjg said:

The likes of Facebook and Google don't have to deal with hundreds of independently managed organizations, each with their own idea of how to do things, their own data sets already, and the power to veto any changes.

For a "national" health service, organizationally the NHS is anything but.

I was talking more about the HW infrastructure, not the actual client demands.

but sill estimated 11 BILLION.. BILLION.

[plasticpig]

98elise said:

The basic fault still lies with the client though. If you don't know what you want in the first place, the you are asking for trouble.

I can't see how it can cost so much though, its not a complex system surely?

Pretty complex. What will not help is the NHS is implementing different patient care systems for different bits of the organization. They also run on top of different database platforms which doesn't help. I presume some middle ware already exists or is being developed to provide interoperability. Then there is the issue of delivery, implementation and training. Implementation may well include things like exporting data from existing systems and importing it into the new system.

[julian64]

plasticpig said:

Pretty complex. What will not help is the NHS is implementing different patient care systems for different bits of the organization. They also run on top of different database platforms which doesn't help. I presume some middle ware already exists or is being developed to provide interoperability. Then there is the issue of delivery, implementation and training. Implementation may well include things like exporting data from existing systems and importing it into the new system.

I can tell you how much money has been spent on training in my area. Bugger all.

Still not sure you lot are getting the scale.

Lets completely ignore hospitals, trusts, central administration, and just concentrate on GP's.

About 12000 practices in the country, mine has between thirty and forty computers, and three servers.

Multiply 12000 by lets say forty computers and ignore the servers, other other incidentals like printers scanners UPCs etc.

Thats close to half a million computers that the British tax payer has bought in the last five years just from that little section of the NHS IT.

It really is on a fairly vast scale.

[V8mate]

[redacted]

[Russ35]

One of my friends works for one of the IT companies on this project, and was on this project for a time. He was glad when he got moved to another project.

He said that nobody could agree on anything, you had 4 (or was it 5) IT companies doing the project, then each health authority did everything different, from their hardware to software. Then each hospital/GP etc did everything different. You couldn't even get people from the same department at a hospital to agree on how things should be done.

[130R]

Comparing the scale of the NHS IT project with the likes of Google and Facebook is ludicrous. Facebook have to serve up 770 billion page views per month, a couple of million photos every second. Something like 4 billion photos are uploaded every month. The amount of data that has to be managed for the NHS IT project is absolutely nothing in comparison. The costs are simply due to appalling project management and nothing to do with the complexity of the project.

[carmonk]

130R said:

Comparing the scale of the NHS IT project with the likes of Google and Facebook is ludicrous. Facebook have to serve up 770 billion page views per month, a couple of million photos every second. Something like 4 billion photos are uploaded every month. The amount of data that has to be managed for the NHS IT project is absolutely nothing in comparison. The costs are simply due to appalling project management and nothing to do with the complexity of the project.

Project complexity is not measured in bandwidth. Never has been, never will be. I don't know the spec (I doubt anybody does, that's the problem) but implementation of a system this size is a monstrous task. Having said that, these figures in the billions suggest something is going very wrong. In projects on which I've worked the greatest issues normally revolve around the lack of an effective project sponsor, lacklustre business buy-in and the clients' lack of willingness or ability to produce their business requirements. Secondary to that is poor project management and in third place are incompetent contractors (part of project management, I know, but not always fully controllable). In terms of the client, the larger the project the more you get different groups of people shouting for different things, changing their minds, arguing amongst themselves, demanding things they don't really want or couldn't actually work and generally having no idea what they're doing. And that's before the supplier work even begins.

[130R]

carmonk said:

Project complexity is not measured in bandwidth. Never has been, never will be.

Do you have any idea of the scaling challenge in serving up that amount of information? I very much doubt the NHS IT project involves anything as complex as writing distributed processing, memory caching and storage systems and APIs from scratch.

[130R]

[redacted]