Could the GP IT system fiasco have been averted?

Time_money_qualityThe General Practice Extraction Service was planned as an IT system which would make data from GP systems in England available across the health service.  It was intended to dramatically improve quality and planning for the NHS.

Unfortunately, the National Audit Office has reported that the service has so far cost £40m, rather than the intended £14m.  In addition the scheduled 2010 launch date failed to materialise with the first transmission taking place in April 2014.  Usage so far has been minimal and the report states that in its current form, it was unlikely that the system could deliver what it was set up for.

Way over budget.  Way behind schedule.  Not fit for purpose.

Surely this situation could have been averted?  The Health and Social Care Information Service who are responsible for the running of the system themselves state: “It is clear the procurement and design stage was not good enough.”

Such large scale failure with the apparent squandering of time and resources inevitable receives a high degree of focus.  How does the impact of this single, high-profile, failed project compare to the collected waste of time, resources and effort on the countless ineffective, badly set-up, small projects which are initiated on a daily basis in every corner of the NHS?  If they are added up are they likely to exceed the waste from the GPES?

Projects which deliver quality, on time and fit for purpose must be set up well from the start with a document or charter which is agreed by all concerned.  This document should be comprehensive in all aspects and include the following points as a minimum:

  • What is the headline aim?
  • What do we want to end up with?  What will it look like/ feel like/ be like?
  • Why is this being done?  What and who is it for?
  • What are the expected benefits and impacts for patients?
  • What are the expected benefits and impacts for the people in our team as individuals?
  • What are the expected benefits and impacts for our practice/ department/ ward/ organisation?
  • What other benefits and impacts are expected?
  • How will we know we have been successful?  How will we know that the results are fit for purpose?
  • Who has overall accountability for key Yes/No decisions?
  • Who is responsible for the day to day management of each aspect of the initiative?
  • Who are the key people whose direct contribution and input is essential for success?
  • Who must be kept unformed of progress and/or output and why?
  • What is in scope?  What will be addressed or incorporated as part of this work?
  • What is out of scope?  Explicitly list will not be addressed or incorporated that some people could expect to be part of this work, but will be excluded.
  • What assumptions are being made?
  • What other events or pieces of work are you relying upon delivering for the success of this initiative?
  • What are the risks to the success of this initiative?
  • What are the risks from progressing this initiative?
  • Which key decisions have still to be made?

Once created, this document must be appropriately agreed and then referred to on a regular basis to ensure the project is on track.  Inevitably, events and experience will mean that some aspects will have to change.  It is imperative here that the impacts of any changes are properly reviewed, with all relevant stakeholders consulted or informed as appropriate.  The toughest decision can be when to call a halt to something when you have already invested time, effort and resources.  Cost versus expected benefit must be closely monitored and balanced.

Well executed projects and initiatives are essential for progress to be achieved.  A properly set up plan, with regular monitoring and control is essential.

How well are you setting up and controlling your projects and initiatives?

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