FORMATNE ASSESSMENT $1$

$[100$ MARK$$]$

Read the Case Study below and answer ALL of the questions that follow.

Reinventing the wheel $-$ a private internet for medical records wastes $10$ billon $-$ stakeholder case study

by Geoff Reiss, Honcrary Fellow of Association for Project Management $($APM$)|$ reviewed: $2404/2024$

This case study reviews a failed IT project to digitise medical records at a loss of $10$ billion. Lack of Stakeholder Management played a large part in making this such an expensive fasco.

To my mind The National Programme for IT$,$ NPIT, is the worst example of a total lack of stakeholder management and a total waste of public funds. Certainly, nothing competes with its vast waste of money. In a nutshell NPIT was conceived as a central database of every UK resident's medical records in a secure system available to all suitably aufhorised medical professionals. Like many projects this started life as an idea that seems great at the time. This was an idea from the then new Blair Labour government. They did of course consult assorted manaoement consultants all of whom rubbed their hands in glee at the vast fees on offer for a vast programme such as this. A key beneft of this system was based on access to your health care records.

If you were away on holiday, perhaps sking in Sootland or surfing in Cornwall, and became ill or injured, the local medical people would have access to your medical reconds. When the programme started, I happened to chair the Programme Manapement Special Interest Group within the Association for Project Management. As programme managers we were especially interested in benefits so$,$ yes, we could see the lifesaving potential of this new idea. To undenstand the benefit better we asked the NHS how big a problem lack of medical records at the point of delivery currently was. We expected to hear that a certain number of people was treated inappropriably, or their treatment was delayed due to this lack of data access. After some while we did get a response. $"$We have no idea," came the answer, $"$we do not stone this data." So$,$ we were off to a bad start committing something in the order of fifeen billion pounds to resolve a problem of unlenown size. It might have been a problem for one person each year. It is important and rather shocking to know that the $\text{'}$b$\text{'}$ word is accurate.

The sum involved was $\mathrm{.}15$bn $-$ the then cest of four or five sparkling new hospitals. The then Parliamentary UnderSecretary of State for Health, Lord Hunt, announoed the proposed major IT reform to the NHS on $12$ June $2002,$ along with the publication of the Decartment of Healfh's 'Delivering $21$st Century IT suppont for the NHS $-$ National Strateoic Programme' $($the NSP Plan$).$ The NSP Plan intisted what would subsequently become known as NPIT, with its vision of "connectlingl delivery of the NHS Plan with the capabilities of modem information technologies" $($DH$,2002,0\mathrm{.}1),$ through delivering the four key elements discussed at the $18$ Februsy $2002$ seminar: an integrated electronic healh recerds system; electronic prescriptions; an electronic acpointment booking systemc an underpinning IT infrastructure with sufficient capacity to support the national asplications and local systems Gung$-$ho as only a public sector programme can be$,$ work beoan on element four $-$ the pivale internet infrastructure. It was decided that the internet was not sufficiently secure for our medical records, so BT was awarded a half a billion quid to create a private, NHS$-$only, intemet to be known as the Spine. A large chunk of this cash went on fore optic cables laid beside railways lines from oly center to oly canter and technological infrastructure to support i$.$

Very considerable expert stakeholder comment arose at this ime saying fat this privale NHS internat would be at best no better, and probably worse than the already existing internet. Government spokeswoman Caroline Flint talled to dispel concems regarding access to patients' data by persons not involved in their care when she commented in March $2007$ that $"$In oaneral only those staff who are working as part of a team that is providing a patient with care, that is$,$ those having a legitimate relationahip with the patient, will be able to see a patient's health record.$\text{'}$ In June $2006,$ the Local Medical Committees' Conference passed a proposal to advise GPs to consider withdrawing from the Spine on privacy and security grounds $($E$-$Health Insider, $2005).$ Several data risks with NPAT around patient awareness, confidentiality, accouracy and security were also acknowledged by the Information Commissioner, Richard Thomas $($Thomas$,2007).$ A ittle while later serious stakeholder issues began to emerge chief of which was that common stakpholder cry; "Why were we not consultid earler?The next group of Stakpholders to raise concerns were the many UK GPs themselves. GPs asked two key questions: If the electronic appointments system, to be known as "choose and book" was to allow a patient to choose which consultant