Incident: NHS Patient Record System Failure: Costly, Ineffective IT Project

Published Date: 2013-09-17

Postmortem Analysis
Timeline 1. The software failure incident related to the abandoned NHS patient record system happened in 2002 [Article 21421].
System 1. National Programme for IT 2. New NHS computer system called Lorenzo 3. Care records systems across 220 trusts in the North, Midlands, and East by Computer Science Corporation 4. Lorenzo electronic patient record system by CSC
Responsible Organization 1. Successive ministers and civil servants were blamed by committee members for the NHS project, which has been described as the biggest IT failure ever seen [21421]. 2. Computer Science Corporation (CSC) was accused of "failure to deliver" and "poor performance" in not delivering the software as contracted [21421].
Impacted Organization 1. The National Health Service (NHS) [Article 21421] 2. Department of Health [Article 21421]
Software Causes 1. Changing specifications and technical challenges led to the failure of the NHS patient record system [21421]. 2. Disputes with suppliers, particularly Computer Science Corporation (CSC), contributed to the failure [21421]. 3. Poor performance and failure to deliver by CSC in providing the Lorenzo care records system were significant software causes of the failure [21421].
Non-software Causes 1. Poor management of large IT contracts by the government [21421] 2. Changing specifications, technical challenges, and disputes with suppliers [21421] 3. Legal challenges and disputes with IT suppliers [21421] 4. Failure to meet contractual obligations by the Department of Health [21421]
Impacts 1. The abandoned NHS patient record system cost the taxpayer nearly £10bn, with the final bill likely to be several hundreds of millions of pounds higher, leading to a significant financial impact on the government and taxpayers [Article 21421]. 2. The failure of the NHS computer system project resulted in delays, technical challenges, and disputes with suppliers, causing the project to be years behind schedule and over budget, indicating a substantial waste of resources and time [Article 21421]. 3. The failure of the NHS project led to a lack of fully functioning Lorenzo care records systems in any trust, highlighting a significant operational impact on the healthcare system and patient care [Article 21421]. 4. The termination of contracts with major IT suppliers like Fujitsu resulted in ongoing disputes over compensation, legal costs amounting to £31.5m over four years, and potential future financial liabilities, indicating a legal and financial impact on the government [Article 21421].
Preventions 1. Proper project management and oversight: Implementing effective project management practices, including regular monitoring, risk assessment, and stakeholder communication, could have helped prevent the software failure incident [21421]. 2. Clear and realistic requirements: Ensuring that the project's requirements are well-defined, realistic, and agreed upon by all stakeholders from the outset could have prevented the software failure incident [21421]. 3. Adequate vendor evaluation and selection: Conducting thorough evaluations of vendors, their capabilities, and track records before entering into contracts could have helped prevent the software failure incident [21421]. 4. Robust contract management: Establishing robust contract management processes, including clear terms, milestones, and penalties for non-compliance, could have mitigated the risks associated with the software failure incident [21421]. 5. Regular performance monitoring and accountability: Implementing mechanisms for regular performance monitoring, accountability, and escalation of issues could have helped identify and address problems early on, potentially preventing the software failure incident [21421].
Fixes 1. Implement better project management practices to ensure clear specifications, realistic timelines, and effective supplier management [21421]. 2. Conduct thorough assessments of IT contracts to ensure they are well-negotiated, monitored, and enforced to prevent cost overruns and delays [21421]. 3. Enhance accountability structures within government departments to ensure proper oversight and management of large IT projects [21421]. 4. Learn from past contracting failures and apply those lessons to future projects to avoid repeating similar mistakes [21421]. 5. Invest in training and development for government officials involved in IT projects to improve their understanding of technology and project management principles [21421].
References 1. Public accounts committee 2. National Audit Office 3. Department of Health 4. Computer Science Corporation (CSC) 5. Fujitsu 6. Richard Bacon, Conservative member of the committee 7. Health minister, Dan Poulter 8. CSC spokesman

Software Taxonomy of Faults

Category Option Rationale
Recurring one_organization, multiple_organization (a) The software failure incident has happened again at one_organization: The National Programme for IT in the NHS was described as one of the worst and most expensive contracting fiascos in the history of the public sector. The project was beset by changing specifications, technical challenges, and disputes with suppliers, leaving it years behind schedule and over budget. Despite attempts to salvage the project, it faced significant failures, with the Lorenzo system not being fully functional even after 10 years. The Department of Health's failure to meet contractual obligations weakened the government's negotiating position with the IT systems group Computer Science Corporation [21421]. (b) The software failure incident has happened again at multiple_organization: The article mentions previous IT-related government problems, including breakdowns in the child support agency, chaos within the passport agency, vulnerabilities in the tax credit system, late payments from the rural payments agency, and difficulties in tracking foreign national prisoners. These incidents indicate a pattern of IT failures across various government departments, suggesting a broader issue with managing large IT contracts and projects in the public sector [21421].
Phase (Design/Operation) design, operation (a) The software failure incident related to the design phase is evident in the case of the NHS patient record system. The original project, launched in 2002, faced challenges such as changing specifications, technical issues, and disputes with suppliers, leading to delays and going over budget. The project was beset by problems introduced during the system development phase, including changing requirements and contractual wrangles [21421]. (b) The software failure incident related to the operation phase is highlighted by the fact that even after 10 years, the IT systems group Computer Science Corporation (CSC) had not delivered the software as per the contract. Not a single trust had a fully functioning Lorenzo care records system, indicating a failure in the operation or implementation of the system [21421].
Boundary (Internal/External) within_system, outside_system (a) within_system: The software failure incident related to the NHS patient record system can be attributed to factors originating from within the system. The failure was a result of changing specifications, technical challenges, disputes with suppliers, delays, and problems within the project itself. The project was beset by issues such as the inability to meet contractual obligations, weakened negotiating positions, poor performance by IT suppliers like Computer Science Corporation (CSC), and failure to deliver the intended software like the Lorenzo care records system [21421]. (b) outside_system: The software failure incident was also influenced by factors originating from outside the system. The government's decision to renegotiate contracts with IT suppliers like Computer Science Corporation and Fujitsu, as well as the legal challenges faced in canceling contracts, contributed to the failure. Additionally, the government's estimates of future costs did not consider the termination of contracts with major IT suppliers, leading to ongoing disputes and legal costs [21421].
Nature (Human/Non-human) non-human_actions, human_actions (a) The software failure incident related to non-human actions: - The NHS patient record system failure was attributed to changing specifications, technical challenges, and disputes with suppliers, leading to the project being years behind schedule and over budget [21421]. - The failure was also linked to the government's decision to renegotiate the original contract with Computer Science Corporation for care records systems, which was weakened by the Department of Health's failure to meet contractual obligations [21421]. (b) The software failure incident related to human actions: - MPs blamed successive ministers and civil servants for the NHS project failure, describing it as the biggest IT failure ever seen [21421]. - The committee members criticized the government's ability to draw up and manage large IT contracts, highlighting a "systemic failure" in managing such projects [21421].
Dimension (Hardware/Software) hardware, software (a) The software failure incident related to hardware: - The failure of the NHS patient record system, including the new regional IT systems, was due to poorly managed IT systems and contractual wrangles [21421]. - The government's decision to renegotiate the original contract with Computer Science Corporation for care records systems across 220 trusts was weakened by the Department of Health's failure to meet contractual obligations, impacting the hardware delivery [21421]. (b) The software failure incident related to software: - The failure of the NHS patient record system, including the new regional IT systems, was attributed to changing specifications, technical challenges, and disputes with suppliers, leading to delays and being over budget [21421]. - Computer Science Corporation was accused of "failure to deliver" and "poor performance" in not providing a fully functioning Lorenzo care records system to any trust, highlighting a software failure aspect [21421].
Objective (Malicious/Non-malicious) non-malicious (a) The software failure incident related to the NHS patient record system can be categorized as non-malicious. The failure was primarily attributed to changing specifications, technical challenges, disputes with suppliers, delays, and poor management of large IT contracts by successive ministers and civil servants [21421]. The failure was not due to any malicious intent to harm the system but rather a result of systemic failures in government's ability to manage such projects effectively.
Intent (Poor/Accidental Decisions) poor_decisions, accidental_decisions (a) The software failure incident related to the NHS patient record system can be attributed to poor decisions made by successive ministers and civil servants. The project was beset by changing specifications, technical challenges, and disputes with suppliers, which left it years behind schedule and over budget. The original contracts signed before 2002 were highlighted as a significant factor contributing to the failure [21421]. (b) The software failure incident can also be linked to accidental decisions or unintended consequences. The government's negotiating position was weakened due to the Department of Health's failure to meet contractual obligations, leading to challenges in canceling contracts with IT suppliers. Additionally, the termination of contracts with major IT suppliers like Fujitsu resulted in ongoing disputes and legal costs for the government [21421].
Capability (Incompetence/Accidental) development_incompetence (a) The software failure incident related to development incompetence is evident in the case of the abandoned NHS patient record system. The project was beset by changing specifications, technical challenges, and disputes with suppliers, which left it years behind schedule and over budget. The project was described as one of the worst and most expensive contracting fiascos in the history of the public sector, highlighting a systemic failure in the government's ability to draw up and manage large IT contracts [21421]. (b) The software failure incident related to accidental factors is seen in the case of the NHS computer system called Lorenzo. Despite the government's efforts to salvage something from the failure by keeping the component parts in place with separate management and accountability structures, the project faced significant failures. The government's negotiating position was weakened due to the Department of Health's failure to meet contractual obligations, leading to delays and problems with the IT systems group Computer Science Corporation [21421].
Duration permanent, temporary (a) The software failure incident related to the NHS patient record system can be considered as a permanent failure. The project was launched in 2002 but faced changing specifications, technical challenges, disputes with suppliers, delays, and being over budget [21421]. Despite efforts to salvage something from the failure by dismantling the National Programme and keeping component parts in place with separate management structures, the project still faced significant failures and challenges [21421]. (b) The software failure incident can also be seen as a temporary failure in some aspects. For example, the government's decision to renegotiate the original contract with Computer Science Corporation for care records systems across 220 trusts in the North, Midlands, and East can be considered a temporary measure to address delays and problems [21421]. Additionally, the termination of contracts with Fujitsu in 2008 and the ongoing dispute over compensation can be seen as a temporary issue that has not been fully resolved [21421].
Behaviour crash, omission, timing, value, other (a) crash: The software failure incident related to the NHS patient record system can be categorized as a crash. The project was beset by changing specifications, technical challenges, and disputes with suppliers, which left it years behind schedule and over budget. Ultimately, the original plan was abandoned, and the total bill was expected to be £6.4bn, but the final cost escalated to nearly £10bn, with additional costs expected to be several hundreds of millions of pounds higher [Article 21421]. (b) omission: The software failure incident also involved omission as a failure mode. The report highlighted that the new NHS computer system called Lorenzo, which was supposed to store data for 220 trusts, was expected to cost £3.1bn. However, the final contract for that project alone is likely to cost the Department of Health £2.2bn and cover only 22 trusts, indicating a significant omission in terms of the system's intended scope and functionality [Article 21421]. (c) timing: The timing of the software failure incident can be seen in the delays and problems faced by the government in renegotiating contracts with IT systems groups like Computer Science Corporation for care records systems across 220 trusts. The renegotiation was prompted by delays and issues, indicating that the system was not performing its intended functions at the right time [Article 21421]. (d) value: The software failure incident also involved failures related to the system performing its intended functions incorrectly. For example, the report mentioned that after 10 years, Computer Science Corporation (CSC) had still not delivered the software, and not a single trust had a fully functioning Lorenzo care records system. This failure to deliver and poor performance by CSC indicates a failure in providing the intended value through the software system [Article 21421]. (e) byzantine: The software failure incident did not exhibit behaviors related to a byzantine failure mode, which involves inconsistent responses and interactions within a system. (f) other: The software failure incident can also be categorized under the "other" behavior as it involved systemic failure in the government's ability to draw up and manage large IT contracts, leading to one of the worst and most expensive contracting fiascos in the history of the public sector. The project faced challenges such as contractual wrangles, disputes with suppliers, changing specifications, and significant delays, showcasing a broader failure in project management and oversight [Article 21421].

IoT System Layer

Layer Option Rationale
Perception None None
Communication None None
Application None None

Other Details

Category Option Rationale
Consequence no_consequence (a) death: The articles do not mention any direct consequences of death resulting from the software failure incident. [21421]
Domain health The failed system mentioned in the article is related to the healthcare industry [21421]. The National Programme for IT in the NHS was a massive project aimed at revolutionizing the IT systems within the healthcare sector. The project involved the implementation of new regional IT systems for the NHS, including the introduction of a new NHS computer system called Lorenzo, which was intended to store data for multiple trusts in different regions [21421]. The failure of the system within the healthcare industry led to significant financial losses and operational challenges within the NHS. The project faced issues such as changing specifications, technical challenges, disputes with suppliers, delays, and being over budget, ultimately resulting in the abandonment of the original plan [21421]. The healthcare industry is crucial for providing essential services to the public, and the failure of such a large-scale IT project within this sector highlights the importance of effective management and implementation of technology in healthcare settings.

Sources

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