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TOC o 1-3 h z u HYPERLINK l _Toc382892269 Executive summary PAGEREF _Toc382892269 h 3 HYPERLINK l _Toc382892270 1. Introduction PAGEREF _Toc382892270 h 4 HYPERLINK l _Toc382892271 2. Literature Review PAGEREF _Toc382892271 h 5 HYPERLINK l _Toc382892272 3. Research methodology PAGEREF _Toc382892272 h 6 HYPERLINK l _Toc382892273 4. Findings/Results and Discussions PAGEREF _Toc382892273 h 7 HYPERLINK l _Toc382892274 5. Conclusion PAGEREF _Toc382892274 h 10 HYPERLINK l _Toc382892275 Appendix 1 PAGEREF _Toc382892275 h 11 HYPERLINK l _Toc382892276 References PAGEREF _Toc382892276 h 12  Executive summary This report describes experiences of the UKs National Health Service (NHS) - one of the most extensive healthcare systems in the
world launching its ten-year National Program for IT (NPfIT). The purpose of this program is to provide an accessible and transparent medical records system for patients in England. This enormous scale project has cost almost 13 billion up till now, resulting in worse performance of the NHS Trusts and thousands of complaints from patients. The findings from this study suggests why project fails, the lessons from its failure and recommendations for further plans. Group work Theory of project management failure critical factors  Introduction The United Kingdoms National Health Service (NHS) is one of the worlds largest funded health services, which was launched in 1948 (The NHS in England, 2013) It is also one of the most comprehensive and efficient systems. With the root idea is the concept of equal healthcare regardless of wealth or social status, the NHS is in charge of providing free healthcare service for all residents in the UK, except for some charges in prescription, optical and dental care. The NHS creates employment for more than 1.7 million people, of which the NHS in England is the major part with more than 1.35 million employees involved. The frequency of patient is 1 million cases every 36 hours. To cover such health demands, NHS is funded by the taxation and is granted by the Department of Health by Parliament (The NHS in England, 2013). In 2002, the Treasurys 2000 Wanless on the future of the health service reported that the NHS IT record did not perform well enough due to the insufficient IT budget and inadequate settings of central IT standard, resulting in a range of incompatible systems across the NHS (Parliament Office of Science and Technology, 2004 HYPERLINK file///C/Users/Anh/Downloads/POST-PN-214.pdffile ). As a consequence, the National Program for IT (NPfIT) was set up by the Government in England to cover the four main project Electronic patient records, Electronic appointment booking, Electronic transmission of prescriptions, and Communication network. For being considered as the biggest computer program in the world (Brennan, 2005 HYPERLINK http//library.brunel.ac.uk/uhtbin/cgisirsi/x/UXBRIDGE/0/57/5user_idWEBSERVERsearchdata13619697Bckey7D ) , NPfIT is a challenging project as it involve an enormous number of people, including people working for it, from the staffs to suppliers, and people using its services. The scale of this project is giant as NHS is a complicated system, nevertheless, the NPfIT is applied to NHS in England only, as Wales, Scotland and North Ireland embark their own programs (Brennan, 2005). However, the NPfIT did not meet the expectation nor proved to worth the giant investment of the government, and was said to be the IT nightmare (the Lancet, 2011). Consider the ineptness that form this project, failure is foreseen, as it lacks leadership, oversight and accountability. This project not only wasted 11.4 billion sterling pounds, but also created chaos and affected the performance of the NHS Trust (Bloxham, 2008). Concerning the massive scale of NPfIT, the failure of this national program comes from many reasons, hence studying about those reasons may help prevent further mistakes and provide deeper insights for experience and lessons to plan future projects.  Literature Review To study about the failure of this project, project management is the initial matter. A project is conducted aiming to reach or fulfil a mission out of the ordinary functions of an entity (Phillips, 2010). A project plays an essential role in innovating and contributing to the development of such entity, which could be a company, an organization, an individual, a team or the society. To be defined as a project, it must contain three characteristics, namely unique, temporary and focused (Maylor, 2010). By which it means a project should have a degree of novelty, it must have a beginning and an end, after that the team moves on and financial supports finishes, besides, it should have a specific missions with clear targets of delivering a products, a service or results, in another saying, a project is said to be undertaken to bring benefits (Maylor, 2010 HYPERLINK http//lib.myilibrary.com/Open.aspxid317332src0 ). Information system is the system which stores, processes and distribute information relevant to an entity or public organization which is accessible by anyone who need it. The information systems works on social or communication technology (Avison and Torkzadeh, 2009). Hardly is there anything not involve to information system nowadays. It helps to change life and the way people carry on their daily activities. As NPfIT is a program for information technology, project management for information system is another terminology to concern. Project management for information system is constituted of nine main types software development, package implementation, system enhancement, consultancy and business analysis assignments, system migration, infrastructure implementation, outsourcing (and insourcing), disaster recovery, and smaller IS projects (Cadle and Yeates, 2008 HYPERLINK http//lib.myilibrary.com/Open.aspxid182978src0 ). The role of information and communication technology is essential. It helps to run a system smoothly and provides better control over different functions. Moreover, the information clarity in an organization or a company is maintained and secured, hence encouraging the operation and management. Not only internal benefits are generated, but also the end-users of such organization (or company) are interested with a better insight and easier access to the source of information they wish to use. With its massive scale, the NHS requires a comprehensive information system to manage all of the patients records and to run this tremendous machine. Because the NPfIT is applied in England only, this report studied on structure of the NHS in England (the NHS from here on). The NHS in England is divided into four regional teams North of England, Midlands and East of England, London, and South of England (NHS England, 2014 HYPERLINK http//www.england.nhs.uk/about/regional-area-teams/ ). With the idea of initiating high quality care with safe, effective and positive experience for everyone and for future generation, the NHS set a vision with Everyone has greater control of their health and their wellbeing, supported to live longer, healthier lives by high quality health and care services that are compassionate, inclusive and constantly-improving. (NHS England, 2014 HYPERLINK http//www.england.nhs.uk/about/our-vision-and-purpose/ ). Nonetheless, this project was a failure, which is said by Verner et al. (no date), can be attributed by many reasons. Obviously, poor project management is the biggest reason, but the cause can be divided into smaller factors, some of them are improper structure, along with impractical project goals, the original business needs are not met, or bad scheduling and financing, the approach to software development, and so on. Software is too popular that its failure causes severe damages to the organization. For example, the table of Software hall of fame reported that in 2004-2005, the software errors of UK Inland Revenue contributed to 3.45 billion tax-credit overpayment, or the case of Avis Europe PLC (UK) with the enterprise resource planning system cost 54.5 million before being eliminated in 2004, and the 547 million supply chain management system breakdown of J Sainsbury PCL (UK) in 2004 (Charette, 2005) Research methodology The most appropriate methodology of this report is using secondary data from books, e-books, newspaper, websites and journals. These sources of data is accessible and feasible, which give this study a more comprehensive overview.  Findings/Results and Discussions The National Program for IT (NPfIT) is delivered by NHS Connecting for Health (CfH) the Department of Health agency supporting the NHS for better quality and improved healthcare services by more accessible information (University Hospitals Coventry and Warwickshire, no date HYPERLINK http//www.uhcw.nhs.uk/about-us/the-national-project-for-information-technology-npfit ). This program is considered as the biggest civilian IT program in the world, in terms of its scale and the involvement information to be managed, as well as the challenge facing (Hayes and MP, 2009). The core of this program is the NHS Care Records service, which aims to be the substitute for the existing local National computer system and paper memos, operating to make clinical records of patients more feasible throughout the system across the country (personal information, medical treatments and allergies, adverse drug reactions (House of Commons, 2007). Other services included by NPfIT are NHS mail, Picture Archiving Communication system, and Choose and Book system which allows patients to book their own appointment with general practices. The General Director of the NPfIT is Richard Granger, he is known for leading the London congestion charging project in 2000 and has been supervising IT programs for most of his professional life. Mr Granger took the position, saying it was the challenge of the work and its society influence once the project is accomplished that attract him (Whitfield, 2003). The NPfIT breaks England into five clusters called Southern, London, Eastern, North West and West Midlands, and the North East (Bainbridge, 2004). Four chosen contractors were Accenture, which was assigned the North East and Eastern clusters, BT Alliance, Fujitsu Alliance and Computer Sciences Corporate (CSC) which were assigned London, Southern cluster, North West and West Midlands cluster in respectively (Lawton, 2012). The first mark of NPfIT was January 2003 when it started the formal procurement, after that, a list of contracts were signed with the contractors. The 65 million-worth E-booking contract was signed with Atos Origin for a period of 5 years, the Broadband network was delegated to BT in 7 years, costing 530 million, together with the 620 million National Care Records Service to be completed in 10 years. The Local Service Provider contracts for five clusters were given 10 year of deadline, which gave Fujitsu Alliance 896 million, Accenture 934 million, CSC 973 million, 996 million to BT and 1099 million to CSC Alliance (Parliament Office of Science and Technology, 2004). One of the first problems arose when Accenture withdrawn from the project in 2006, which was taking responsible for 80 of the system installed at that time (Bowers, 2006) HYPERLINK http//www.theguardian.com/technology/2006/sep/28/news.business . However, Accenture only had to pay 63 million compensation for its 2 billion contract, blaming Isoft for the deday which led to its pulling out of NPfIT (Kablenet, 2006). Some months earlier, the US software supplier, IDX, also gave up its participant to the project (Wright, 201). One year later, NPfIT missed its first deadline to present a new system of medical records, despite of the unchanged bills from the suppliers (Curtis, 2011). In 2008, the second contractor, Fujitsu also made its decision to abandon this program, remaining BT, CSC and Isoft (Oates, 2008) and within the same year, the Head of NPfIT left his position (Ritter, 2008), putting pressure on the government and the team. By 2009, this project had spent more than 6 billion with the Common Public Account Committee doubted on its efficiency and value for money (Ritter, 2010) HYPERLINK http//www.computerweekly.com/blogs/public-sector/2010/01/npfit-spend-of-more-than-6bn-b.html . Finally by 2011, the government announce the dismantling of NPfIT (Department of Health, 2011). Obviously, the 12.7 billion project is an enormous loss and concerning the scope of NHS, this failure has caused various impacts on the public and the government as well as the NHS itself, the system fails to prove its value for money (National Audit Office, 2011). One of the most well-known affected cases was the Barnet and Chase Farm Trust, in 2008, due to the system of NPfIT, 63 patients operations were postponed and cancer patients were late to get their medical check which were supposed to be arranged within a fortnight (Bloxham, 2008). Moreover, the introduction of the Cenner Millenium Care Records service led to delay in waiting time between July 2007 and January 2008, resulting in 8.500 extra complaints from patients (Computer Weekly, 2008). This Trust was the first Trust in the Capital starting using system under NPfIT (Ritter, 2007), furthermore, its experience of IT using and the full support from BT as well as financial support from Department of Health (Collins, 2014) makes its breaches more revealing than others. Another serious case happened to Royal United in Bath, with the death of a three-year-old boy due to suspension in heart treatment arrangement (Tute, 2014). The new booking system Cenner Millenium did not give this boy a proper heart scan after five month delayed, which then believed to be the reason of his stroke and his passing away in Bristol Royal Hospital for Children (Morris, 2014). Besides, hundreds of patients records vanished for the pioneering of the NPfIT system (Computer Weekly, 2009) making patients wait longer than their 18-week target, and Trusts staffs facing confusing situations as they lost tracks of the clinical database, unreliable data said by Department of Health. There are a great range of reasons to cause this national project fail, Alistair Maughan (2010) pointed out six of them. According to him, one reason is the motives, as the decision of NPfITs launch came from the government, it came with a political purpose rather than people-focus, hence it lacked of practice and feasibility. The final users of NPfIT is the NHS staffs and outpatients but their opinions and needs were not absorbed as the project planner did not understand their users (Zhen, 2005) HYPERLINK http//search.proquest.com.v-ezproxy.brunel.ac.uk2048/docview/216071181 .
The inadequacy of trust from doctors direct users of this system was shown in a survey with 91 suspicious the idea of a better change by NPfIT, as the medical profession was not involve from the beginning of this project (CIO staff, 2007). Additionally, the complication of NHS system was underestimated by project architects and suppliers (Hellford, 2011) HYPERLINK http//www.cio.co.uk/insight/strategy/why-nhs-national-programme-for-it-didnt-work/ . The extent of NHS and its clinical database is so wide that it requires a great range of differentiation, which NPfIT failed to meet. Another cause to mention is poor planning and lack of flexibility, either details or specification were ignored, the contractors were assigned tasks based on their general ability rather than digging deep into details, which later shown on their insufficient ability to complete the missions (Smith, 2011). Besides, such a massive project was not prepared carefully and thoroughly enough in terms of time. Indeed, the haste and hurried process led to the decline of integration, with so many suppliers that it is difficult to achieve a homogeneous system (Pathway Software, 2011) HYPERLINK
http//www.pathwaysoftware.com/blog/why-did-the-npfit-fail/ . Last but not least, a failed project, with not excuses, proves a weak management of the Head (Kappelman el at, 2006). Mr Grangers credentials was suspected by his own mother from the beginning (Revill, 2006), and his departure from the project (Knights, 2007) caused the existing instability become worse. Lack of commitment from the Head to the suppliers and neither gaining trust of the public, the failure of the biggest IT program in the world therefore seemed to be unavoidable. The influences of NPfIT still linger after its demise, parts of the project, for example the Lorenzo signed with CSC, is being continued in order to cut loss and avoid costly litigation (Smolaks, 2012). After the unsuccessful experience with NPfIT, the NHS aims to a paperless future though, this time focusing only on electronic personal health records, which is planned to be achieved by 2018 (Hall, 2013). The Spine platform (part of NPfIT) is being updated as well, targeting to transfer patients records electronically and securely among different GP practices with the US open-source database Riak (Baldwin, 2013).  Conclusion This report has evaluated the unsuccessful story of the NHS National Program for IT. There are plenty of lessons to learn from the failure of NPfIT, to avoid repeating those crucial mistakes, it is necessary to have a brutal audit applied to all over procurements of this program (Fishenden, 2010) HYPERLINK http//eprints.lse.ac.uk/39719/ . Simpson and Rankin suggest that the NHS should use public procurement law effectively to design their own procurement process, should collaborate and consider a framework and use the appropriate contract forms, also not to lose sight of deal essentials (Simpson, Rankin, 2014).
For its future development, the NHS should consider a long-term plan with more specific goals focusing on details, as one-size-fits-all program is a disaster for such a giant system (Health Direct, 2006). However, this study has not examined the positive impacts of NPfIT, neither reasons behind the departures of suppliers and leaders of the project. It is recommended that further research be undertaken in the above areas, as well as the reactions of public to this programs termination.  Appendix 1 MG5615 Understanding Business and Management Research Methods Assignment (Group Poster) GROUP AGREEMENT FORM We, the undersigned members of this group, undertake to be bound by the following agreement If you have a problem, you MUST contact your seminar tutor immediately. To attend all group meetings on time, except when agreed by other group members in advance, or where a documented excuse is provided. To be well prepared for each meeting, ensuring that all relevant material is adequately researched and presented. To be actively involved in the work of the group, by contributing to the best
of our abilities. To participate in the editing and preparation of the final reports. We agree that if a group member breaches these undertakings, then the group has the right to recommend a reduced mark for the individual concerned, below the group grade. In this eventuality the group would submit reasons in writing to the seminar leader. We accept that the seminar tutor may require further information before making any penalty mark adjustments. We accept that the seminar tutors decision is final in these matters. Group Membership SURNAMEFIRSTNAMEStudent NumberEmail(NGUYEN)(MY)(1042134)( HYPERLINK [e-mail] t _blank [e-mail])TRANPHUONG1340420 HYPERLINK [e-mail] t _blank [e-mail]1401581 HYPERLINK [e-mail] t _blank [e-mail]1339180 HYPERLINK [e-mail] t _blank [e-mail]1339054 HYPERLINK [e-mail] t _blank [e-mail]1339802 HYPERLINK [e-mail] t _blank [e-mail]  References Avison, D., Torkzadeh, G. (2009) Information System Project Management. Sage Publication, Inc. Bainbridge, M. 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Available at HYPERLINK http//www.hsj.co.uk/news/in-rude-health/19610.article.UycBV_l_vuI http//www.hsj.co.uk/news/in-rude-health/19610.article.UycBV_l_vuI. (Access 26 February 2014) Wright, O. (2011) NHS pulls the plug on its 11bn IT system. Available at HYPERLINK http//www.independent.co.uk/life-style/health-and-families/health-news/nhs-pulls-the-plug-on-its-11bn-it-system-2330906.html http//www.independent.co.uk/life-style/health-and-families/health-news/nhs-pulls-the-plug-on-its-11bn-it-system-2330906.html. (Access 26 February 2014) Zhen, J. (2005) Why IT Projects Fail. Computerworld. 39(6), pp. 31. PAGE 5 Y, dXiJ(x(I_TS1EZBmU/xYy5g/GMGeD3Vqq8K)fw9 xrxwrTZaGy8IjbRcXI u3KGnD1NIBs
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