NHS Computer Scheme - Coursework Example

?A Report on the NHS Computer Scheme Project Executive summary The need to ensure efficiency in the provision of services in the medical industry is the sole driver of the adoption of Information technology in medical operations and processes. The NHS computer scheme project was aimed at addressing similar concerns in the UK health sector. The main aim of the project was to deliver a more integrated IT system for storage and retrieval of medical information records. It was established in the report that the project was faced with a number of challenges that affected its successful accomplishment. The main issues that were found include: lack of planning, poor management of the project, lack of an established risk management strategy, poor statement of project objectives and a poor execution strategy for the project. It was thus recommended that the project should have begun with the establishment of a comprehensive project charter and plan that would have guided the project. A project board is seen as the second thing that the project lacked that would have motivated the project manager to work harder on the project. A third recommendation was to greatly involve stakeholders including patients and clinical professionals and lastly it was recommended that the project would have come up with effective objectives setting the vision of the project and thus enabling the project to stay on course. Introduction and background The 21st century has continued to witness an upsurge in the use of technology and technology applications. The medical world has not been left behind either and there have been developments around the world that are aimed at streamlining operations as well as the management of patients and resources. There have been success stories around the globe with many successfully moving from a field marked by papers to a paperless world where people can access their medical information at the click of a button. Such developments have been made in the US; however, there are still many challenges that have continued to slow growth in this sector. This paper is going to provide a critical analysis of an ambitious IT project began by the UK department of health dubbed NHS National Program for IT. The ?12 billion NHS computer scheme project was an initiative of the UK department of health that was aimed at achieving a single, centrally-mandated electronic care record for patients and to provide a connection of more than 30,000 general practitioners to over 300 hospitals (Deloitte, 2009). The system was also aimed at providing a secure platform where authorized health practitioners could access medical records in the process of providing care to patients. The project had other aims as well including the ability to provide a platform where any patient could be able to access their medical records online at any time with the appropriate authorization. If the project was to succeed patients would have been able to access their medical records online through a service dubbed Healthspace. The project was going to be a leap forward in the healthcare industry and was said to be a world’s first most comprehensive civil information technology program of the century (PAC, 2010). The program began in October 2002 and since then its management has continued to spur debate and discussion among the public and other stakeholders as well. The first bone of contention is the cost of the program that was estimated to cost ?12 billion (Campbell, 2011). The second problem came up as a result of poor management and or the subsequent sacking of four of the proposed IT provides (PAC, 2010). Third, the public accounts committee on the other hand has continued to criticize the project terming it to have flaws from the point of initialization, budgeting, scope, planning and also noted that the project had little practical value to the patients if any in order to warrant implementation (PAC, 2010). A review by the Cabinet Office’s Major Projects Authority (MPA) established a number of things and concluded that the project was not fit to provide the much needed IT services which both the patients and the National Health Service require. The review team thus recommended the dismantling of the project activities and the establishment of a better system, less costly and more valuable to the patients and the medical professionals (Martin, 2011). However, the NHS said that the successes that had been achieved so far could not be neglected and that the already laid down infrastructure made possible by the sections of the project would be maintained and used effectively (PAC, 2010). Findings Large projects come with major responsibilities and concerns. The cost involved in such projects is usually high as compared to smaller projects. The planning of these projects takes a long time in order to be successfully implemented. Smaller projects take off immediately almost everything is present and thus the project can successfully proceed (Lester, 2007). The first problem with this project was that the planning of the project was short and did not involve all the stakeholders. The department of health acknowledges that there was no clinical engagements at the onset of the project and this might have contributed to project failure. Major projects have a number of stakeholders whose needs must be addressed (PAC, 2010). Therefore planning has to take time to understand their needs and to ensure that the project takes into consideration their concerns as related to the project. Project planning is a detailed stage that determines the success of any project (Cleland, 2007). Without effective project planning, nothing constructive can go on in the project as it translates to lack of proper goals and objectives of the project increasing project failure. Stakeholder involvement at this time is crucial for any project something that was not done in the NHS computer scheme project (Kerzner, 2004). During project initiation, the project manager and the project board has to set the project aims and objectives which will translate into project deliverables (PMI, 2008). In the case of the NHS computer scheme project, limited planning translated into poor statement of project objectives. This is because the project was too ambitious and impractical in its objectives. The major objective of the project was to replace the existing IT structures in hospitals with on nationwide system to be used by both patients and medical professionals (PAC, 2010). This was not possible given the difficulties that have been experienced in setting up IT systems in hospitals. Project planning involves the setting up of project objectives which must be clear, practical and achievable. Without clear objectives, it becomes difficult to deliver project deliverables and this leads to project failure (Fewings, 2005). Project objectives must be set within a time limit that is practical and achievable (Kerzner, 2009). In the case of the NHS system, the setting up of the systems was to be complete by 2007, only five years from the initiation of the project. It was not practical to deliver this within the stipulated time and this led to project failure (PAC, 2010). The third issue that has received considerable attention as concerns this project is poor project management on the part of the project manager. The most prominent cause of the failure of the project was problems with accountability and well as the poor management from the top (Campbell, 2011). According to the Public accounts committee, the project failed because of weak management and oversight of the program that generated into poor accountability for project performance (PAC, 2010). The reason as to why the project was not managed effectively was because of the project manager’s significant other duties that weakened accountability and caused extensive delays in the project (PAC, 2010). Every project manager is required to have three types of skills that are very crucial in the management of any project: interpersonal skills, administrative skills and technical skills. The first two are crucial for project success and this is because they determine how the project is carried out, how resources including people are managed and how the project is handled as a whole (Turner and Muller, 2003). The project manager in this case lacked administrative skills of managing the project and this translated into project failure. Large projects require a great deal of commitment in terms of time and efforts to understand what is happening and ensuring that the project stays on cause and project milestones are achieved as stated. This was not the case in the project and contributed significant to the failure in achieving its objectives (PMI, 2008; Lock, 2007). The fourth issue in this project has to do with the identification and the management of risks inherent in the project. Large projects have many risks and require a risk management strategy in order to avoid problems that could lead to project failure (Tzri, Shenhar and Dov, 2002). At the initiation of the project, it was impractical for the project to succeed. At the signing of the contracts for the delivery of care record systems in 2003, it was established that the suppliers did not have a product to deliver. Risk assessment made on the project was also poor because the project was politically motivated and ministers passed the project aware of the risks. The department of health noted that the delivery of a one-size-fits-all-system to NHS was the biggest risk of the project as this did not work (PAC, 2010). A second risk was the lack of clinical engagements as well as lack of engagement with the product users (patients) which contributed to the failure of the project (PAC, 2010). All projects whether big or small have risks. The successfully mitigation of these risks, stems from the creation of a risk management strategy, to identify and address all risks that might face the project (Kendrick, 2009). It is the responsibility of the project manager to set up a risk management team at the onset of the project that will look at the stages or phases of the project and identify risks to the project and how they can be managed. A risk register is an important tool at this stage and greatly contributes to the easier and early identification of project risks (Lester, 2007). The fifth issue is poor project execution/ implementation that resulted in project delays, difficulties in accomplishing project milestones, difficulties in achieving project goals as well as project deliverables. This was a massive project and its execution was not spread to a longer time frame to accommodate changes that might occur during the process (Lock, 2007). By the end of 2011 which was four years later, the NHS was supposed to have delivered the care record systems and also by this time, patients were supposed to have records already in place. The patient records were to be in place by 2010, something which did not happen (PAC, 2010). There was no consistency in the implementing of the project as the project was only divided into two phases. Large projects are more complex in terms of structure and operations. They require that their execution is carried out in phases so that one deliverable could lead to the development of another (Chapmen and Ward, 2003). The problem with huge projects is that they are time consuming and any delays could lead to a delayed project in the end. Such projects are divided into phases for easy management as well as easy handling of the sections. It is important that the project manager establishes the best method of accomplishing any project and divides it into section so that the project is easily achieved and delays are minimized otherwise project failure in such large projects is quite high (Clayson, 2005). Many of the large projects are usually divided into phases and these phases are usually evaluated as soon as they are complete in order to establish the next course of action. This means that all stakeholders and any other group of people responsible for any part of the project must be aware of their responsibilities in order to ensure project success. A clear understanding of tasks ad processes is required in order to achieve overall project success (Cleland and Ireland, 2006). Discussion There are five major findings that have been established from the case and these are the main issues that marred the successful implementation of the NHS computer scheme project. The first issue that was identified was poor planning which is resulted in poor objectives and delays in the implementation of the project. What the project manager would have done is begin with planning by laying down a project plan or project charter that would have explained the scope of the project as well as the different things that are required in the project. The project plan would have helped the project stay on course and at the same time ensure that the project objectives are being implemented as laid down in the project charter (Cleland and Ireland, 2006). Effective planning would have gone a long way in achieving project success. Scholars argue that poor planning is among the top causes of project failure. The project manager thus needed to ensure that all the stakeholders were involved and the project plan was in place before beginning the project (Kerzner, 2004). The second problem which was a lack of clear objectives could have been resolved at the planning stage of the project. The main aim of the project was unrealistic and the objectives thus created were impractical and could not be achieved within the stipulated time frame. What was required is the creation of mart objectives that would have been instrumental in ensuring project success. It is argued that lack of clear objectives as well as unrealistic expectations set in the objectives is a sure way not to meet the project milestones. What the project needed was a clear project charter with specific, measurable, achievable, realistic and time-bound objectives (PMI, 2008). The third issue was poor project management and this was on the part of the project manager as he was torn between two duties of handling the executive work of NHS and in handling the project. This resulted in lack of accountability. Poor management has been cited as a contributory factor to project failure (Turner and Muller, 2003). The project manager needed to first have the right skills and competence to encourage the project team to accomplish project objectives. Communication and feedback, motivation as well as the effective management of resources are things that the project needed in order to succeed. A project board if in place would have helped to ensure that the project was successful and this is what was lacking in this case (Lock, 2007). The fourth issue had to do with risk management. The project had no risk management strategies in place. Much of the risk assessment occurred at the parliament level and the project moved on without a further risk management strategy. The project manager needed to come up with a risk register which would have set out all the risks and mitigation strategies (Kendrick, 2009). The advantage with this is that risks are identified earlier on in the project and dealt with instead of waiting until an event has occurred that impacts negatively on the success of the project. This was the best way to solve this problem but was highly neglected (Chapmen and Ward, 2003). The last issue identified was poor project execution/implementation and this stemmed from the fact that the department of health wanted to implement the project in two phases but had no specific strategy to use to accomplish this. This led to conflict of interests and the project milestones were delayed. There is no specific way to implement huge projects but contemporary project management knowledge has that, such project should be divided into manageable “chunks” which can be effectively monitored in the course of project implementation. Being over ambitious with huge project, only results in lack of accomplishment of project deliverables and leads to project failure in the end (PMI, 2008). Conclusion The NHS computer scheme project was actually an ambitious project that was marred by a number of problems that contribute to its failure. As it has been seen in the findings, the project was poorly planned, had poor management, there was no risk management frameworks in place, no clear objectives were made and lastly the project execution was carried out in the wrong way. The cumulative effects of these problems resulted in the failure if the project which had already cost the nation a lot of money to establish the necessary supporting infrastructure. The project failed to deliver project objectives, was overly delayed and led to a number of losses for the nation. It has also been established that proper planning was required and this had to involve all the stakeholders affected by the project. It was also seen that the project objectives were not clear and were also impractical and thus could not be achieved. The project needed SMART Objectives and goals with a clear vision of what was expected and how it could be achieved. It was also established that poor management and the lack of involvement by the project manager is what contributed immensely to the failure of the project and thus it was necessary that the project manager is available to oversee the whole project to the end. Risk management was also identified as poor as the management failed to come up with a risk management strategy to address the risks inherent in the project. Therefore, with all these in place, it was not possible to successfully accomplish the project and a number of strategies were required to boost the chances of project success. Recommendations Through the events and the issues that marked UK’s first major IT project, there are a number of things that needed to be changed to boost the chances of the success of the project. It is recommended that first; NHS would have established a project board together with the project manager and the project team to ensure effective management of the project. This would have helped in establishing responsibilities and authority so that the project manager is under a larger authority which would have put pressure on him to enable the effective accomplishment of his duties. Secondly, the project needed a careful review from an independent body in order to establish risks inherent in the project and how they could affect the project. Although this was done, it was no sufficient and it was later realized that the assessment was poorly done. It is thus recommended that a careful review of the risks of the project should have been done to help in identifying potential risks and impacts on the project. Third, it is also recommended that the project should have come up with a comprehensive project charter entailing the project vision, mission goals among other things. This would have helped in making arrangements and in effectively planning on how the project objectives would be achieved. A comprehensive plan was lacking in this case. Fourth it is recommended that the project would have been divided into a number of phases so as to make the project manageable. The project was huge and was only divided into two phases spread over a four year period. The magnitude of activities in each phase made it difficult to monitor and achieve the intended results. Therefore the project should have been structured into four or five phases spread over 10 years to achieve success. Fifth, in order to gain support for the project, it needed to establish contact with the clinical support staff as well as the people who were going to use the system. It is thus recommended that the project should have begun with consultations with stakeholders before implementation. This would have helped to garner their support. Reference List Campbell, D., 2011. NHS told to abandon delayed IT Project. [Online] Available at: http://www.guardian.co.uk/society/2011/sep/22/nhs-it-project-abandoned [Accessed November 13, 2012]. Chapmen, C., and Ward, S., 2003. Project Risk Management: Processes, Techniques and Insights. New York: John Wiley and Sons. Clayson, T., 2005. Project Management: Controlling risk. Materials Management and Distribution, 50(6), pp. 55. Cleland, D. I., 2007. Project Management: Strategic Design and Implementation. New York: McGraw-Hill. Cleland, D. I., and Ireland, L. R., 2006. Project Management: Strategic Design and Implementation. London: McGraw-Hill. Deloitte., 2009. NHS Connecting for health National Programme for IT. [Online] Available at: http://www.deloitte.com/assets/Dcom-Australia/Local%20Assets/Documents/Industries/LSHC/Deloitte_The_NHS_national_programme_for_IT_Dec2009.pdf [Accessed November 13, 2012]. Fewings, P., 2005. Construction Project Management: An Integrated Approach. London: Taylor and Francis. Kendrick, T., 2009. Identifying and Managing Project Risk: Essential Tools for Failure-Proofing Your Project. New York: AMACOM Div. American Mgmt. Ass. Kerzner, H., 2004. Advanced Project management: Best Practices on Implementation. New York: John Wiley & Sons. Kerzner, H., 2009. Project management best practices: Achieving Global Excellence. New York: John Wiley. Lester, A., 2007. Project Management: Planning and control. Oxford: Butterworth-Heinemann. Lock, D., 2007. Project management. London: Gower Publishers. Martin, D., 2011. ?12 bn NHS Computer system is scrapped...and it’s all your money that labour poured down the drain. [Online] Available at: http://www.dailymail.co.uk/news/article-2040259/NHS-IT-project-failure-Labours-12bn-scheme-scrapped.html [Accessed November 13, 2012]. PAC., 2010. The national Programmer for IT in the NHS: An Update on the delivery of detailed care record systems. [Online] Available at: http://www.publications.parliament.uk/pa/cm201012/cmselect/cmpubacc/1070/1070.pdf [Accessed November 13, 2012]. PMI., 2008. A Guide to the Project Management Body of Knowledge (PMBOK) (4th Ed.). Newtown Square PA: Project Management Institute. Turner, J., and Muller, R., 2003. On the nature of the project as a temporary organization. International Journal of Project management, 21, pp.1-8. Tzri, R., Shenhar, A., and Dov, D., 2002. Risk Management, project success and technological uncertainty. R&D Management, 32(2), pp.101-109. Read More