I read with interest your article and comment on the Gateway reviews for the NHS National Programme for IT (Unheeded warnings highlight NHS flaws).
This large-scale programme has fundamental, but not unique, challenges. With a culture of non-accountability, no one wants to have to shoulder the responsibility for a lack of basic communication, the misinterpretation of the scheme as merely an IT project, limited ongoing buy-in from clinical staff as the programme changed, and inadequate programme and resolution management.
Effective communication is the lifeblood of any programme. If the scope and scale of the business requirements are not adequately recognised and understood, the complexity of the execution spirals, and without the hearts and minds of all stakeholders on board, there is little or no chance of success.
The view of the effort as an IT programme is also flawed. There is no such thing as an IT project. Every project has a business impact and benefit. The business case should be compelling and work for everyone. In this case, there is a substantial gap between the stated objectives and strategies of the programme and the real context in which they are delivered.
There has never been a widely accepted view of the “do-ability” of the programme. Perhaps what has been detrimental to this programme and many others is that suppliers are keen to win the business without full definition and acceptance of scope, challenge and risk.
Continuing failure to meet deadlines necessitates a fundamental change in approach to overcome root causes – for example, requirements not understood, business case not defined/believed, or a lack of delivery competency. I wonder how helpful the repeated “warnings” you mentioned have been. Do they come with remedies taking into account the deficiencies and defining what success looks like and how the programme can get back on track?
These reviews could be more proactive. Remedies must be specific and an action plan agreed with the relevant programme team. Collaboration is key – it is unclear whether or not the findings of these reviews were accepted by the people who matter. If a remedy is necessary, the governance for that review should include the execution of those remedies. If the remedies are not achieved, warning flags should be raised immediately without waiting for the next Gateway review to recognise that the same problem still exists. What is the point of project assurance if it doesn’t fix anything?