Background of NHS and the Civilian IT Project

Discuss about the Relationship between project management methodology.

This report is based on a particular project case that has been chosen to critically analyze the criteria to determine the success or failure of projects. The NHS (National Health Service) civilian IT project has been chosen for this particular study which is considered to be the world’s largest IT project. The development of the system was left upon a large central team rather than the stakeholders who were most directly involved with the organization. The case study illustrates that it was a major failure due to involvement of various risks as it was large in nature (Harrison and Lock 2017). The discussions in this paper has been carried out to determine the criteria of project failure along with justification. The analysis of the project case is also presented in this report to demonstrate the main reasons that caused failure of the project. Further, the suggestions has been provided for project success in case it is re-run in the near future.

NHS (National Health Services) stands for the each of the services related to public health that are being offered all over the United Kingdom. This organization is funded publicly for England and it is oldest single payer healthcare system in the whole world. The services being provided by the organization are comprehensive, universal and free for the citizens of United Kingdom. The services being offered by NHS includes a wide range of health services except dental and optical treatment (BrightWork 2016). On 5^th July of 1948, NHS was born with a motive to bring good healthcare for all where hospitals, doctors along with nurses and other clinical personnel’s were brought together for providing healthcare services. The principle objective of the organization was to provide free healthcare services to all and the financing will be done from taxation. With the rise in technological advancements, NHS has also driven innovations in the field of patient care. NHS is rising to be more integrated and with the application of digital technologies, it has ensured longer as well as healthier lives.

The project case that has been chosen for this study is related to IT implementation of NHS for the civilians to integrate the various Electronic Health Record (EHR) systems into a single system. The case is considered as the largest IT project in public sector of UK that has been ever attempted which originally was budgeted at £6 billion approximately. The project aimed at bringing the use of Information technology by NHS into the modern technological world (Computerweekly.com 2018). The focus was on integration of EHR systems, online services booking along with computerized prescription systems. The objective of NHS related to this specific project was to develop a unified system of healthcare for the citizens of England. The project would have served almost over 40000 GP’s as well as 300 hospitals. The major reason being identified behind failure of this project was the astronomical size and from the beginning only it was difficult to successfully accomplish the project (Syal 2013). This particular case can be taken into account while determining the serious causes that lead to failure of projects.

Factors Affecting Project Success and Failure

The common theme that can be gained from the contributions to projects is people which is considered as an important factor for determining whether a project is success or failure. The measurement of technical or financial aspects of a project can be considered as important aspect but only if the project is completed. The involvement of stakeholders is another essential aspect for success of any project (Kerzner and Kerzner 2017). Hence, it is important to take input from stakeholders at every stage of a project. The success of any project lies within the interaction being carried out with the range of stakeholders that are associated with the project but are not directly related to the activities being undertaken to accomplish the project. There is a requirement to acquire input from the stakeholders regarding their opinions and agendas before proceeding with execution of a project. The characteristics of a successful project includes well definition and proper understanding of requirements, proper scheduling along with effective use of channels for communication (Harrison and Lock 2017). The success of a project also lies with the clear procedures being followed for reporting, following suitable procedure for managing changes and effective leadership.

The failure of a project may occur due to various reasons such as expectations that maybe unrealistic, undefined requirements, improper communications, failure to manage changes, lack of effective leadership and lack of resource management (Schwalbe 2015). Another major factor behind the failure of any project is the size which in turn leads to greater complexity thus causing improper handling of the project. The unavailability of adequate information leads the Government into unsuccessful management of the IT needs. The outsourcing of projects to various small or medium sized enterprises to avert risks and be more innovative (Kerzner 2018). The improper integration of IT in wider policy along with change programmes related to the business.

The work by Hornstein (2015), has represented that failure can happen at any phase of the IT project development lifecycle. The author has featured a rundown of reasons for inability to each stage of lifecycle, either by means of Strategy or Tactical. The key stage concerns the general point of the project. This is largely done in the opening phases of an IT lifecycle, for example, in analysis of requirements. The strategic stage refers to how the goal is met, including the assignments and exercises to be executed to meet the general system. As indicated by Serra and Kunc (2015), failure rates of large IT projects are higher than small IT projects. It is evident that large projects have a high risk to be failure since there may be increase in complexity when the size of task becomes bigger. An IT project with a long lifecycle is liable to changes of objective which is viewed as a significant factor for failure of a project.

Reasons for Failure of NHS Civilian IT Project

It is evident from analysis of various large IT projects that they often fail however, there is still debates going between academics and scholars to find out the precise reason (Mir and Pinnington 2014). In both public as well as private sectors, there is evidence that IT projects fail due to size. The causes of failure of public IT projects that has been identified are listed as below:

• Unavailability of adequate information that leads the Government into unsuccessful management of the IT needs.
• The outsourcing of projects to various small or medium sized enterprises to avert risks and be more innovative (Kerzner 2018).
• Improper integration of IT in wider policy along with change programmes related to the business.
• The Government intends to commission large and complex projects for increased profitability however those strive to survive under changing circumstances (Kendrick 2015).
• The lack of skills or leadership to manage the IT requirements in the Civil service leads to failure of projects.

The lack of skills related to IT and over reliance on contracting the projects to other enterprises are considered to be the major reason behind failure of IT projects.

The NHS civilian IT project has been chosen as the case for this study which was undertaken by NHS to develop a central unified Electronic Health Records system. The project was a big failure and the major reason being identified is the astronomical size. The system of systems was developed by a central team which was done by outsourcing the project and there was no involvement of the stakeholders (Joslin and Muller 2015). The four major stakeholders of those system is presented as below:

Patients – They use those system for viewing their own test results sitting right at their home. They feel it easier to access those system for diagnosis rather than visiting the clinic every time to get their test reports.

Healthcare professionals – They use the system for gaining fast access to the information about the patients such that those are reliable and accurate.

NHS managers and planners – They use secondary data from those systems for gaining access to information of high-quality that eventually assists them to target as well as utilize resources (Computerweekly.com 2018).

Public – They are able to access secondary data such systems for assessment of the services provided by local hospitals as well as other healthcare service providers and their performance (BrightWork 2016).

The reasons in context to the failure of NHS civilian IT project is illustrated as below:

Haste – The rush to progress with the project and gain the benefits that will be delivered from the project has been the major cause of failure (Syal 2013). The Government has pushed far to put the project running which has not provided enough time for consultation with the stakeholders as well as failed to deal with the concerns of confidentiality.

Design – With an end goal to decrease costs and guarantee quick take-up at the local levels, the administration sought after an overambitious and awkward central model, without considering the impact upon the satisfaction of users and issues related to confidentiality.

Lessons Learned and Recommendations for Future Success

Culture and skills – There was lack of clear direction, application of project management methodology and an exit strategy. Thus, the pursuing of such an ambitious within a short time led to system-wide failures (ul Musawir et al. 2017). Moreover, the way of life inside the Department of Health and government was not helpful for quick recognizable proof and correction of vital or specialized errors.

Inevitably, new information technologies come up against restriction, both from inside the segment they affect or without. The most harming feedback of the proposed national EPR from the mid-1990s onwards was that such a framework undermines to make private medicinal services data accessible for abuse. Kendrick (2015), cautioned that central databases of healthcare data would be a target for organizations and governments, while Kerzner (2017), additionally opines against aggregation of data, referring to various cases of risks postured by the military and banking areas, and blames the NHS for the season of surging quick down through wide and dangerous slope.

Conclusion

From the analysis, it can be said that failure of a project does not depends only on the complexity or size of a project. There are various other factors associated with failure of a project such as involvement of stakeholders. In context to the particular case of NHS civilian IT project, it has been identified that the major reason behind the failure was size and the stakeholder involvement was not given priority. The development of the system was left upon a large central team rather than the stakeholders who were most directly involved with the organization. It has been identified that the stakeholders should have been given the opportunity to choose their suitable IT systems to meet their requirements and ensure success of the project. Hence, it can be concluded that there is a requirement to involve the stakeholders at every point for ensuring success of that project.

The suggestions that can be provided in case the NHS civilian project has to re-run in the future are presented as below:

Proper definition of requirements – The requirements must be identified and defined properly prior to starting execution of the project. Proper procedures must be followed to acquire the requirements from the stakeholders.

Proper involvement of stakeholders – The stakeholders must be aware of deliverable that will be offered upon completion of the project and the steps that are being taken to conduct the project. The feedback from the stakeholders must be acquired at every stage of the project so that they are able to express their concerns and opinions.

Implementation of proper communication channels – The communication channels play an important role in demonstrating awareness on the project. The communication during conduction of the project is an essential aspect for success hence it is important that proper procedures are followed for communication purposes.

References

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