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Doomed IT Project costs NHS £26M

A report has revealed that the NHS was forced to write off over £26m after an IT project failed due to a ‘lack of consistent programme leadership’.

Ian Trenholm, who now manages the Care Quality Commission, had overseen the project in his then-role as chief executive of the National Health Service Blood and Transplant (NHSBT).

According to NHSBT’s annual report, poor planning and leadership meant the project started so badly that it was rated as ‘red’ throughout 2017/18.

It led to NHSBT bringing in auditors PwC to investigate the problem and the plug had to be pulled on the whole project in September 2018 – two months after Mr Trenholm had left to join the CQC.

NHSBT’s annual 2018/19 revealed that £26.2m had been declared a ‘constructive loss’ in relation to system, known as the Core Systems Modernisation (CSM) programme, which was designed to replace the blood supply chain management system (Pulse).

In a foreword to the report, new NHSBT chief executive Betsy Basis cited “a lack of consistent programme leadership and limited experience of large technology transformation programmes” as contributing to the collapse of the project.

“Given ongoing support costs and duplication with our legacy system, we have concluded that it is prudent to declare the full investment of £26.2m as a constructive loss in these accounts.”

The PwC report found that people working on the project felt unable to contradict their bosses about what was being done wrong, in particular Mr Trenholm.

It said:

‘Individuals who flagged issues or concerns, either within delivery partners of NHSBT, often felt that they were viewed in a negative light or ignored.

‘For a large part of the programme the Chief Executive at the time took on the role of the Senior Responsible Officer. This contributed towards ineffective governance as members of the programme board felt unable to challenge decisions made and also made it difficult for the Chief Executive to provide effective independent challenge to programme delivery.’

The NHSBT annual report 2018/19 said that all 28 recommendations made by PwC to do with ‘programme management, culture and governance ‘would be implemented in 2019 before any further attempt was made to replace Pulse.

In the report’s foreword, Betsy Bassis said:

“This is a highly disappointing situation for the organisation but one that we accept and are committed to turning around. As part of the wider review of our operating model, I have already taken steps to commence a fundamental review of our governance and risk management processes”.

She added:

“NHS Blood and Transplant remains in a good position financially. Our financial controls have been audited as substantial and we ended the year with a larger than planned surplus because of the decision to stop spending on the core systems modernisation programme part way through the year.”

It was not the first time a large technology transformation project spearheaded by Mr Trenholm had fallen flat.

In 2015, he was one of four people named in the National Audit Office’s review of the Common Agricultural Policy Delivery Programme, a £215m project designed to modernise the payment of subsidies to farmers.

The NAO concluded that “deep rifts between Programme leaders at many stages” and “inappropriate behaviour at the very top” resulted in the project being unable to meet its set objectives.

The programme ultimately exceeded its budgetary constraints and was withdrawn and replaced by a “paper-assisted digital” application process.

Trenholm now earns £195,000 a year as chief executive of the CQC, a role he took up in July 2018. The CQC is now in the middle of its own multimillion-pound IT revamp, under the leadership of Mr Trenholm, who has cut the number of hospital inspections to free up money to spend on the new technology.

Peter Wyman, Chair of the CQC praised Trenholm’s appointment back in May 2018, saying:

“His [Trenholm’s] track record of delivering technological innovation at scale in order to deliver benefits for people was the deciding factor”.

Talking about the CQC’s annual plan, Mr Trenholm promised “a significant investment in the core systems” which will make “systems and processes faster, more effective and robust.”

Last month he was called before a parliamentary select committee to answer questions on how the CQC failed to spot patient abuse at Whorlton Hall.

Despite numerous visits to the Co. Durham residential care home the CQC missed the abuse, and awarded it a ‘good’ rating.

An independent investigation is currently examining a CQC failure to publish a report in 2015 which highlighted serious concerns surrounding Whorlton Hall.

About the author

Anthony Harwood is a former Daily Mail foreign editor and Head of News at the Daily Mirror. In 2015 he sent up a press agency, Clio Media, supplying stories to the national papers and news websites. He runs Clio Media with his wife, the parenting author Tanith Carey.