British National Health Service: Suppliers, Heal Thyselves

Doctors in the U.S. are not the only ones struggling to implement electronic patient records. According to a recent article in Computing, a UK publication, the National Health Service (NHS) in the UK continues to run into continued trouble implementing electronic patient records. The main reason: poor supplier performance. BT, a large IT provider to the healthcare market and key prime contractor for developing the core electronic patient records product for NHS, has repeatedly missed deadlines and has thus far failed to deliver the core product.

Although NHS was warned about supplier performance problems as early as May 2005, milestones continued to be missed. And there is no guarantee that future milestones will be achieved. BT has had major problems with its own suppliers, including IDX, the principal subcontractor, who had to be replaced. Most of the supplier problems seemed to come from poor and insufficient supplier management and BT's underestimating the scale, scope and project challenges.

Not surprisingly, a total breakdown in trust and confidence between BT and the NHS Trust has occurred. Interestingly, BT has been trying to anglicize an American product. And based on my own conversations with doctors who have been trying to implement electronic patient records American style, I have yet to hear about a software package that has been anything but extremely difficult and costly to implement.

In an unprecedented move, a set of 31 Gateway reviews (designed to test the business case for projects at various different stages of their lifecycle and have never before been made available to the public), was released by NHS after a Freedom of Information request. These noted that poor supplier performance was the culprit and recommended that NHS develop a more partnering-based relationship.

The prognosis is not very good that BT and its suppliers will improve their performance. They are many years into the mission without any reasonable results. Partnering with suppliers doesn't happen overnight, particularly between a government entity and suppliers and especially after so many failures to deliver. NHS seems to have made a serious mistake selecting BT in the first place and then managing both the relationship and the project. A supplier performance management process should have been in place a long time ago. And when milestones were missed, there should have been serious consequences and remediation. Whoever is responsible for auditing NHS or implementing Gateway review recommendations has certainly been asleep at the switch. NHS has gone far down the tracks with this supplier, and more needs to be done to turn this dismal situation around than just improve customer-supplier relations, as they continue to throw good money after bad.

- Sherry Gordon

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