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Britain's highest paid civil servant has announced his resignation as head of the £12 billion computer project for the National Health Service.
Richard Granger, 42, chief executive of NHS Connecting for Health, was responsible for upgrading information technology (IT) systems and introducing electronic patient records. Although computer systems have been improved in many trusts, the project has been criticised for delays and design flaws.
The departure of Granger, who was paid £290,000 a year, will be seen as a further setback for the project. He has been credited with updating hospital IT systems from “the stone age” and ensuring that private contractors involved in the project were not rewarded for failure.
Granger will leave in the next few months and said he was considering offers to return to the private sector. “I passionately believe the programme will deliver ever greater levels of benefit to patients over the coming years,” he said.
The NHS project, the biggest civilian computer project, was backed by Tony Blair to deliver detailed electronic records for every NHS patient. The electronic record system is now more than two years late and Gordon Brown is expected to review its progress when he becomes prime minister.
Tony Collins, executive editor of Computer Weekly, the industry magazine, which has called for an independent inquiry into the project, said: “Without Granger the risk is that this programme will now fall apart. The programme has highlighted the need for proper electronic records in the NHS, but you have to ask what it has achieved that trusts could not have done on their own. It has also not delivered on the main objective of a centralised patient record system.”
Granger was appointed head of the project in 2002 after successfully managing the introduction of the IT element of the congestion charge in London.
Confronted with what he saw as the intransigence of the medical profession and the determination of IT suppliers to make high profits at the taxpayers’ expense whatever their performance, Granger tried to introduce a tough competitive climate for the contractors.
His metaphor for the project was a sledge being pulled by huskies. Those who fell by the wayside would be “chopped up and fed to the other dogs” to ensure that those who survived worked harder.
The former management consultant was respected by many in the industry but others were taken aback by his abrasive and demanding approach. One contemporary once described working with him as a “deeply corrosive experience”.
Connecting for Health proved to be a huge challenge as NHS staff complained they had not been properly consulted and experts argued it was foolhardy to keep patient records in one central database, warning the system might be vulnerable to unauthorised users.
Some of the most stringent security measures in the IT industry have been devised to protect confidential information and patients can also opt out of their records being uploaded.
To add to Granger’s woes, the contractors tasked with developing the computer technology were hit by problems. Last year Accenture, the consulting and technology company, withdrew from the programme and iSoft, one of the programme’s software suppliers, is being investigated for alleged accounting irregularities.
Granger will point to systems in the project which he believes have been successful. These include the “choose and book” scheme, under which patients can choose a hospital for treatment while at the GP’s surgery.
Norman Lamb, the Liberal Democrat MP, said: “This is a grandiose scheme but it was not properly defined at the start. It is costing billions of pounds and we need to make sure that we are not building something that isn’t fit for purpose.”
Granger’s resignation has surprised many in the industry. Last weekend he gave an interview in which it was said he was keen to steer the project to “calmer waters”.
Dr Simon Eccles, the project’s national clinical lead for hospital doctors, said: “He is going to be a hard man to replace. He has brought a unique set of skills to the programme. If this had been delivered by the NHS the budgets would have been bigger and the delays would have been greater.”
Lord Hunt, the health minister, said the IT programme would not be adversely affected by Granger’s departure. “The NHS IT programme will provide safer, faster and more efficient healthcare for patients,” he said.
“It is already being used by clinicians and bringing benefits for patients with digital technology, transforming diagnosis and treatment every day.”
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We have used the Lorenzo system for about 3 months and this highly inferior rubbish has all but destroyed our Medical Records tracking system. Our files were kept in military order and were to hand at a second`s notice. The PAS system that we used was extremely fast and efficient and could have been adapted. Demoralized is an understatement when describing the staffs` attitude. We can not believe how the Management are getting away with such incompetance. We will not strike or take any action that would ever cause suffering to a patient, and sadly the Management know this - leaving staff very little power to protest.
Jean, Ipswich Hospital,
"Granger will point to systems in the project which he believes have been successful. These include the choose and book scheme, under which patients can choose a hospital for treatment while at the GPs surgery."
It is simply not working reliably/not fit for purpose in most GP practices that I know of.....
Mark, Nottingham,
The infrastructure already exists. Anyone can place files on a website, password protect them, allow edits, and keep an audit trail. Such a system would cost only a few thousand pounds to set up.
As for confidentiality, it might be a bit embarassing for Mrs Bloggs if the teenager next door finds out she has malignant hypothermia, but it would take a creative crook to turn that information to advantage. This has got to be balanced agaist the danger to Mrs Bloggs if she is rushed to hospital after a major road accident, and because of some confusion the surgeons aren't able to obtain authorisation to access her records. Confidentiality is just a flimsy excuse for ripping the taxpayer off for literally billions of pounds.
Malcolm McLean, Bradford, UK
I don't blame Grainger - it is just another example of the Blair ship sinking. He has just left it a bit late to jump. Maybe he can now set up Blair's diary on his PC for a living. Hopefully now Brown/Cameron can get real and listen to real professionals - the doctors, nurses, receptionists etc in the NHS.
Gordon, Woking, Surrey, UK
Did Mr Granger give a reason for this sudden departure?Better Job?More Money?or was he just fed up working for the NHS!!!!!!!!!As a rate payer I have great concern for Lord Hunt who other worrying Public Health issues, adding IT which as we all know is a very specialised area ,can only/delay the agenda for change and projects.My advice to Mr Hunt would be to get more of the Public who know just whats going on involved.He might learn much more than asking the professionals.
ME Hoult
Leeds
M E HOULT, LEEDS, Yorkshire England
Richard Granger has been engaged on work of Brunel proportions. It is the single most important development in the modern NHS - bar none. Accepting the brilliance of clinicians, it is the use of data and the management of information by the use of technology that will advance the well-being, treatment and safety of patients, make more meaningful the information we have about them and be the determinant in how taxpayers money is spent more wisely. We will look back at his time at the Department of Health and be content that we were present whilst history was made.
In addition he has confounded his critics and revolutionised procurement. We squander his inheritance at our peril.
Roy Lilley, camberley - surrey,
So the denial that we had from the Government, not six months ago, that there was a problem with the development of this system, was not true...... I am surprised. What?....The Government tell lies? There won't be a problem though, it will all be several years later than expected and cost 10 x what the initial estimate led us all to believe. No change there then. VOTE THEM OUT.
judy, Liverpool, england
Having worked myself in the civil service, the quality of many such who work in the IT departments there is so low, it would astound you if you saw the level of incompetence on a daily basis. From reports blantently lying about the level of security which fail the next day due to a virus infection which was apparently impossible to catch due to updates having been done, which was not. To staff being employed who lie about their qualifications, such to the extent that sometimes entire departments have not a single person who can do the job!
Whilst there are gifted individuals who do work there, they are ran ragged working all hours whilst their fellow workers sleep on the job, or spend all day in chatrooms/surfing porn. The overall effect is of a system struggling to work on its best of days, with the Yes Prime Minister civil service attitude effecting anyone who wants to make things actually work, I'm suprised the lights are even on!
ex civil servant, London, UK
It is simply not true to say that "Some of the most stringent security measures in the IT industry have been devised to protect confidential information." The proposed measures in the NHS system are fairly standard - and some, such as the "sealed envelope", do not even have a credible timetable for deployment. The Leeds University NHS trust found that in just one month, their staff made 70,000 unauthorised accesses to IT systems, while South Warwickshire General Hospitals NHS Trust allows its staff to share logins to save time.
Ian Brown, London, UK
This would be an ideal time to review the project, so that whoever takes over from Richard Granger starts from a clean baseline, with clear objectives and budgets, and known risks and opportunities.
Independent, constructive reviews are recognised as established best practice in the US defence industry and elsewhere, as a way to provide the clarity and perspective that is easily lost by the project team themselves. In the UK, the new, en-route air traffic control centre at Swanwick benefited from such a review in the mid 1990s.
Richard Granger agreed in April last year that such a review could be useful, but he was blocked by ministers. The national programme for NHS IT should be reviewed now as a matter of urgency.
Martyn Thomas, Bath, UK