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It Infrastructure Assignment Critically Analysing The Causes Of Project Failure

Question

Task: Provide a critical analysis on IT infrastructure assignment outlining the causes that led to the failure of the project.

Answer

1. Project Snapshot
This section of IT infrastructure assignment is focused on delivering a brief outline of a project. The NHS Connecting for Health (CFH) was a part of the health department of UK and was formed in the year of 2005 (Price et al., 2018). The formation was intended towards replacing the existing NHS information authority. The primary role of this was to cause substantial amount of improvement in the IT infrastructure of healthcare. The primary responsibility of this program was to ensure the successful inclusion of NPfIT (NHS National Programme for IT), which was an initiative to start the system of electronic care records that was singular and centrally mandated. This initiative promised a connection between more than 25,000 general practitioners and 300 hospitals, providing a safe and secured access to all of the electronic health records for the health care professionals (Price et al., 2018). The program however, failed to deliver the goals. The criticism was mainly induced because of the identified risks associated with data security, ignorance and lack of trust from the side of the health care professionals, irregular accounting and others.

2. Introduction
The IT systems are meant to cause improvisation in the existing services such as effective standardization and centralization of the healthcare information among the hospitals, clinics and numerous other healthcare facilities (Jane et al., 2017). These improvements are highly inclined towards enhancing the potential of the regional healthcare services and provide better options for the people. On the contrary, the implementation of such services is one of the sot difficult aspects that lead to major failures. Britain’s NPfIT is one such case of the failure that caught every individual and government institutions off-guard in terms of its failure. It has often been described as the biggest IT failure the world has ever seen.

As mentioned by Wachter (2016), the strategic aim of the entire project examined in the IT infrastructure assignment is mentioned as follows:

  • To ensure that a safe and reliable service is provided by the NHS professionals for 24 hours
  • To ensure that the NHS professionals have an access to the latest guidance on treatment facilities and can conduct own evaluation to witness their professional development
  • Ensure that all kinds of unnecessary delays and online access for the patients have been dealt with
  • To ensure that the public involvement in terms of healthcare measures enhances their understanding of the better aspects and the strategic aim of behind the system as devised by the government

This IT infrastructure assignment is meant to present a critical analysis of the entire scenario of the case and at the same time, mention the prominent reason behind the failure of this venture. At the same time, this report would identify the major issues that were found in the entire system and conduct an analysis of the cost/schedule overruns, the relationship between the overruns and the stakeholders, and the major lack of support from the side of the project execution team. Meanwhile, after a thorough and critical analysis of the all possible prospects numerous suggestions would be made with regards to how the situation of failure could have been avoided.

3. Major Issues
In the words of Justinia (2017), it has been found that the history of NHS with IT has been intertwined with both successes and failures. However, during the launch of NPfIT, almost 60% to 80% of their IT projects ended in failure. The IT infrastructure assignment study illustrates that the aim of the entire program is to improve the quality of patient care with the help of following components:

  • Doctor appointment with the help of e-booking
  • An e-record service that is integrated in nature
  • The use of an e-prescription system that can support the IT infrastructure and make access to medicine a speedy process

Some of the new infrastructure such as N3 (New National Network) and CRS (Care Records Service) were added to ensure that the requirements have been fulfilled. Mainly there were three issues identified in the IT infrastructure assignment that led to the failure of the entire infrastructure system. As mentioned by Sittig et al., (2016), the three reasons are as follows:

3.1 Process Driven Issues
In terms of the process driven issues one of the biggest issue was the unrealistic schedule that was formulated for the completion of the project. Being a project of a complex nature, the timetable of 2 years and 9 months was highly unrealistic and could not have possibly assured the success of the project. In addition, the outline of the project discussed in this IT infrastructure assignment was not tentative either for its successful range

3.2 Context Driven Issues
The context driven issues identified in the IT infrastructure assignment mainly developed here after the use of top down approach and the lack of execution from the project management team. There was a constant change in the senior leadership and an extreme politicization directed the entire program to a wrong path. A range of poor relationship was inherently established with the local service providers and the contractors of the project that eventually led to the underwhelming outcome of the project

3.3 Content Driven Issues
The essential aspect that tampered with the content aspect of the entire project displayed in this piece of IT infrastructure assignment was the maintenance for confidentiality. There was no agenda that was fixated upon maintaining the confidentiality of the entire project. There was no clarity on the subject of how the information about the patient were to be protected for the betterment of the people and to not make the entire government structure for the people to be untrustworthy.

The project was considered as an overall failure due to its inability of not being able to deliver anything within the projected timeline, exceeded budget and failure in delivering the expected goals.

4. What is the use of Control Systems for a project examined in this IT infrastructure assignment?
The use of a control system for a project is of utmost necessity. It eventually allows in understanding the analytical tools and techniques that are required to be used for controlling a project (Leitão et al., 2016). There were way too many loopholes in the project. However, with the number of tasks that were to be completed each day by the system created a sense of doubt because as a part of the daily procedure about 3 million critical processes were to be handled and 30 million transactions were to be occurred. Thus, the control systems had to be efficient enough to handle every edge of the situation on a weekly basis.

4.1 Control Systems for Cost
The study of IT infrastructure assignment explores the words of Brocklehurst and Speight (2018) which states that the cost control system can be considered as the practice of proper identification and reduction of business expenses to enhance the chances of gaining profits and it eventually starts with the budgeting process during the consideration of the project. The person in charge of the project eventually compares the eventual result with their planned budget and if the actual costs ends up being the higher one then there is a chance that the management eventually takes strict actions for the situation. The initial phase of the project examined in the study of IT infrastructure assignment began with the cost of £6.2 billion and the regional clinical information systems were accounted to be provided with almost 79% of the budget and on the other hand, the infrastructure systems were provided with 18% to bring security and connectivity services to the project (Brocklehurst and Speight, 2018).

IT infrastructure assignment

Figure 1: Essential Services and the budget allocation accordingly
(Source: Jane et al., 2017)

4.2 Control Systems for Schedule
There were various reasons for the failure of the project and the time constraint was one of them. It was the designated wish of the then PM of Britain that the project should be completed within the time range of 2 years and 9 months. The project highlighted in the present report on IT infrastructure assignment was eventually initiated in the year of 2001 and was expected to be done by the year if 2003. However, the project took a delivery time of 10 years only to be dismantled in the year of 2011 (Fitzgerald et al., 2015). By the time the project ended the budget almost reached the amount of £12.7 billion (Fitzgerald et al., 2015). The schedule was not properly maintained as the relationship with the suppliers and other service providers were subjected to complete mismanagement.

4.3 Control Systems for Scope and Quality
The scope for the work outlined in the IT infrastructure assignment was extended to both national and regional level. The inclusion of national and regional aspects of the work is entitled to make sure that the expected scope had been met. According to Campion-Awwad et al., (2014), the expected scope and the quality of the project demanded the following elements:

  • Patient visits in GPs should be amounted to 6 million
  • 64,500 emergency calls are to be handled by the ambulances
  • The use of Patient X-rays should amount to 360,000
  • 7 million of prescription should have been dealt with

Eventually, it was the unrealistic timetable that gave away all of the potential of the project. In the case of NPfIT illustrated in this IT infrastructure assignment, the expected scope of technological systems such as EPR, online booking services, e-prescription systems and others were not met and the eventual quality of the outcome was heavily disappointing.

5. Analysis of Cost and/or Schedule Overruns
The cost overrun was eventually occurred due to the reasons of haste, design and lack of skills from the side of the people who were assigned to induce successful returns for the project. The eventual outcome was not as expected. The study of Currie (2012) collaborates with the context of IT infrastructure assignment and illustrates that the government was intended towards reducing the cost of the project and thus, took up a rather centralised method, which was apparently considered to be overambitious as well that led to the downfall of the entire program. Eventually, the government compromised on the aspects of confidentiality and user satisfaction as well, that degraded all the potential of the work. This eventually led to the idea being misunderstood and unconstructive in nature. Meanwhile, the constant conflict with the suppliers further deranged the possibility of the project to gain any kind of success. NHS has had a history of initiating controversial IT projects, which has had a very minimum success range.

IT infrastructure assignment

Figure 2: Timeline for some of the Biggest NHS Projects
(Source: Jane et al., 2017)

The cost and schedule overrun reasons for the project were highly interrelated and were considered to be parallel to each other. There was a lack in a detailed cost-benefit analysis that would have been extremely beneficial for the entire work. On the other hand, it was found in this IT infrastructure assignment that the government also lacked sufficient amount of strategic view of the entire programme. Also, the contracts that were signed at the initial stage of the project created further issues during the time of the renewal. In UK, The House of Common’s Public Accounts Committee (PAC) eventually revealed that the entire programme cost the taxpayers more than £9.8 billion and is considered to be the biggest financial fiasco to have ever happened (Johnson, 2010).

Similarly, it has been noted here in IT infrastructure assignment the project’s delivery was dismantled in the year of 2011, following a delay of almost 10 years which continued because of the conflicts between the suppliers. Also, the lack of communication with the key stakeholders and the local service provider eventually created more hassle about the work and thus, the key outcome was never achieved. The 10-year delay created contract conflicts and also resulted in a failure in achieving the key cost objectives as well (Brocklehurst and Speight, 2018).

6. Analysis of the Project Execution Team
The analysis of IT infrastructure assignment signifies the readings of Hendy et al., (2005) that there was a substantial lack of judgement in terms of ensuring that the project outcomes can be accurately met. The lack of enthusiasm and the constant voyage of conflict eventually showcased the deficiency that was obvious between the team members and the project execution team thus, faced a major deficit. Firstly, there was a constant politicization of the entire project that eventually ruled out its potential to work in a prominent manner. The constant change in the senior responsible owner made it difficult for the project examined in the study of IT infrastructure assignment to be established in the sense of complete proficiency (Omar et al., 2017). Lord Hunt, who was the Parliamentary Under-Secretary of the State of the Health, resigned less than a year after the programme was launched. Also, numerous individuals belonging to the senior most position of the health department were essentially reluctant at first because none of them were sure if the project could have been completed within the span of 2 years (Jane et al., 2017). In addition, there was a constant issue of communication between the NPfIT headquarters and at the same time there was a lack of clinical engagement as well making it evident that there was a chance of dysfunctional team performing for the completion of the task.

IT infrastructure assignment

Figure 3: The constant changes in senior leadership
(Source: Jane et al., 2017)

When a team witnesses frequent changes time after time, there is a lesser chance of it gaining adequate amount of success and achieving the designated project outcomes that would be beneficial. As mentioned by Randell (2014), the executive directors of various trusts and the IT manager faced the maximum amount of difficulty while dealing with the constant changes of the programme. There were constant replacements and wreaked havoc amongst the junior executives and the individuals involved in the lower hierarchy of the team.

The SRO of NPfIT and the Chairman of NPB quit the program in the year of 2003 for not being able to handle unrealistic stature and expectations of the programme. Further, it is noted in this IT infrastructure assignment there were even more replacements and resignations until the year of 2005. Dr. Halligan, who was appointed as the SRO resigned after only 6 months of service and was later replaced by Alan Burns (Bond, 2015). Again, in the year of 2005, Richard Jeavons replaced Alan Burns in the position of SRO (Randell, 2014). This eventually provides an insight about the constant changes that had occurred and the impact was severely identified in the form of constant delays and extra costs. Thus, it can be said that there is a lack of proper intricacy in the entire work and lacked adequate amount of retention strategies for the senior officials.

7. Analysis of Relationship between Overruns and the Stakeholders
This section of IT infrastructure assignment is shedding light on the relationship between overrun and the stakeholders. The involvement of the stakeholders in any project plays an essential role for inducing maximum amount of benefits for the project. The key stakeholders of this programme were the healthcare professionals and the patients. As mentioned by Bcs.org (2013), it was found that majority of the government officials failed to establish an effective communication with the patients or their guardian and in the meanwhile did not even bother to hold meeting with the key communication officials. However, during the initial stage of the project the health minister made sure that adequate amount of information has been provided about the reigning complexity of the programme. The government managed to create Front Line Support Academy which would eventually be successful in providing information about the use of new technology. Since, it was evident that with the implementation of the new IT infrastructure much of the staff would lose their job because the new technology would eventually replace their work threshold (Pouloudi et al., 2016). On the other hand, there were several aspects that were constantly being upped for launch by the government. However, no intricate measures were taken to make sure that proper contact to make sure that the patients have been explained about the measures that would be used.

The IT infrastructure assignment study analyses the research of Rotomskien? (2011) and identifies that the convenience and measures used to make sure that the people are able to understand how the entire system is being used and appreciate it accordingly or voice their disapproval accordingly. At the same time, the top down approach that was considered by the government did not fit the mechanisms of all the healthcare professionals operating on different levels and even the patients felt uncomfortable in understanding the actual methods. All kinds of preferences towards the needs of the hospital staff and the patients were ignored and the eventual outcome that was that the people failed to adjust with the newly designed system (Cresswell et al., 2011). Even though the government took the initiative of providing them with the training of dealing with the new technology, but the choices and the opinion of the key stakeholders were eventually being ignored for the entire project. Further, the government was in a constant conflict with the local service providers and the suppliers as well. This caused havoc in terms of schedule disposal in an inappropriate manner.

8. Analysis of Possible Actions for Success of project outlined in IT infrastructure assignment
The range of mismanagement that occurred and the amount of dysfunctional conflicts that took place eventually tampered the potential of the programme (Clarke et al., 2017). With the help of the following suggestions the success range of the IT programme could have been assured by the government.

  • It is an utmost necessity that longer duration has been considered applicable for the completion of a project of such high end complication
  • Given the fact that the nature of the industry is semi-autonomous, there is a requirement of the fact that the preferences of the healthcare professionals and the patients had to be taken into consideration. The inclusion of local preferences and user preferences is of prime importance
  • The development of a proper business case evolved in the IT infrastructure assignment highlighting the essential objectives of the project should have been prioritised which would have avoided the existence of confusion
  • The use of risk management plan with mitigation strategy would have equipped with the information of knowledge loss in the case of major replacements
  • The use of proper communication system is of incremental value as well because, at the end of the day it is the user’s involvement which would determine the success range of the project
  • According to the research on the project of IT infrastructure assignment, the aspect of confidentiality should not have been ignored at any cost because every patient is extremely cautious and conscious about their health records and nothing should be compromised at any cost
  • There should have been a prudent choice from the side of the government about the choice of the supplier count, which should have been kept at minimum to avoid all kinds of difficulty with the work

9. Conclusion
The report on IT infrastructure assignment generated above provided with substantial amount of knowledge about the essence of different complications and analysis of the causes that led to the failure of the project. The eventual outcome was that there was less consideration from the side of the government in terms of planning and consultation that led to the downfall of the project. The cost overrun was a resultant factor because of the complications involved in the project. Meanwhile, it was found in this context of IT infrastructure assignment that there was a lack of consideration for an authentic communication process that would have generated maximum amount of benefit for the project. There was a lack of cooperation and understanding of the complexity in the infrastructure that resulted in delays and failure of the entire project examined here in IT infrastructure assignment with a huge loss of taxpayer’s money.

Reference List
Bcs.org. (2013). Stakeholder involvement in NPfIT. [online] IT infrastructure assignment. Available at:https://www.bcs.org/upload/pdf/nsg-itin-volume16-jun04-news.pdf [Accessed 4th Oct, 2019]

Bond, C.S., 2015. Innovation in health informatics: much is underpinned by eHealth and better information for patients. BMJ Health & Care Informatics, 22(4), pp.i-iii.

Brocklehurst, P.R. and Speight, P.M., 2018. Screening for mouth cancer: the pros and cons of a national programme. Br Dent J, 225, pp.815-819.

Campion-Awwad, O., Hayton, A., Smith, L. and Vuaran, M., 2014. The National Programme for IT in the NHS. A case history.

Clarke, A., Watt, I., Sheard, L., Wright, J. and Adamson, J., 2017. Implementing electronic records in NHS secondary care organizations in England: policy and progress since 1998. IT infrastructure assignment British medical bulletin, 121(1), pp.95-106.

Cresswell, K., Morrison, Z., Crowe, S., Robertson, A. and Sheikh, A., 2011. Anything but engaged: user involvement in the context of a national electronic health record implementation. Informatics in Primary Care.

Currie, W.L., 2012. Institutional isomorphism and change: the national programme for IT–10 years on. Journal of Information Technology, 27(3), pp.236-248.

Fitzgerald, N., Platt, L., Heywood, S. and McCambridge, J., 2015. Large-scale implementation of alcohol brief interventions in new settings in Scotland: a qualitative interview study of a national programme. BMC public health, 15(1), p.289.

Hendy, J., Reeves, B.C., Fulop, N., Hutchings, A. and Masseria, C., 2005. Challenges to implementing the national programme for information technology (NPfIT): a qualitative study. Bmj, 331(7512), pp.331-336.

Jane, L.C.C., Chi, T.Y., and Zhiqiong, S. (2017). The Worst Fiasco Ever: Britain's National Health Service's National Programme for IT (NPfIT). IT infrastructure assignment [online] Available at: https://janelicc.files.wordpress.com/2017/07/paper-global-it-case-study-britain_s-national-health-service_s-nhs-4.pdf [Accessed 4th Oct, 2019]

Johnson, C.W., 2010. Case studies in the failure of healthcare information systems. available online a t http://www. dcs. gla. ac. uk/~ johnson/papers/AHRQ/case_study. pdf.

Justinia, T., 2017. IT infrastructure assignment The UK's National Programme for IT: Why was it dismantled?. Health services management research, 30(1), pp.2-9.

Leitão, P., Colombo, A.W. and Karnouskos, S., 2016. Industrial automation based on cyber-physical systems technologies: Prototype implementations and challenges. Computers in Industry, 81, pp.11-25.

Omar, A., Weerakkody, V. and Sivarajah, U., 2017. Digitally enabled service transformation in UK public sector: A case analysis of universal credit. International Journal of Information Management, 37(4), pp.350-356.

Pouloudi, N., Currie, W. and Whitley, E.A., 2016. Entangled stakeholder roles and perceptions in health information systems: a longitudinal study of the UK NHS N3 network. Journal of the Association for Information Systems, 17(2), pp.107-161.

Price, C., Green, W. and Suhomlinova, O., 2018. Twenty-five years of national health IT: exploring strategy, structure, and systems in the English NHS. IT infrastructure assignment Journal of the American Medical Informatics Association, 26(3), pp.188-197.

Randell, B. (2014). The NHS’s National Programme for Information Technology. [online] Available at: http://homepages.cs.ncl.ac.uk/brian.randell/Concerns.pdf [Accessed 4th Oct, 2019]

Rotomskien?, R., 2011. Unfolding National eHealth Implementation Processes: Stakeholder Engagement as a key lesson from the National Health Service in England and Wales. Societal Studies, 3(4), pp.1329-1344.

Sittig, D.F., Wright, A., Ash, J. and Singh, H., 2016. New unintended adverse consequences of electronic health records. Yearbook of medical informatics, 25(01), pp.7-12.

Wachter, R., 2016. Making IT work: harnessing the power of health information technology to improve care in England. London, UK: Department of Health. IT infrastructure assignment [online] Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/550866/Wachter_Review_Accessible.pdf [Accessed 4th Oct, 2019]

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