Three things came together to prompt this diatribe. First a personal anecdote. I recently needed to get an appointment with a consultant in an NHS hospital. My local doctors' surgery - the very model of process efficiency - did their thing behind the scenes, as they should, and hey presto an appointment confirmation appears. Unfortunately it coincided with my annual holidays so I phoned the 0845 number on the mis-named "Choose and Book" form to get another appointment. Result - they could cancel my current appointment but they could not issue a new one because they "hadn’t received any new ones from the hospital", but I could phone back or even try online at a later date to see if any had turned up. I was stumped by the incompetence of this. That they had a process break down between themselves and the hospital was bad enough, but apparently they couldn't even stack up the list of patients awaiting appointments until they'd sorted out the link to the hospital and then reapply them.
Of course to put the tin lid on it the letter that accompanies the Appointment Confirmation bares the legend "Your appointment has been allocated on the basis of your clinical need." Wrong! It's a lottery based on whether the system has any appointments when you phone up!
And by co-incidence Computer Weekly (Computer Weekly 30th June 2009 page 6) ran an article featuring Christine Connelly the NHS CIO on, amongst other things, NPfiT and Connecting for Health. Seems there is an acknowledgement from the first Gateway review onwards that there was insufficient frontline experience involved in the programme. It was all too much a "Head Office" mind set.
Finally I was talking to a local GP - as front line as you get - and, no surprise, he was pretty dissatisfied with the way he felt the doctor's opinions had been ignored. Now that the system is creaking at the seams, all the users are finding work-arounds to make their day jobs tenable. But in place of a usable system, the heavy hand of authoritarian rule is being substituted, with financial penalties for practitioners who try to circumvent a not working system for the good of their patients.
So what has this to do with Data Migration? Well, here I think I'll be the ultimate narcissist and quote myself:
"The users blame the project for the additional work loaded on them... the project blames the users... for the delays in the project end date. This is reflected in their reports to the project steering committee. This further alienates the user population. Time scales are extended. Functionality is postponed... The end of the project descends into a spiral of mutual recriminations, disappointment and damaged careers" (Practical Data Migration; John Morris; BCS Publishing; May 2006)
Although poor data migration is not obviously to blame (despite rumours) for the poor design choices illustrated, the disconnection between users and designers, the growing mutual mistrust and yawning responsibility gap are all too reminiscent of a programme where business engagement has been neglected to the point of irresponsibility. And, of course, fixing it now is going to be an uphill struggle. No wonder there seems to be lack of people willing to pick up the baton dropped by Martin Bellamy (departing head of the Connecting For Health programme).
As the immortal bard would have it "Vex not my prescience", or, in other words "I could've told you so". You should have known better and you should have done better.
Johny Morris
jmorris@iergo.net
