Tens of millions of pounds were spent by the NHS on a new system to centralise GP data, known as the General Practice Extraction Service (GPES). However, a furore followed the project’s conclusion because the service was found to have ‘fundamental designs flaws and did not work’. As a result, the Public Accounts Committee (PAC) delivered a scathing review of Atos – accusing it of ‘sharp practice’ and of showing a lack of care with the taxpayer’s money.
It seems though that PAC’s findings may have been premature. A recent Cabinet Office review, requested as part of the conclusion of the Committee’s report on the project, not only determined that no such ‘sharp practice’ could be found, but that Atos in effect went above and beyond their contractual duties.
Such praise from the Cabinet Office is rare indeed, so we determined that our own review of the two reports was called for. What was it that brought each to their conclusions, and what can be learned from them which could be of practical benefit to all – both suppliers and public sector clients alike.
A brief look at the GPES project
GPES was designed to extract data from the four major clinical IT systems used by 8,000 GPs in England, so a single source of data could be used by all for accessing patient information. Initiated in 2007, Atos was brought on board in December 2011 to produce the software required. This was intended to interact with each of the other four systems, which their suppliers had been developing extraction tools for over the preceding years.
The project was, however, plagued by delays and skyrocketing costs. The 2009–10 launch was delayed until 2014, when only two of the eight user organisations had access to the information they needed through the system. And, although the project costs were initially estimated at £14m, these rose by almost a multiple of three in the planning and procurement stage to £40m. The PAC report estimated that a further £5.5m could be added to that figure.
Unfortunately, it was reported that even after all of this additional time and money, the system that was delivered was flawed. It seems it was not adequately tested. However, this lack of appropriate testing appears to have remained unnoticed until after delivery. By the time of the PAC report, it was found that GPES was delivering half of what was originally asked and that query times needed to be reduced and extraction volumes increased.
The Public Account Committee review (2015)
It was clear from the outset of the PAC report that Atos were in for a rough ride. The bold subtitle ‘In their approach to this project Atos did not show an appropriate duty of care to the taxpayer’, says it all.
Under this heading it starts: ‘We are not satisfied Atos provided proper professional support to an inexpert client and are very concerned that it appears to have acted solely with its own short term best interests in mind.’ It continues on to say that Atos admits they would normally have tested the system more thoroughly, but, due to time constraints caused by delays on the project, they agreed with NHS IC to a more limited testing process which did not identify any major issues.
The PAC report went on to say that Atos ‘…may have met the letter of its contractual obligations but took advantage of a weak client by taking the client’s money while knowing full well that the whole system had not been properly tested.’ Strong words indeed.
The PAC report did suggest that Atos has taken responsibility for repairing the system’s flaws, but this seems to come with a question mark in the statement ‘Atos claims it fixed the issues relating to its software at its own expense and that the additional £1.9 million it received while doing so was for additional work related to 15 new features.’
Other comments in the report, such as ‘we expect more from those contracting with government’, and that Adrian Gregory, CEO of Atos, ‘appeared rather indifferent to the plight of the client’, continued the critique of the supplier’s relationship.
The PAC report concluded that the reasons why the system was not fit for purpose, were based on:
- Lack of relevant client-side expertise
- An unusually high rate of staff turnover
- Governance that was not fit for purpose
- Insufficient testing, which should have been end-to-end, but could not be done at the time as other component parts of the system were yet to be completed.
The Cabinet Office review (2016)
The PAC report recommended that the Cabinet Office undertake a full review of Atos and its ‘relationships as a supplier to the Crown’, suggesting that ‘sharp practice’ had been employed by Atos and that this should impact on the government’s general view of a supplier’s duty of care within a relationship with them.
The Cabinet Office undertook an extensive review. It took into account 12 contracts between the government and Atos that had a value of over £500m a year. According to one source, this was 80% of the value of all Atos’ contracts with Central Government.
In the findings from the review, the Cabinet Office concluded that in fact no ‘examples of behaviour that might be described as sharp commercial practice’ could be found.
In fact, across the 12 reviewed contracts, the Cabinet Office paid a rare compliment, saying that in some of those relationships Atos was actually working ‘beyond their contractual obligations to act in the client’s interests’.
They went on to say: ‘It is clear that Atos values its relationship as a supplier to the Crown; it has a comprehensive approach to the governance of all the contracts reviewed and the Atos leadership team shows commitment to its customers.’ Beyond this, the report talks of Atos addressing issues raised in the PAC report and of the behaviours Atos engenders in its workforce through the incentive schemes it has developed to encourage professional support to its clients.
5 lessons to follow to avoid the accusation of ‘sharp practice’
However positive the Cabinet Office report was about Atos’ approach in general, the fact of the matter is that not every project they undertake has been a success, the GPES being one of them, despite what it seems were their best intentions.
There are five fundamental lessons to always bear in mind within your outsourcing or major project relationships to assure fitness for purpose and to avoid the need for a PAC or Cabinet Office review.
- Clarity is king. Develop a formal process that ensures clarity of vision, accuracy of the quantified current position and stated objectives, and the clear and verified articulation of all of this in a form and language most likely to be completely understood by all concerned. Then agree it both internally and with your delivery partner.
- Know who will do what and how to influence them. The stakeholders who provide you with the information you need for your business case development, the in-house team members whose buy-in and support you’ll rely upon and the external suppliers whose expertise and commitment will be vital to the success or failure of your relationship, are just a few ‘use case’ examples of why having the right people with the right mindset in the right roles is so vital. Such planning and motivation appreciation should never be thought of as a one-time consideration. Monitoring the relationships most important to your meeting expected outcomes and adding value through innovation should be an end-to-end process so you can tweak and adapt those relationships accordingly to achieve best results.
- Early market testing. In-house specialist expertise is not always available, and even when it is, there is sense in having others who can be sought out to supply the solutions and review the foundations that your project’s business case is built upon. How realistic are your expectations? Are your expected outcomes achievable? What compromises might have to be made and what will be the results of such compromises? These are just a few of the questions which must be asked of capable external suppliers to help you make the best project and procurement decisions.
- A fit-for-purpose contract. One size does not fit all. Your contract serves many purposes, but chief among them are its capacity to provide strong foundations to drive the ‘right behaviours’ between all concerned – not just penalise the wrong ones. If your contract has been created to present an accurate and clear account of who does what and when to achieve the appropriate results, then it offers guidance that both sides can refer to in order to ensure that they are focused on the goals of the relationship. And if your contract provides defined milestones, KPIs to follow, along with fair, equitable and agreed penalties and rewards for failing to achieve those milestones or surpassing them, then it provides the capacity to monitor and realign that relationship. Remember though, your contract is not a finite document. It should adapt to the realities of your relationship and the environment it is working within, and this requires regular (at least twice a year) review and refinement to stay ‘current’ and aligned with your changing business objectives.
- Intelligent Client Function. Your outsourcing and major project relationships deserve the best management structure so that you can evidence that you are driving really good value between you. In most cases, that involves the development of a team of individuals selected for their business, commercial awareness, specialist domain expertise, their relationship building and analytical talents. This is your intelligent client function (ICF) team, tasked with overseeing the stability and strength of that relationship. It will take a macro view of the project and guide that relationship to achieve the best results, behaviours and commitments to drive maximum value. It will also tap into any threats and risks to ensure that they are recognised, reported on and resolved before they can cause any material damage.
Conclusion
Positive though the Cabinet Office review on Atos may have been, there are some, including those at UK Campaign 4 Change, who suggest that we should always question how reliable civil servants can be at judging the performance of their IT suppliers after the revelations of the 2013 Audit Office report into Universal Credit. This insightful assessment revealed a clear lack of understanding in the Department for Work and Pensions (DWP) of how its suppliers were charging. And if the largest central government department had these issues, then could the same be said of others?
Atos clearly failed to achieve the standards expected of it on the GPES project, but their ‘can do, will do’ attitude and that it seems they listen to constructive criticism and act upon it, obviously counted in their favour with the Cabinet Office. Not every relationship will result in all objectives being achieved, but taking the right diligent approach from the outset will ensure that you give yours the best chance of success.
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