The Biggest Computer Programme in the World…Ever!’: Time for a Change in Mindset?

Abstract

In this paper we offer a critique of The National Programme for Information Technology’ (NPfIT) currently being undertaken in the National Health Service (NHS) in the UK. We begin by offering a brief introduction to the project. Next, we review the lessons learned from a wide range of experience with IT and business change projects and comment on why changes in the NHS are likely to be harder than in most other organizations. We then elaborate the implications of these ideas and identify potential areas for change, with particular focus on the current guiding mindset that this project is about the provision of a technical infrastructure. We argue that this is, thus far, a technology project and question whether the current strategy is the most appropriate way forward to achieve service improvements. We suggest changes in the underlying mindset, along with the leadership, ownership, metrics and labelling of the project.