Clinical Informatics

Information System Failures and the NHS


  1. Introduction and Context of Information Systems Failure at large and in the NHS

  2. The definition of Information System Failure

  3. The causes of Information System Failure

    1. Pre-implementation

      1. Lack of research, risk management and long term commitment
      2. The “acceptability” of failures
      3. Lack of user buy-in and ownership
      4. Inappropriate use of technology

    2. During Implementation

      1. Poor communications
      2. Lack of a powerful guiding coalition
      3. Lack of change management
      4. Lack of short-term win

    3. Post-implementation

      1. Declaring victory too soon
      2. Failure to learn from previous mistakes

  4. Managing Individual and Organisational Change

    1. Management of change and organisational change models

  5. Conclusions

  6. References


Since pre-historic times, the advancement of human civilisation has been led step-wise by the discovery of new technology. The mastery of fire, the invention of the wheel and the steam engine have all led to the increased productivity and further new innovations in all major aspects of society. Today, we now look towards Information Technology and Information Systems with the same expectations.

Indeed, the developments of hardware, software, Internet and networking technologies have all made tremendous progress in the last 30 years. We now have consumer mobile computing power and wireless networking capabilities that would have been more science fiction than reality not too long ago

Context of Information Systems Failures at large and in the NHS

Unfortunately, the implementations of Information Systems both in US and the UK ("UK wasting billions on IT projects", British Computer Society 2004) (1) , in the private as well as the public sectors have been much less successful than expected. This applies to both the implementation process as well as to the expected but unmet gains in productivity that has been expected. Failure seems to be the norm, rather than the exception. The precise figures are unknown but there are research work that suggest that the failure rates ranges from 75% (2, 3) to 98%(4) in the US.

These figures imply that the high profile failures that are widely known may just be the tip of the iceberg.

They include the London Ambulance Service Computer Aided Despatch System in 1992 (5), the London Stock Exchange Taurus Settlement System in 1993 and the CONFIRM booking system in the US in 1992. They cost £1.5 million, £300 million (total spent by all participants) and US$ 125 million respectively.

Other failures such as the Passport Office in 1999, NIRS2 Inland Revenue system in 2000, Child Support Agency in 2003, the Department of Works and Pension in 2004 and the Criminal Records Bureau Criminal Checking system in 2004 suggests that the problems persist despite the increase in available research and guidelines.

In addition, the scale and cost of such projects seems to be increasing at an alarming exponential rate with the latest Connecting for Health project now expected to cost close to £20 billion, which will be about 28% of the total national NHS budget.

To put it in perspective, the total Information Technology expenditure for UK was put at £22.6 billion in 2003 to 2004.


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Page Updated: 17 May, 2017

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