Post AnP8O9ADv0N7ZHyS24 by tokensane@mastodon.me.uk
 (DIR) More posts by tokensane@mastodon.me.uk
 (DIR) Post #AnP8O2Fzb9pM99cSYK by ChrisMayLA6@zirk.us
       2024-10-26T09:52:51Z
       
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       Here's a Q. for anyone who is employed by the NHS.... in the FT Camilla Cavendish argues this morning that one major contributory factor to the NHS crisis is a failure of management - she sees this as a recurring (and oft-reported) problem....The NHS is a complex organisation that needs better management, but fails to train or attract enough great managers.So my Q. to  NHS-Masto is this:Do you agree that better management would unlock potential improvements in health care?#NHS #health
       
 (DIR) Post #AnP8O3EbxmJhB9ys2S by tokensane@mastodon.me.uk
       2024-10-26T15:58:00Z
       
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       @ChrisMayLA6 I'm a developer, so I want to comment on the IT side of things.Big IT projects *never* deliver a good system on time and on budget. Not just rarely, *never*. At best they make something mostly-functional, but *2 late and over-budget. Reason: its not just the IT you are designing, its the people who use it and the processes they follow. But if you talk to those users they are too busy to give you more than the barest outline of what they do and how. /1
       
 (DIR) Post #AnP8O42axwIbgBMmwq by tokensane@mastodon.me.uk
       2024-10-26T16:01:10Z
       
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       @ChrisMayLA6 Still less are they able to work with you to re-envisage how they are going to work with all the other people in the system, about who's work they know little.Big systems are supposed to be developed from requirements, but those reqs can't be written without understand what everyone does and how, including Jane In The Office who has a big tottering collection of spreadsheets that only she understands. /2
       
 (DIR) Post #AnP8O4shqBz0HnkPAm by tokensane@mastodon.me.uk
       2024-10-26T16:05:19Z
       
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       @ChrisMayLA6 Meanwhile government has a system for big projects: put it out to tender. Trouble is, there are few orgs big enough to tackle such a project, and merely bidding is a big project in itself (I once saw 20 people work for 2 years on a bid, with no guarantee of any contract at the end). Getting The Contract is a "Core Competence". That's why its always one of the Usual Suspects who wins. Ability to do the job is secondary to ability to bid./3
       
 (DIR) Post #AnP8O5cR6AYwZd8vS4 by h4890@liberdon.com
       2024-10-26T16:57:27Z
       
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       @tokensane @ChrisMayLA6 Same in sweden. If you have the lawyers to get the government contract, you don't have to lift a finger for 3 or 5 years and can just take a nice margin off everyone wanting to sell through your company.
       
 (DIR) Post #AnP8O7MuarKi03tYX2 by tokensane@mastodon.me.uk
       2024-10-26T16:08:16Z
       
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       @ChrisMayLA6 Merely bringing the whole thing in-house doesn't fix the problem either. You just wind up with a huge department soaking up money and not producing any visible value while being hated by everyone else. Have you ever seen a corp IT dept praised by its end users? I haven't./4
       
 (DIR) Post #AnP8O9ADv0N7ZHyS24 by tokensane@mastodon.me.uk
       2024-10-26T16:10:46Z
       
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       @ChrisMayLA6 If I had to make one suggestion, it would be for the NHS to focus on defining interoperable standards for health care information, and then let different parts of the NHS get their products from wherever. That way you could have niche products for different departments or specialisms from different vendors, but be confident that they can all talk to one another. If one product doesn't work it can be swapped out. Interface definitions are firewalls for change./end