Why Change? Spreadsheet error delays opening of £150m children’s hospital

A common question when looking at improving an excel based budgeting, planning, forecasting and reporting is why change? The following excerpt, taken from Accountancy Web, highlights how a Scottish based children’s hospital missed 11 opportunities to spot the spreadsheet error which ended up delaying the opening of the new hospital.

A spreadsheet error led Scottish health secretary Jeane Freeman to overrule NHS Lothian plans to open Edinburgh’s new £150m children’s hospital. £16m remedial work and public inquiry are underway.

A report has cited a copy and paste error in a 2012 spreadsheet as responsible for preventing the opening of NHS Lothian’s £150m Royal Hospital for Children and Young People (RHCYP) in Edinburgh.

The RHCYP was the first NHS hospital to be constructed under the Scottish government’s private financing model Non-Profit Distribution (NPD). Private consortium IHSL was responsible for designing, building and funding the project.

The state-of-the-art facility, due to open in July 2019, was postponed due to incorrect ventilation specifications within the “environmental matrix” meaning critical care rooms would not operate at the ten air changes per hour required to control the spread of infections.

So who was culpable?

The erroneous spreadsheet was dispatched for the perusal of three, separate construction firms bidding for the contract. According to the report, one of the firms identified the error and sent corrections, but the firm didn’t win the contracts and the corrections were not noticed.

According to Edinburgh Evening News, an independent tester had also been appointed by both sides who also failed to identify the error.

Independent checks did not discover the issue until after NHS Lothian has assumed responsibility for the hospital and had begun £1.4m monthly repayments.

As a result, the hospital’s July 2019 opening was postponed at the last minute with remedial work set to cost around £16m. A public inquiry has now also been organised. No date for the hospital’s full opening has been agreed yet due to coronavirus restrictions, and is under review.

NHS Lothian commissions Grant Thornton audit

The NHS Lothian audit report, carried out by Grant Thornton, ascertained a “human error in copying across the four bedded room generic ventilation criteria into the critical care room detail” into the correct spreadsheet matrix.

“An error existed over critical care ventilation (and the other four bedded rooms within the hospital) within the versions of the matrix developed first by NHS Lothian (2012) which continued into the versions created by Project Co (2014 onwards).”

The report also points out that a separate mistake had occurred in the environmental matrix in September 2014 which required “ensuites within critical care by Project Co in the environmental matrix [which] was not identified until 2016. However, when the ensuite errors were flagged as incorrect, the air change errors were still not identified.

“It is absolutely staggering that this mistake has had such huge repercussions and was not picked up until after the new hospital had been built,” commented Lothian Tory MSP Miles Briggs. (Edinburgh News)

Eleven missed opportunities

The audit concluded: “Our review identified a collective failure from the parties involved. It is not possible to identify one single event which resulted in the errors as there were several contributing events.”

The report lists 11 missed opportunities (par 46.) where the error could have been identified.

“This must be up there as one of the most expensive typos in history. This has been a catastrophic episode from start to finish,” said Edinburgh Western Lib Dem MSP Alex Cole-Hamilton. (Edinburgh News)

Grant Thornton’s review includes recommendations for NHS Lothian to strengthen it’s “control environment”. Several of these have already been addressed, according to NHS Lothian chief executive Calum Campbell, and “others will be implemented within the agreed timeframes”.

In addition to the £14m monthly maintenance and facility payments for, the private children’s hospital will cost the Scottish government £432m over the next 25 years.