I have to wonder how they've managed to spend so much money on this system, it's unbelievable but I can see how the budget has spiralled out of control. It's actually reminiscent of the out-sourcing era when big companies would ship their development to countries such as India. Most of them have now realised that the costs get out of control as they have to make constant revisions of the software because it follows the spec too tightly.
Developers get out of your Ivory Towers, you need to be Business Aligned. No that's not fancy business speak, it simply means you have to work with the people who make the business. In the NHS that would be the Doctors, Nurses, Clerks and so on.
I'm fortunate to work very close to the Business and a lot of feedback goes both ways. This means that very little time is wasted developing useless solutions. Yes I have thousands of lines of code that I'd love to review and re-engineer in to a super solution but I don't because we have something that does the job. It's not such a mess that you can't extend it sensibly but it's not perfect. Evolution has shown us that there's no such thing as perfection, if you grew to live perfectly at 20 degrees celsius then your species wouldn't last 10,000 years due to global warming/cooling.
Sorry bit of a rant!
Management is supposed to be a facilitating layer between the ivory tower world where the code gets built and the business world where it gets used. It's always helpful to have overlap between those two worlds, but management needs to coordinate it.
From what I've seen of the NHS, management isn't their forte. Neither is making people un-sick, so I don't know exactly where their talents lie.