Re: Always a "central database"
Getting requirements nailed down is always good, but outsourced projects fail more than in house ones in that scenario. Partially because you're over a barrel at that point with your current supplier, where you either get the wrong thing delivered for (maybe) the original cost, nothing delivered if you can walk away and lose what you've already paid, or pay a premium to change the spec.
The NHS is paying £77m per year (as of 2018) to EMIS and TPP just for patient records systems that probably don't even cover the whole of the NHS. Could build quite a team with that budget!