Thursday, 29 January 2009

NHS planning for termination of NPfIT?

Perhaps we will not have to wait for a change of government before we see the termination of the existing NPfIT projects – a little bird tells me that the NHS is already planning for the failure of its LSP projects.

As I understand it, one of the two problem projects still under investigation by BT to decide on provisions against overruns (see my updated post
BT deep losses illustrate NHS IT problems) is their London £966M LSP contract. But at the same time the NHS is still negotiating with BT for BT to take on some of the projects that Fujitsu walked away from last year (although Fujitsu is caretaking the support of these projects until a new supplier is found). My understanding is that BT has not been able to assess its exposure to the London LSP as it is playing hardball with the negotiations over the Fujitsu projects, and linking the London LSP into the negotiations.

In return, presumably to keep up the pressure on BT, the NHS is preparing contingency plans both for the failure on negotiations on the Fujitsu contract and BT walking away from the London LSP contract. If both were to happen, the NHS NPfIT would effectively be over – with CSC the only remaining supplier – currently contracted as LSP for England outside London and the South – and the NHS is (rightly) unwilling to have a single, monopoly supplier.

As I have predicted almost since the NPfIT projects were let, these are projects destined for failure, the only question is when they will fail. It would appear that it may be sooner than I previously thought.....

At the moment, unless an NHS trust has foundation status it has a duty to buy the NPfIT Care Records Service software from its local service provider. But if the LSP projects failed and this mandate were removed, the NHS would need to control/supervise the way individual trusts procured systems so that their vision of truly interoperable access to records across the UK is still achievable.

However, given a free hand, would Trusts purchase the (iSoft) Lorenzo system – a system that is way behind schedule, currently has limited functionality (with promises of increased functionality over the coming years) and a tarnished track record to date – or the Cerner system - that has been a successful product in the US and elsewhere, but has required substantial modification to meet NHS requirements (with more changes yet to come), is a 1990’s developed client/server system without a very intuitive user interface, and requiring massive amounts of training for end users before it can be implemented live.

I’m not sure what the NHS’s contingency plan will be – but I would be looking to ensure that there were at least three potential suppliers of core software rather than just Lorenzo and Cerner – hopefully the NHS might follow some of my recommendations in recent post
How NHS NPfIT should have been procured.

P.S. I recommend the following Holway’s post for further information on BT’s position -
BT Global Services and the NHS - Part 3 – it’s also worth following his links to the Ovum article.

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