CfH on the brink of new deals with CSC and BT

Tags: BT Cerner CfH Community Contract CSC Cuts GP iSoft London Lorenzo Millennium RiO South

14 Apr 2009

NHS Connecting for Health is on the cusp of signing renegotiated deals with both of its two main regional contractors, Computer Sciences Corporation and BT.

CfH says “agreement has been reached” with both suppliers. But while the final ‘Penfield agreement’ with CSC has been signed, the agreement with BT is understood to be a non-binding Memorandum of Understanding.

The two deals are intended to ensure that the struggling local service providers can successfully deliver iSoft’s Lorenzo and Cerner’s Millennium electronic record software to a significant number of hospitals by the end of the year.

Extra money appears to have been found, functionality scaled back in some areas, previous release schedules ditched, and the central concept of single shared system sacrificed in a final attempt to achieve delivery through the LSP model ahead of a 2010 general election.

The deals cover the three LSP contracts CSC holds for the North, Midlands and East of England and BT’s LSP deal in London. Termed ‘Contract Change Control Three’, they are the third major renegotiation of the LSP contracts since they were signed in 2003.

A spokesperson for CfH said: "We can confirm that contract discussions have been successfully concluded with our two main suppliers, BT and CSC, demonstrating their continuing commitment to the National Programme for IT.”

"We are confident that the Lorenzo and Millennium systems can be deployed successfully and will bring significant benefits for NHS patients.”

Officially termed a ‘reset’, the LSP contract renegotiations have, in the case of CSC, been running for almost a year.

E-Health Insider understands the renegotiation of the three CSC deals focuses on reworking the Penfield delivery strategy for the Lorenzo software and concentrating resources on implementations of the initial versions of the software now in use on a small scale in South Birmingham, Morecambe Bay and Bradford.

EHI has learned that development work with NHS trusts has been suspended for later versions of Lorenzo, which was set to include clinical modules such as maternity and theatres from release three onwards. CSC will also continue to provide trusts with versions of older iSoft software, where required.

In London, the new LSP contract is understood to focus on moving to a new delivery model for NPfIT, which focuses resources on a series of stand-alone acute implementations of Cerner Millennium, with more local configuration at a much higher cost than originally planned.

In London, BT is also understood to have negotiated a deal that will see it hand back responsibility for providing new GP systems out of a hosted data centre. The LSP will, however, continue to offer CSE-Servelec’s RiO community system.

BT Group is reported to have examined all options in London, including quitting the LSP contract, unless it could agree a new delivery model. The exit of BT would have left the NHS with just one surviving LSP out of the original four appointed; Accenture and Fujitsu having already departed.

But a clear indication that deadlock had been broken came at the end of March, when BT was awarded a lucrative deal to support eight existing Cerner sites in the South. The eight sites have been in limbo since Fujitsu exited as LSP for the south last May.

BT’s beleagured Global Services Division last year announced a £336m write-down against 15 of its 17 contracts; one of the remaining two is thought to be NHS London. Originally signed in 2003, the deal is worth £996m.

The company is expected to announce further write-downs against the London NHS deal next month. BT Global Services has already slashed thousands of contractor jobs, with further cuts expected.

This raises questions of how BT will deliver new implementations when much of its NHS expertise resided with now departed contractors. The biggest winner of a contract reset in London may prove to be Cerner, gaining additional lucrative implementation and configuration work from working with trusts directly.

Martin Bellamy, head of NHS Connecting for Health and director of programme and systems delivery at the Department of Health, recently said the priority for the next 12 months is to demonstrate that Cerner and Lorenzo can be deployed over the next year in large, complex hospital trusts and provide value to patients and clinicians.

The CfH spokesperson said: “ The NHS is delivering something which no other comparable size health system in the world has managed.

"Most people using the health service, or working in it, agree that high quality, safe patient care depends on shared patient information. The core aims of the National Programme for IT remain, as does our focus on delivering them."

Jon Hoeksma

Reader's Comments

Progress of sorts

14 Apr 09 13:04

How long can this corpse remain on the life support of taxpayer's billions? Any vestige of the interoperability aspirations of the Output Based Specifications are now explicitly abandoned - and hence the entire raison d'etre of the programme. We now have merely a very unwieldy mechanism for installing standalone systems. And slipping in under the radar - the explicit overriding of the 6 month deadline set by the House of Commons Public Accounts Committee. So in summary - the business case for NPfIT has moved on from a supplying gimmicks in time for the May 2005 election... to supplying gimmicks in time for the 2010 election. Does anyone believe it can even do that?

DNR?

14 Apr 09 15:04

Isn't it now eminently clear that this poor patient should be allowed to expire with dignity rather than continue with invasive investigations, limb amputations, organ removal, and expensive palliative care. Perhaps it's time to involve NICE?

P.S. Is the six months review up yet?

On the brink - don't do it !

14 Apr 09 21:04

Self delusional to think this can still work.

Re: On the brink ...

15 Apr 09 08:04

It was delusion to think it would <strong>ever</strong> work. Didn't they look at all the work done by IMG and NHSIA before they embarked on this 6 years of madness?

Understatement of the year!

15 Apr 09 09:04

"The biggest winner of a contract reset in London may prove to be Cerner". Have you only just realised that???

It never could and it never will

16 Apr 09 16:04

I've been reading these web pages for over six years now and I have consistantly made the point that the whole NPfIT programme is completely undeliverable.

It always was and always will be impossible to deliver because:

1) Its over ambitious

2) There isnt a proper business case for it

3) Its not technically deliverable within an acceptable level of operational risk

4) The NHS is not structured to use the system if it existed

5) The system doesnt exist and will take 20 years of development effort to get to the maturity of the 20 year old systems that are already available

6) The project demobilises and disenfranchises the existing IT infrastructure and replaces it with contractors who have no long term investment in its future

7) The project is predicated on a mistaken belief that the reason why the NHS doesnt have 'advanced' IT systems is because it's current IT staff couldnt or (for some obscure and never stated reason) dont want to introduce such systems

The people in charge of this farce have a vested interest in keeping it going, they wouldnt get the same salary in the real world. So expect more tripe.

In the mean time, us normal IT folk in the NHS will continue to do the best we can while the various dunderheads above us flail around in the ususal NHS management fasion. However if I go to one more conference where I am patronised by a youth who, covered in fresh paint, crows to me about how he can improve hosital computer systems or even worse a Doctor who thinks he has the slightest clue about IT, I am going to buy a snipers rifle.

Re: Never could be ...

16 Apr 09 17:04

Interestingly - if my memory serves me right - that was the main conclusion of ERDIP and also why the programme didn't rush into progressing its workstream on delivering the "EHR" back in the early 2000s. And how right they were!

What a pity the Granger Programme hasn't exercised the same degree of intelligent restraint.

Really?

16 Apr 09 20:04

"The CfH spokesperson said: “ The NHS is delivering something which no other comparable size health system in the world has managed."

Interesting use of the concept of delivery.

A slip of the pen?

17 Apr 09 09:04

Surely, what they meant was: "The NHS is mismanaging something which no other comparable size health system in the world has attempted."

In response to 6...

17 Apr 09 19:04

Ah Yes,

And you just know the next phrase that will be trotted out....

"Lessons will be learned"

which really means

"We will now learn the lessons that NHS staff did years ago"

I weep

What happens to the NHS obligations?

maryhawking@tigers.demon.co.uk

18 Apr 09 20:04

The board minutes of Yorkshire and the Humber SHA frequently refer to the contracual requirements for fulfilling quotas for the purchase of LSP products in order to prevent financial penalties to the NHS for failing to purchase a sufficient volume - even if the secondary care product wasn't available.

Will the re-negotiation remove this obligation - which may only apply to the North East?

If it doesn't, and Foundation Trusts are not obliged to take LSP systems,will the full cost of poorly functioning secondary care systems *not* purchased by secondary care - with good reason - be borne by the PCTs? In other words, by primary care?

I appreciate the ineptitude of the original LSP contracts: is there any hope that the renegotiated contracts will have removed some of the inanities?

"Data model that nearly killed me"

20 Apr 09 10:04

You may be interested to read this article by Joe Bugajski at

www.syleum.com/2009/03/17/healthcare-data-model/

He is a professional in enterprise architecture, data access strategies, application engineering, and information integration and quality, to name but a few.