Lorenzo delivery plans now stretch past 2010

18 Oct 2007

E-Health Insider has learned that the latest plans for the delivery of Lorenzo software in the North of England are based on key elements of the software not being available for deployment into the NHS as an integrated solution until after 2010.

Under the revised four-stage plan, codenamed Penfield, order communications tools would be delivered first, followed by a basic PAS, departmental systems and then upgrades. The initial order communications would have to be integrated into existing PAS systems.

The plan is being sold on the basis of it planning for delivery of clinical functionality at a slightly earlier point than the release plan it supersedes.

GP, child health and community systems - which at one stage were to have been the first elements of Lorenzo provided to the NHS - are now not expected until at least 2010. Sources say the date being discussed for the fully integrated Lorenzo is now 2011.

NHS Connecting for Health is now understood to be negotiating with Local Service Providers (LSPs) to extend some existing system contracts by a further three years – trusts would be required to pick up the support and maintenance costs

Industry and NHS sources close to the project say that the latest Penfield plan for delivery of Lorenzo by iSoft, CSC and NPfIT are now based on a release strategy in four parts.

A board paper from West Midlands Strategic Health Authority states: “CSC have put forward a revised release strategy for the strategic software product Lorenzo, leading to software being released to the NHS in four phases rather than two”. It adds that the first release (R1) “will be deployed as early as April 2008 compared with the original scheduled date of June 2008.”

In phase one of the ‘Penfield’ plan it is now proposed that an order communications system be delivered to hospitals, which can be interfaced to existing PAS systems such as iSoft’s iPM, together with clinical documentation – ostensibly similar functionality to iSoft’s existing iCM clinical manager product.

Phase two of the plan would then be to deliver a basic Lorenzo patient administration system. One industry source told EHI the plan was to initially deliver a system that “contains less functionality that iSoft’s existing iPM PAS”. Two dates are being discussed for Phase two, the more optimistic being November 2008, the other is February 2009.

One industry source told the PAS functionality being discussed may not include 18-week wait modules and “will be light on reporting”.

Phase three would be based on delivery of clinical departmental modules for areas including accident and emergency, maternity and theatres. Delivery is being projected in 2010.

Phase four, meanwhile, would be based on delivering upgrades to the previous three phases, including the basic initial PAS. Insiders suggest the earliest this would be available is 2011.

If these forecasts are accurate it suggests full Lorenzo PAS, meant to form the foundation of a Lorenzo-based Care Records System, remains three to four years away. As a result, some acute trusts now have to look again at extending existing systems or interim alternatives.

Sources indicate the proposed Penfield schedule has been already been presented to a number of trusts but affordability is proving a serious issue. “Trusts are finding the business case for installing iPM as an interim system is unaffordable,” one industry source told EHI.

They added that CfH is now “negotiating with LSPs to extend the current system contracts for another three years”, but Trusts will be required to pick up the support and maintenance costs.

The Penfield strategy is the latest in a long-line of plans for delivering Lorenzo that stretch back to 2004, none of which has so far resulted in completion or delivery of the next generation software. One of the procurement principles behind the NHS IT programme, led by NHS Connecting for Health, was claimed to be only buying proven product that had been shown to work after exhaustive expert testing

Both CSC and iSoft have declined to give any details about the proposed delivery dates or functionality to be provided under Lorenzo, other than to state that contract negotiations are continuing.

Some details of recently proposed Lorenzo delivery schedules have been included in recent NHS board papers. According to a September board paper from Yorkshire and Humber strategic health authority, the earliest discussed date for GP, community and child health functionality being made available is June 2009, with deployment not being possible until 2010.

Some encouragement comes from a September board paper from West Midlands SHA which says many aspects of releases one and two of the software have been demonstrated and been “well received” by NHS staff. CSC has recently been demonstrating early versions of the software to NHS staff from a truck in a car park in Leeds.

Jon Hoeskma

Reader's Comments

A truck!!!!

18 Oct 07 21:17

Sorry this did make me laugh. I think CSCA may take offence at you calling their Solution Bus a Truck!!

Penfield or Penfold

19 Oct 07 10:40

Maybe they should have chosen Penfold, rather than the totally forgettable Penfield, as the name for the new four-part schedule. As Dangermouse's sidekick Penfold's code name was Jigsaw because he often "goes to pieces".

A joke surely?

19 Oct 07 10:53

This has to be some kind of joke....yes? iPM as it stands, is not really suitable for most Trusts (no alerts for starters), with everyone having to put in enormous amounts of resource to plug the gaps, so to tell us that Lorenzo PAS has even less functionality is nothing short of outrageous. (Post edited by EHI)

Truck?

19 Oct 07 11:28

Does each trust have to buy it's own truck to run Lorenzo?

The side effects of CSC's failure to deliver Lorenzo?

maryhawking@tigers.demon.co.uk

19 Oct 07 11:37

"Yorkshire and Humber SHA says the mass-migration to TPP route .... while avoiding the SHA becoming liable for penalty payments to local service provider CSC."

So it looks as though these marvellous, efficient, world class organisations, the LSPs - or at any rate, in this case, CSC - *still* cannot deliver the systems promised - and contracted for - in 2003 - but *can* still demand that a certain volume of systems has to be purchased in each Cluster and/or SHA - and that this has not changed since NLOP. http://www.e-health-insider.com/news/3125/yorkshire_and_humber_sha_plan_tpp-based_epr

Result? A strategy to force ( alright, "persuade") 100% of GPs to change to CSC's TPP regardless of GPSoC or practice requirements - and an open statement that this is to avoid the SHA having to pay penalties to CSC for failing to purchase a sufficient volume of "systems" as stipulated in the original contracts!

I don't think this was quite what was intended when the National Program for IT was launched: or was it?

CfH software development life cycles

19 Oct 07 12:04

The NHS is now asked to wait another three years for clinical functionality, some of which was slated for December 2004 delivery in the Output Based Specifications (i.e. Phase 1 Release 2 Which the 2006 NAO report informed us had been rescheduled and fully delivered by the time of its publication).

Even given the necessarily long lead time for electronic patient record system development, ‘after 2010’ is beyond a realistic development horizon. The software industry demonstrates repeatedly that when major novel functionality is promised more than 2 years in advance, expectations are overwhelmingly likely to be disappointed.

Projects succeed by taking many small steps with sharply specified products never more than 18 months away - ideally less than a year. Beyond this plans are typically worth less than the envelopes they are written on the back of.

Down-scoping and 'delays' and NPfIT are not restricted to any one supplier - every other article on this site now documents slippage across the board.

NPfIT from the outset combined the ingredients of untrammeled blue sky thinking, marketing led software development and political hubris. This 'perfect storm' of promises and sound-bites preceded objective feasibility studies - let alone the setting of pragmatic timetables for development, testing, deployment and change management. This storm is proving as inexplicably durable as Jupiter's Great Red Spot.

Unless this culture changes, jam tomorrow will remain the main course on CfH's menu.

A reason for a more mature open approach.

nhstechie@btinternet.com

20 Oct 07 11:21

This whole story demonstrates why CfH needs to adopt a more mature and open approach to communications with its stakeholders - including the tax paying public. Information about Penfold (as we've been calling, for obvious reasons, it since April) is now slowly dripping out of the system and wherever there is a lack of information rumour and conjecture fills the gaps.

Looking on the bright side (hard I must admit) CSCA has now finally admitted that its development and deployment model was flawed and has moved to the phased approach urged by the local NHS back in 2003.

Alan Spour's interview with Jon H is worth revisiting as he was talking about exactly this subject. As well as the long-delayed Order Comms, Release 1 brings a modest element of clinical documentation - not a huge leap forward in the general scheme of things but it will give NHS frontline staff access to the final application and enable early adoptors to influence the look and feel of the product.

There may not be a great deal more functionality in Release 1 than was offered by iCM but it promises to be more flexible to local requirements - which ought to greatly improve usability within the clinical documents.

iSOFT seem to win whatever happens. On my patch many Acutes have legacy iSOFT PAS and Departmental systems which will now generate income for several years compensating iSOFT for revenue lost by delayed Lorenzo development and deployment, surely a perverse incentive if ever there was one?