CSC and Fujitsu NHS contract resets continue

20 May 2008

Negotiations to reset the local service provider contracts in the North, Midlands and East of England, plus the South of England have still not been finalised.

E-Health Insider learned this week that a 6 May deadline for the completion of the contract with LSP Computer Sciences Corporation has passed unmet. Both Connecting for Health and CSC told EHI this week the contract reset had not yet been signed.

A memorandum of understanding on the new CSC/CfH contract was agreed in early March.

A board paper from North West Strategic Health Authority (SHA) says it has “achieved the inclusion of ‘interoperability’ i.e. exchange of patient data between existing GP systems and Lorenzo as a key strategic change in the contract”.

The reset contract will also focus on a agreeing a new “outline implementation plan (OIP) for all organisations up to 2016, based on new Lorenzo 4 releases”. It will in addition set a sechedule for roll out of maintenance release updates to existing iSoft patient administration systems (PAS).

Delays in the delivery of PAS maintenace releases by iSoft and CSC are said by the SHA to be causing problems “the delays in this area are now impacting on several areas of our detaield delivery plan”.

The impact of the delays in software delivery and the contract reset in the North, East and West of England is shown in deployment statistics from the NHS North West show, which show that during March no new systems were deployed in the area by CSC.

In addition to delays in the North, East and West of England, there has still been no announcement about the stalled contract reset with Fujitsu for the South of England which has been underway for ten months.

In late March health minister Ben Bradshaw said further development of the Cerner Millennium product remained on hold until deadlocked contract negotiations are resolved.

“The development of the Cerner Millennium by Fujitsu in the South of England, where eight hospitals are using the Release 0 version of the software is the subject of a current contract reset.”

The reset process, which began in July 2007, set January 2008 as the deadline for negotiations between Fujitsu and the Southern Programme for IT to be completed.

Reader's Comments

NW SHA common sense

20 May 08 21:55

It's hard to imagine that the transfer of existing GP systems data into any new system to be introduced wasn't in the original LSP contract - one can only hope that this 'detail' insisted upon by the North West SHA is built into any and all future contracts.

No fig leaves

21 May 08 10:39

If these contracts had any traction to protect the NHS, then they should be way past termination by now.

Those hospitals in the South who have taken Cerner have been moved significantly backwards. Those awaiting NPfIT have been held up by empty promises. Those who continued to develop their existing local solutions, in disbelief that the CfH/LSP model would deliver anything worthwhile, appear to be in the best position, though planning and financial blight has been a problem to them too.

That the apparent aims of the NHS and the LSPs are irreconcilable is no surprise. Time to call time. We always thought the emperor was bare.

Delays can only be good news for Bath and Royal Free

21 May 08 21:39

Any delay must be good news for Trusts. Southern Cluster CERNER R0 requires significant additional ongoing costs to run the business (patient care) at the same capacity i.e. is inefficient and ineffective and costly in time and staff. Barts has suffered the fate of other Southern Cluster R0 sites, in getting the unmodified, glitch rich R0 product, when another Trust in London after years of hard work has already dealt with these problems, found solutions and has a useful product for patient care and billing. Lessons were not learned. The only way ahead is to abandon centralist control and the middle men (Fujitsu and BT) and allow client Trusts and providers to work closely and flexibly together, only using a central process to share good practice. And those who wrote and signed the contracts and did not learn the lessons from the pilot site in London must question their own management abilities and act appropriately - some chance! So delayed contract reset must be good news for Bath and the Royal Free - be wise, do not go live with Southern Cluster R0! A wise CE will not use a product without a good robust contract, especially after other Southern Cluster R0 experiences.

Apparently it didn't have to be like this

22 May 08 20:29

If you read the original Tony Blair briefing, whilst the (I'd suggest mistaken) belief in big companies being partners rather than suppliers was there, the potential to use standards and allow diversity was too, and the warnings about big projects going wrong were clear.

http://www.wikileaks.org/wiki/Tony_Blair_2002_NHS_IT_briefing

Interesting that the PM was briefed to make it "go even faster", and shame on those who turned this unique opportunity into the mess we are lumbered with.

Existing GP systems data transfer and Darzi

nhstechie@btinternet.com

25 May 08 17:10

Not really surprising this wasn't in the original contract. At the time the NPfIT contracts were written in 2003 GP systems used disparate messaging standards and GP to GP messaging was just a glimmer in someone's eye.

Delaying the CSC contract announcement may have something to do with the timing of the Darzi and Swindells report. I'm sure Swindells mentioned in passing the need to get these aligned from the stage at HC2008. Agreeing and announcing a new LSP contract a few weeks before the requirements might change wouldn't be very clever, would it?

It didn't have to be like this - revisited.

25 May 08 17:35

The pressure to deliver more quickly came from Blair, not his advisors. Tony Collins pointed this out in his article linked from the wiki link above. Quote "Tony Blair repeatedly sought to shorten the timetable for the NHS IT programme in a move that would have brought results for patients in time for a general election in 2005, Computer Weekly has learned. " Anyone working at a high level within NPfIT at the time should be able to attest whether this is true or not.

Could it be a coincidence that the original timescales for the first go-live of all the "strategic LSP solutions" were originally contracted for May 2005 when the contracts were signed off?

This was a PM who couldn't (or wouldn't) recognise the difference of complexity between scheduling life or death healthcare interventions and booking a flight through EasyJet for a stag night in Prague. Perhaps the best efforts of a range of people from Patterson through Hunt to Granger to explain this simply weren't enough to get through to this most Presidential of Prime Ministers whose mind was set on the goal of achieving a second term in office?

Layer on top of that the "Choice" agenda which converted a simple eBooking system designed to meet a genuine demand from GPs and patients to be able to book local or regional hospital appointments at the patient's convenience into a bureaucracy designed to deliver "Choice" and perhaps you can see why things inevitably went wrong, despite the best efforts of those of us working within NPfIT/CfH at the time.

Apologies for the anonymous posting, Granger may have gone but the real power within HMG remains in place!

It didn't have to be like this - reafirmed

28 May 08 07:50

I dont know what role your previous correspondent held in NPfIT during the negotiations, but I dont recognise his (her?) description of the organisation I worked for at the time, which seems to be one of the sensible voices of Granger and Hunt being overridden by TB dictating the detail of how NPfIT would work. TB's government was notoriously lax on detail and my recollection was that the mandate said only 'deliver some results ASAP, if not sooner'.

Those contracts were doomed to failure. Not only that but at least 1 procurement expert (who i spoke to at the time, and who was subsequently got rid of) did point this out. He had come from the defence field, where the proscriptive contracts defining in detail the number of systems to be deployed have been demonstrated time-and-again not to be deliverable. The reason is simple: almost as soon as the contract is signed, the technology it describes is out-of-date and the contract has to be revised. The MOD has learned lessons from this. CFH and DH have not

Worse - so far as it is possible to determine in this most opaic of processes - those same people are continuing to make exactly the same mistakes in exactly the same ways all over again

Belated response ...

02 Jun 08 00:34

Apologies, in my posting above I wasn't trying to imply TB had any interest in, or grasp of, the detail - quite the contrary. He was simply interested in the unrealistic timetable, itself dictated by political ends. Anyone within what became CfH who expressed the view that the timetable or the underlying business or architecture models were flawed didn't last long.

I probably left at about the same time as your acquaintance as did so many others, ironically many of them emerged as "NHS domain experts" employed by the NASP and LSPs!