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Southern NHS trusts get systems of choice

Tags: A   BT   Cerner   Choice   Clinical 5   Community   Connelly   England   Fujitsu   Information   iS   iSoft   NPfIT   South   US  

23 Jun 2009

Southern systems of choiceNHS trusts in the South of England are to be offered a choice of systems and to have them funded as part of the National Programme for IT in the NHS.

Under a new project, the 52 trusts in the South not covered by the contract with BT will get funded 'acute systems of choice'.

The core requirements will be for existing products that deliver the Clinical 5 capabilities set out in last year’s Health Informatics Review.

It is hoped some implementations will occur in advance of the hard November deadline set for NPfIT’s two main software providers, Cerner and iSoft.

In an exclusive interview with E-Health Insider, Christine Connelly, the Department of Health’s director general of informatics, said: “We’ve just begun a procurement of systems for the South.”

The procurement will cover 29 acute trusts, 21 community trusts and two mental health trusts, which will be offered a limited choice using the Additional Supply Capability and Capacity (ASCC) framework catalogue.

John-Jo Campbell, the chief information officer for NHS South Central, has been seconded into the Informatics Directorate to run the project.

“Our intention is to work with trusts and go out to market, to look at what’s available in the market, and evaluate existing product,” said Connelly.

“We will ask trusts to look at existing systems and take a decision on which of those they would like to have, with the view that we will ask [them] to implement this version of the system and [they] can take account of one more release that the supplier tells [them] is coming down the line.”

Connelly made it clear that this was a very different approach to the one with which the National Programme began, which was based on a complex specification that suppliers were asked to meet. “Instead, we’re actually saying to suppliers 'let’s go license an existing product’.”

Connelly added: “One thing that it will tell us is 'do better products exist?'. That will inform our options as we get to the end of November.”

She added: “It will tell us whether the product set in the acute sector are more mature than the products we have in Cerner Millennium and Lorenzo, or whether everyone is at the same stage.”

But she stressed that she envisaged choice would be limited, “We don’t expect to pick 29 different products but a very small number of products. But we’re not pushing to say there will just be one, or there will just be two.”

Asked how quickly trusts would be able to pick product in conjunction with CfH, she responded: “I hope it will be in a few months”. In the case of two mental health trusts, she said she hoped to reach an agreement and begin roll-out quite quickly.

Community trusts will take a little longer and acutes longer still. But she promised decisions on community trusts would not be held up by decisions on acutes.

Connelly added that for hospitals of different scales it may be appropriate to deliver different types of product. “So it could be quite informative to us to work with clinicians on the types of things that matter to them.”

Being able to look at real product will change the dialogue with trusts, she predicted. “We think the quality of the conversation will be better and it will be more colourful.”

Connelly confirmed that, crucially, the systems selected will be funded. “They will be funded as part of the National Programme for IT. We see that as in that portfolio of product we would have expected to have deployed to the South as part of the National Programme.”

She agreed that it would be interesting to see whether trusts choose NPfIT systems suppliers, as a number of foundation trusts procuring outside the National Programme have done.

“If every trust looked at it and said what we want is Cerner, then perhaps we would wait a few more months [beyond the end of November, when a hard deadline has been set for Cerner and iSoft to make progress with their 'strategic' systems]."

Asked whether the Southern Choice Project offered a model that could be applied to other parts of the country if the need arose, Connelly replied: “Yes. Its prudent for us to use the opportunity we have in the South in this we, because it actually informs our choices when we get to the end of November.”

Jon Hoeksma

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© 2009 E-HEALTH-MEDIA LTD. ALL RIGHTS RESERVED.

Readers Comments
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Readers Comments

1

Good News for mental health

bentleyj@registerednurses.com

24 Jun 09 08:24

As a clinician who has had input to Mental health systems for 20 years I am glad to hear this news. Despite the comments from nameless persons to praise the BT Rio system, I am not a fan, and nor are many clinicians from my organisation and otehrs in London. It is not flexible for different organisations, it is very rudimentary from a security viewpoint and will be most cumbersome to change to adapt to the changing NHS environment. I know that there are better systems out there so I really hope that my Mental health colleagues take advantage of this lifeline and fully evaluate all other options with these constraints in mind.


2

More questions than answers

24 Jun 09 13:51

This IS a very different and more rational approach.

However do unrealistic deadlines remain?

>>It is hoped some implementations will occur in advance of the hard November deadline<<

Now "implementation" may not equal "go-live" - and the latter has itself proven equivocal. However one could be hard pressed to deploy an updated version of Microsoft Office across an acute trust inside four months!

Can a clinical system only being procured now be anywhere near a working clinician / real patient to prove itself in service by November? Such optimism is surely contradicted by all experience to date.

The maxim "procure system and sign contract in haste - pay penalties at leisure" is partly offset by buying from systems proven elsewhere rather than from supplier PowerPoints and marketing departments. However "tak[ing] account of one more release that the supplier tells [them] is coming down the line" still gives them plenty of rope to hang themselves if they rush!

>>interesting to see whether trusts choose NPfIT systems suppliers, as a number of foundation trusts procuring outside the National Programme have done.<<

Will an LSP 'equivalent' exist at all in these arrangements? If not - who provides the centralised data stores, spine connectivity etc?


3

Choice?

24 Jun 09 14:08

I am unclear. Are trusts going to be able to make their own choice from the ASCC? Or are they going to get DoH's choice i.e. the outcome of the procurement activity that you report the Informatics Directorate is undertaking?


4

Response to Choice

david.hannam@strandtechnology.co.uk

25 Jun 09 11:36

In response to the comment on choice. The rules regarding choice in an ASCC procurement are fairly straighforward. If we take the example of mental health solutions, should a Trust which to take an alternative system via ASCC their Requirements / Statement of Need documents should be distributed to the 18 suppliers named in the Mental Health Category of Lot 2. The Trust is then free to evaluate all the systems that are on offer from those suppliers and select the one that best meets their needs. All the expert suppliers are named in this category so Trusts will be able to select a best of breed solution.


5

good news but......

cunpr@globalnet.co.uk

26 Jun 09 09:25

This is good news and what secondary care should have had long ago. BUT, the argument that its good because its what GPs have benefitted from only goes so far. GPs have benefitted from choice because we also had a system to force convergence and commonality and thus comparability which eventualy lead to compatibility between systems.

Systems of Choice for secondary care has nothing like that, what it needs to be backed up by is the secondary care equivalent of RFA.

We need choice but without techical / functional freeforall.

Regadrs

Paul C
 


6

RFA for Secondary Care!

26 Jun 09 20:31

For those who don't know:  RFA is 'Requirements for Accreditation' - a set of standards for GP systems, published and updated annually starting from well over 10 years ago (maybe as much as 15).   

The standards covered functionality and gradually became more sophisticated, growing for example to cover EDI. 

Each year's update also gave notice of what would be added in the following year - genius and simple.  (Oh, and they were produced on time.)

They weren't mandated for several years but set a standard against which many FPCs/FHSAs set rules for reimbursement to practices of system costs.  At first they had to argue the toss over NHS-GP finance rules but in time the link of accreditation to reimbursement was made formal nationally.

The whole thing was quietly just got on with by the IMG and the FHS Computer Unit.  There must have been more to it than I saw, but there weren't hosts of expensive consultancies, PR agencies, wrangles (no mentions of 'bullets in the head').  And the whole thing worked:  the annual updates giving - heavens - an incremental approach against an obvious strategy; the accreditation itself giving incentive for a supply of systems of proven worth.

User choice remained, ok with an interest in the choice being one which was accredited, but, hey, accredited systems met standards and, guess what, sold.

Why on earth this approach wasn't taken to secondary care was a mystery to me and my RHA/SHA/Unit/Trust colleagues.  Too simple to impress Mr Blair, perhaps?  Not exactly what B Gates would recommend, not what sharp-suited teams with slick slides would present - oh no. 

 

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