BT document reveals that milestones have been "adversely
affected".
BT's £1bn contract to build and operate NHS IT systems in London
has run into contractual issues only five months after the deal was
signed.
A leaked BT document marked "confidential and commercially
sensitive" that has been widely circulated to NHS executives in
London, gives an insight into the strengths and weaknesses of one
of the UK's most ambitious computerisation programmes.
It sets out plans by BT for rolling out new systems to the
hospitals and GP practices in the capital, as part of the
government's IT-based modernisation programme for the NHS.
BT's implementation plan reveals that there are "a number of
material contractual issues" over the "detailed definition of
requirements and practical deployment not envisaged at the
Effective Date of the Agreement".
It highlights a series of gaps in specifications and uncertainties
which some IT specialists say could jeopardise the successful
take-up of new systems. For example, the paper says there are
"numerous issues to be resolved" in the area of legacy systems some
of which will need to be integrated into the national
projects.
The paper, which went through six drafts before it was issued last
month, reported that system designs have proceeded on the basis of
assumptions, and that some specifications and products not due to
be supplied by BT have been late or outstanding. It referred to
"inconsistencies within contract schedules," and ambiguity and
uncertainty in requirements.
One conclusion of the report is that there have been "delays in
requirements definition and solution design" which have "adversely
affected the interim milestones".
BT said in the report that if its assumptions are proved wrong it
may lead to "further delays in the programme". In explaining the
position on key dates, it said that requirements workshops had
occurred later than planned.
The Department of Health and BT are working to ensure that key
milestones are met and the document states that significant
progress has been made towards some programme goals. It emphasises
BT's aim of moving forward with its plans for London, "without
prejudice to each party's position with respect to the unresolved
contractual issues".
The overwhelming majority of NHS IT specialists support the aims of
the national programme, which involves up to 10,000 people working
on software development. The Department of Health hopes that
teething problems and initial criticism of the programme will be
countered by success with early adopter sites.
A spokesman for the national programme questioned whether Computer
Weekly should publish details of the paper, saying it was an
"out-of-date draft of a document that is work in progress".
However, senior London NHS IT staff have told not allow ourselves
to be diverted from the very important work we are undertaking and
our commitment to make it a success."
The national programme's spokesman said, "The national programme is
confident that it has robust contracts in place for the effective
delivery of systems and services that will support improvements in
patient care.
"It is not surprising when managing a major programme that there
will be issues to discuss. It was always anticipated that the
drafting of implementation documentation would raise issues that
would need debating and resolving. The national programme continues
to be on track to deliver benefits for the NHS, clinicians and
patients alike."
However, MP Richard Bacon, who sits on the Commons Public Accounts
Committee, criticised the rush to sign contracts. "The evidence
suggests that the time spent in preparation is rarely wasted," he
said.
He feared that the desire to sign contracts quickly was "possibly
at the expense of getting things right to start with". Computer
Weekly it is the latest version distributed to them.
Tim Smart, chief executive of BT Syntegra, which is responsible for
the London contract, did not seek to downplay the importance of the
paper.
He said, "Although an internal document, this plan was developed in
conjunction with the London Care Communities and it has been
circulated widely across all our stakeholders in London. It seeks
feedback and represents work in progress."
As the programme advances, issues are identified, discussed,
clarified and resolved in agreement with the customer, said Smart.
"This project is so important for the people of London that it is
bound to attract interest, sometimes criticism but also suggestions
and encouragement. We take note of everything but cannot allow
ourselves to be diverted from the very important work we are
undertaking and our commitment to make it a success."
The national programme's spokesman said, "The national programme is
confident that it has robust contracts in place for the effective
delivery of systems and services that will support improvements in
patient care.
"It is not surprising when managing a major programme that there
will be issues to discuss. It was always anticipated that the
drafting of implementation documentation would raise issues that
would need debating and resolving. The national programme continues
to be on track to deliver benefits for the NHS, clinicians and
patients alike."
However, MP Richard Bacon, who sits on the Commons Public Accounts
Committee, criticised the rush to sign contracts. "The evidence
suggests that the time spent in preparation is rarely wasted," he
said.
He feared that the desire to sign contracts quickly was "possibly
at the expense of getting things right to start with".
BT's part in the NHS programme
BT is the main supplier to the national programme with contracts
worth more than £2bn. As a local service provider, it has produced
a detailed implementation plan of the new systems and when they can
be expected.
The plans provide for a web-based gateway, based on a BEA
Weblogic portal environment running on clustered Sun hardware. This
will help book hospital appointments electronically and will
provide access to a central database of up to 50 million medical
records.
One of BT's main systems is based on an innovative US-based
product, Carecast, which will need to be adapted to the UK market,
instead of Last Word which has an established user base in
London.