Some managers in the health service are struggling to
meet contractual commitments to multinational suppliers of the
National Programme for IT (NPfIT) – and their organisations are
being fined for failing to meet obligations.
There is also evidence that the NHS’s contractual obligations to
IT suppliers, which were negotiated and agreed centrally without
being agreed by trusts, are resented by some local managers.
The disclosures reinforce the case for extended inquiry into the
programme by the House of Commons Health Committee.
Last week health minister Caroline Flint explicitly rejected a
call for the government to commission an independent audit of the
NPfIT.
“We remain confident that the technical architecture of the
national programme is appropriate and will enable benefits to be
delivered for patients, and value for money for the taxpayer,
without further independent scrutiny,” she said.
But in the South of England, the NHS has been unable to meet a
contractual obligation to place the equivalent of about 50
employees with Japanese-owned Fujitsu, and it is to pay £19m to the
supplier to be released from the requirement.
This means Fujitsu will receive compensation to the equivalent
of about £380,000 per NHS employee – but the supplier could have
potentially fined the NHS up to £1.4m per employee over the 10-year
life of the contract if it failed to meet the contractual
obligation.
The £19m to be paid to Fujitsu will come from hard-pressed NHS
budgets.
In the North West and West Midlands cluster, the NHS has a
contractual obligation to place about 50 full-time equivalent staff
with US company CSC, and papers to the boards of trusts show that
managers are struggling to make up the numbers. They face penalties
from CSC of up to £6.9m a year, a total fine over the 10-year life
of the contract of about £70m. The potential penalty is reduced for
each NHS employee placed with the supplier.
The cluster has investigated paying CSC to buy out the
obligation but no deal has yet been done. The obligation is known
as the Supplier Attachment Scheme, also referred to as Managed
Authority Employees.
As a result of the scheme, at least one strategic health
authority has “fined” another NHS body after it failed to deliver
the required number of staff to a private IT supplier.
The minutes of an IT programme board of South Warwickshire Local
Health Community meeting said the local Strategic Health Authority
was “determined to apply the full contractual penalty under
Connecting for Health to those Local Health Communities which have
not seconded appropriate resource” to the Supplier Attachment
Scheme.
But Teresa French, acting chief executive of South Warwickshire
Primary Care Trust, said that penalties should work both ways and
there should be compensation paid to local health communities over
delays in providing software. She asked for this suggestion to be
raised formally in a letter the local strategic health
authority.
The obligation for the NHS to provide 200 staff or man-day
equivalents during the life of the contracts of the contracts to
local service providers was made centrally without the agreement of
all trust IT managers.
Details of the payments to Fujitsu came to light after MP
Richard Bacon, a member of the House of Commons Public Accounts
Committee, asked a series of parliamentary questions.
Connecting for Health, which runs the NPfIT, declined to answer
a range of further questions on the Supplier Attachment Scheme put
by Computer Weekly last month.
The scheme covers four of the five NPfIT regions with BT,
London’s supplier, not a party to it.
The suppliers want higher-grade technical and support staff, but
these skills are also in high demand in the NHS, and managers
cannot force employees to work for the local suppliers.
A particular problem for the NHS is that, under the scheme, its
staff would continue earning only their health service salaries but
would work alongside employees in the private companies who may be
earning at least twice as much doing similar jobs.
It has also emerged that the NHS has failed to meet its
commitments to place minimum orders with local service
providers.
Health minister Liam Byrne said, “The minimum revenue
commitments are spread across the 10-year term of the contracts,
and, in the third year of a 10-year programme, have inevitably not
yet been met.”