The decision by Accenture to walk away from its original
£2bn contracts to deliver IT systems to the health service in the
North East and East of England has raised important questions about
the NHS National Programme for IT (NPfIT).
Accenture's work will be taken over by CSC, which already has a
£973m contract to deliver systems in the North West and West
Midlands.
Accenture will continue to supply profitable x-ray picture
archiving and communications systems, which were added as a core
NPfIT service in September 2004.
Health minister Lord Warner said there would be "no significant
delays" as a result of Accenture's decision, adding that it was
"nonsense" to suggest that Accenture's move was a major blow to the
project.
However, questions being raised by health practitioners, IT
professionals and politicians include:
●How will Accenture's withdrawal affect the confidence of
doctors and nurses in the programme? The support of clinicians is
vital if they are to make good use of new systems.
● Does the NPfIT have an architecture that is likely to work?
Core medical records systems have been delayed by at least two
years and an outage at CSC's datacentre, which brought down
services to dozens of trusts, has raised questions about the
resilience of the specifications.
● What assurance is there that the standalone systems being
installed as interim solutions will share key clinical information?
This was one of the principal reasons for launching the national
programme.
Ministers are also likely to face questions about how CSC could
be awarded a contract worth nearly £2bn without a specific open
competitive tender, and about the terms under which Accenture has
withdrawn.
The ability to rapidly replace Accenture with CSC is likely to
reduce delays caused by the contract switch. But CSC's new deal is
worth about £2bn - the price of the contracts signed with Accenture
nearly three years ago, and Accenture has since made thousands of
deployments.
CSC's European president Guy Hains last week expressed
confidence about his firm's ability to deliver in three of the five
NHS cluster areas in England. Yet few acute hospitals have gone
live with CSC's early releases of patient administration
systems.
Accenture has absorbed heavy losses, and it has only had to
repay the NHS £63m in full and final settlement of its legal
obligations under the contract. This is a long way short of the
damages Whitehall executives could in theory demand from suppliers
for an early exit. Without a settlement, the government faced a
long legal dispute with the supplier and, possibly, enforced
disclosures about the programme.
Questions about Accenture's withdrawal are fuelling demands for
the government to publish the reviews it has commissioned into the
NPfIT. There have also been renewed calls for an independent review
of the project.
Tom Brooks of the Parliamentary IT Committee said the withdrawal
made an independent review of the NPfIT more important.
"Accenture's withdrawal could produce a challenge for chief
executives of trusts in the North East and Eastern clusters. If
they consult with their lawyers, they are likely to be told they
are under no obligation to hold to any promises made to take a
service from Accenture."
Steve Webb, Liberal Democrats shadow secretary for health, said,
"This suggests that Accenture may have spotted something coming
down the track. There is so much political credibility resting on
this project that I wonder whether, even if the programme is going
off the rails, the government will simply continue to pour money
into it."