Health officials are considering plans to double the amount of
money spent on go-lives of new systems at large hospitals under the
NHS National Programme for IT (NPfIT).
Computer Weekly has learned that health officials in London and
their lawyers have been discussing a new delivery model for the
NPfIT in London which would increase by between 200% and 400% the
amounts spent on installations of the Cerner Millennium system.
Ministers want to speed up the roll-out of NPfIT systems,
particularly in large hospitals. But trust boards are wary after
the installation of the BT Cerner Millennium system at several
London hospitals
hit the care and treatment of patients - and the go-lives cost
millions of pounds more than trust boards had expected.
Doubling the money for each implementation of the Cerner
Millennium system would encourage more trusts to go live. It would
allow dozens of extra staff to be on hand in case new IT slowed
down the running of hospitals or caused severe disruption.
The extra money would also ensure BT remains in the NPfIT as the
local service provider to NHS trusts in London.
The Department of Health cannot allow BT to quit, as the NPfIT
would then have lost three of its four local service providers and
would be perceived worldwide as an unmitigated failure. BT has run
up hundreds of
millions of pounds of losses under the NPfIT.
As a further encouragement to BT, officials have given the
supplier a generous settlement - worth at least £120m - to supply
some NHS trusts in the south of England with Cerner's Millennium
and maintain systems that had been installed by the outgoing local
service provider Fujitsu. No single company will take over
Fujitsu's contract in the south.
Another incentive to keep BT in the programme is giving it a
deal to supply the
Rio
system to primary care trusts throughout the south of England. Rio
has proved a popular choice for trusts, whether they are taking it
through a local service provider or are buying it outside the NPfIT
directly from supplier CSE Healthcare Systems.
Already each go-live in a large hospital under the London
Programme for IT costs much more than pre-NPfIT installations of
patient administration systems. This is because the original NPfIT
plan was for centrally-bought systems to be integrated and able to
be upgraded en masse.
But those working on the NPfIT say that integration has been put
to one side. Instead, NHS Connecting for Health's priority is for
systems to be installed even if the technology is tailored locally
in such a way as to make integration and standardisation with other
NPfIT systems difficult.
It's unclear, therefore, whether an extra spend on deployments
will represent value for money.
To fund the extra spend officials have considered using unspent
cash on the NPfIT. They could do this without necessarily
increasing the total cost of the contract with BT because the
Department of Health has a "bounty" of four years of running costs
for systems that were not installed by the end of 2005, as had been
expected when contracts were signed.
The plan, if adopted, would commit some of the unspent cash on
the NHS's National Programme for IT, ahead of any change of
government at the next general election.
But there are many uncertainties. In the rest of England,
outside London and the south, local service provider CSC is due to
install dozens of Lorenzo systems by the end of December 2009. It
is unclear whether this will happen.
Martin Bellamy, head of NHS Connecting for Health and director
of programme and systems delivery at the Department of Health, has
said that the top priority for the next 12 months is to demonstrate
that Cerner and Lorenzo can be deployed over the next year in
large, complex hospital trusts and provide value to patients and
clinicians.
NHS Connecting for Health made no comment.
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