Foundation trust forfeits "free" Lorenzo PAS and buys its own

The Chief Executive of Rotherham NHS Foundation Trust has explained why his board is to buy a patient record system on the open market without waiting for the “free” Lorenzo software which is due for delivery under the NHS IT scheme.

Interviewed by Computer Weekly, Brian James said his board is expected to make a decision on a supplier of patient administration and clinical systems shortly, having run an open competitive tender.

The Lorenzo software from CSC, the government’s appointed supplier of IT to trusts in the north of England, is not on Rotherham’s shortlist.

Rotherham’s decision to spend millions of pounds on its own choice of hospital software means it can advance its IT-based modernisation plans without waiting for Lorenzo to be delivered under the £12.7bn National Programme for IT [NPfIT].  Rotherham Hospital is already a top performer in the Yorkshire and Humber region.

The trust’s decision shows that semi-autonomous foundation trusts can buy outside of the NPfIT if their business cases justify it.

In contrast, the boards of most trusts are under more of an obligation to accept assurances of delivery dates given by NPfIT suppliers and Whitehall officials, even when the dates slip repeatedly.

If most foundation trusts buy their own hospital systems it will further undermine the national programme.

Contracts put in place by Whitehall officials give local service providers CSC and BT the guarantee of a minimum amount of business. The guarantee relies on trusts buying the “Cerner” Millennium system in London and the south of England, and the “Lorenzo” software elsewhere in England.

Taxpayers may have to fund compensation or the equivalent to BT or CSC if trusts buy patient record systems elsewhere. 

James said that his board had been unable to obtain firm dates for the delivery of Lorenzo. Originally the trust had hoped to install Lorenzo in 2006/7 but the software has been delayed by several years.
James said: “We did as much investigation as we felt practical as to whether it [Lorenzo] would be deliverable in a form that would be acceptable by 2010 and our assessment was that it would be possible but unlikely.”

Rotherham has argued that its purchase will be an “interim” system –  though there are no plans to replace it within eight years. Interim systems can be bought under the NPfIT but usually only from suppliers which have been specifically approved by NHS Connecting for Health, part of the Department of Health.

James said that the trust’s new systems must be able to link to the NPfIT spine and meet the national programme’s EPR standards.

Asked about the lack of guaranteed delivery dates for Lorenzo a spokeswoman for CSC said: “CSC can’t discuss detailed implementation plans for individual Trusts.”

James has IT strong credentials including a Master’s degree in Health Information Management and executive experience implementing NHS systems. 


NPfIT executives will stand by Lorenzo (come what may?) – IT Projects blog

Newcastle’s break-away trust – “NPfIT was taking forever”

Monitor guidance to foundation trusts on the NPfIT – Monitor publication

Officials threaten trusts who consider bypassing NPfIT – Computer Weekly analysis 

What medical records mean for you

Foundation trusts tender outside the NPfIT – E-Health Insider 

NHS IT Project – what it comprises

Minister confirms low Lorenzo usage – The Register

Doctor attacks NPfIT security