Is the NPfIT close to imploding?

Whitehall officials have little idea what to do if the all-important go-live of Lorenzo 1.9 at Morecambe Bay doesn’t happen in the near future.

The Guardian’s website has a long piece on the NPfIT, saying that the programme is “close to imploding, potentially triggering a deluge of legal claims against the taxpayer running into billions of pounds, which could start to emerge weeks before a general election”.

It says that there is intense political pressure from Whitehall now falling on Morecambe Bay NHS Trust and a software “go-live” deadline set for the end of this month. This is some of what The Guardian says:

“Preparatory testing at Morecambe Bay is believed to have failed some weeks ago, though iSoft, the firm behind Lorenzo, last week insisted testing was “on track” and dismissed as “media speculation” suggestions that the deadline was in jeopardy.

“If Lorenzo is not running smoothly at Morecambe Bay in the next two weeks it will send financial shockwaves throughout Labour’s National Programme for IT, potentially forcing profits warnings from iSoft and others. It will also be devastating for the Department of Health, which is locked in frantic contract renegotiations with contractors to keep the project alive.


“Conservatives fear the government is poised to sign a dealthat will allow suppliers to receive payments, or recognise revenue intheir accounts, before Lorenzo has shown it can work in an acute trust.

“Tory shadow health minister Stephen O’Brien said: “Ministers admitnegotiations on the hugely controversial National Programme are goingahead. Not only is this bad news for the NHS, it is highly worrying fortaxpayers. At best it is a last-ditch attempt to tackle a deficit of[Labour’s] own making. At worst, it is an underhand effort to tie thehands of the next government…

“Failure at Morecambe Bay could see the largest regional contractor onthe 10-year programme, US outsourcing firm Computer SciencesCorporation (CSC), come under renewed pressure to book heavy provisionsagainst the value of three £1bn NHS contracts – a move likely to sendthe group’s share price tumbling…

“A Morecambe Bay delay could also push mounting tensions between theDepartment of Health and CSC into the hands of lawyers, as a squabblebreaks out over who should foot the bill for seven years ofunder-performance since the National Programme contracts were signed in2003.

“The government is already facing a reported £700m legal dispute withCSC’s fellow regional contractor Fujitsu after the Japanese consultancyfirm walked away from a £1bn contract to supply and install IT systemsat NHS trusts across the South of England and the West Country threeyears ago…

“As the National Programme moves into its seventh year, the Departmentof Health and regional contractors are trying to thrash out a back-roomcompromise over how to apportion the bill for an army of IT workers whohave failed to deliver – particularly on patient administration systemssuch as Lorenzo at acute hospitals, the most costly element of theNational Programme.

“The government has offered to slash the functionality requirements forLorenzo as well as reduce the number of acute trusts into which CSCmust install the software.”

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Comment:

My understanding is that the Guardian is right in its portrayal of confusion at the centre over Morecambe Bay.

Ifthe all-important go-live of Lorenzo 1.9 doesn’t happen at MorecambeBay in April – and the signs are it won’t –  officials at theDepartment of Health and NHS Connecting for Health are unsure what todo. They have predicated the settlement of a renegotiated contract withCSC on a go-live of Lorenzo 1.9 at Morecambe Bay by the end of March.

Theidea is that CSC and its subcontractor iSoft should receive a paymentof tens of millions of pounds if Morecambe Bay goes live with 1.9 by the end of March. The payment would be a recognition that the system was proven and could go live at other trusts – even thoughLorenzo is being heavily customised for Morecambe Bay.

But Morecambe Bay isn’t going to go live by the end of March. The projected go-live date has shifted to April.

It’snow likely that the forecast date for go-live will shift again andagain: from April to May, then perhaps May to June and so forth. It’soften said that an IT disaster happens a day at a time: a day’s delayturns into a week, a week into a month, and months into years.

Repeatedlyputting off the all-important Morecambe Bay go-live date has thebenefit to NHS Connecting for Health of putting off a day of reckoning: nobody wants to admit that the NPfIT is a failure. 

The truth is, as far as I know, that CfH doesn’t know what it’s goingto do if the Morecambe Bay go-live doesn’t happen in the near future.  

The Lorenzo 1.9 Care Records Service was originally due go live at Morecambe Bay in 2009. This paper by NHS East of England set out the Lorenzo plans in 2009.

**

Mostimportantly, the University Hospitals of Morecambe Bay NHS Trustdoesn’t seem too troubled by the political pressure to go live. ItsChief Executive Tony Halsall says all the right things. 

Asked by The Guardian if he would personally ensure patient safety wasnot compromised by political or commercial pressures to installLorenzo, Halsall said:

“Throughout the entireproject, patient safety has always been our top priority and we havedeveloped a rigorous testing regime as part of the project.” He addedthat deployment of Lorenzo was “progressing at a safe and steady pace”.

Asto The Guardian’s point that the NPfIT is close to imploding, it couldbe said that the original programme has been dying slowly over a periodof years.

The Summary Care Records database is a good idea and it has a high profile nowthat primary care trusts have mailed around nine million leaflets on the SCR scheme to those on the books of GP practices in England.

 But the SCR database is already flawed: the data isprofoundly inaccurate and contains material omissions.

It can be argued that the SCR is a meretricious set of clothes on a corpse.

Links:

NPfIT executives will stick with Lorenzo come what may – IT Projects Blog

Delays with £12.7bn NHS software program bring it close to collapse – The Guardian

Rescue plan to fix NPfIT published – E-Health Insider

Don’t axe NPfIT says thinktank – Smarthealthcare.com

iSoft says it is on track for NPfIT milestone – IT Projects Blog

Confidential draft report on Summary Care Records – IT Projects Blog 

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