Below are excerpts from a letter sent last week by Ruth Carnall, NHS London Chief Executive, to all London IT directors and NHS Chief Executives.
The letter makes no apology for the signing of a new NPfIT deal with BT shortly before a general election.
The deal will commit a new government to paying BT for installations of Cerner’s Millennium electronic patient records system – even though the Conservatives have announced that they want to halt and review the NPfIT local service provider contracts of BT and CSC.
Carnall says that as a result of the new deal, which is known internally as Change Control Note 3:
“we now have a firm commercial basis for the New Delivery Model for Cerner”.
Meanwhile The Guardian says that BT’s record on successful delivery of NPfIT systems is “dire”.
TheGuardian says: “The company had been due to install core IT systemsat all major hospital trusts in London by 2005. In fact, it has so farinstalled just five – in some cases throwing patient records intochaos, and deployments since then have slowed to a snail’s pace.”
Carnall’sletter also reveals an official intention to turn the Summary CareRecord into a more comprehensive health record – which will delight someGPs who advocate the wider sharing of medical records, and will angerother doctors who say that medical data on a central system is unlikelyto be kept confidential.
Carnall’s letter says:
“Thepurpose of this letter is to advise you that CCN3 (Change Control Note3) has now been signed with BT. This means that we have a revisedcontract for the delivery of the National Programme for IT in London.
“TheNHS London Pogramme for IT [LPfIT] team has worked tirelessly to securethe best possible deal for the NHS in London, but inevitably with theneed to secure over £100m of savings there will still some financialpressure.
“I know that the LPfIT team have worked hard to keepeveryone informed of their progress and have sought input and advicefrom the wider NHS during this process. I would like to take thisopportunity to pass on my thanks to everyone who has been involved inthis work.
“The signing of CCN3 secures the future for thethousands of users that we have on the systems that are deliveredthrough the Programme.
“At the last count there were nearly50,000 users of RIO and over 25,000 users of Cerner, following itsdeployment at St George’s. Despite the many challenges this puts us wellahead of the rest of the country.
As a result of CCN3 we nowhave a firm commercial basis for the New Delivery Model for Cerner.
Thiswas developed following the challenges faced at the Royal Free, whichhave been used to successfully roll Cerner out at both Kingston and StGeorge’s. This means that we have more flexibility to deliver a locallytailored solution that will meet the needs of the clinicians on theground.
“For RIO users we have secured two future softwarereleases and regular configuration releases, so that we have a route todeliver changes and enhancements to meet local needs.
“The £100mreduction in the available funding inevitably means a reduction in thescope of the Programme. It will not longer be possible to provide thecomprehensive solution that was anticipated in 2003.
“As aresult the provision of GP solutions has been removed and this will nowbe supported nationally through GP Systems of Choice.
“On asimilar basis the nationally delivered Summary Care Record will now beused as a basis for sharing information between care settings in placeof a dedicated London solution.
“In addition to this, Cerner andRIO will not now be available to all organisations. I know that forsome Trusts, a solution delivered through the Programme was not thepreferred route, but for others it will mean a re-think of theirstrategy.
There are other areas where scope has been reduced, forexample, it has only been possible to afford a further 12 month licencefor the use of the Map of Medicine. This will give us time to considerhow to continue meeting the needs provided by this system. The provisionof an ambulance solution has also been removed.
Over the nextfew weeks the LPfIT team will clarify the specific impact of CCN3 onindividual NHS organisations in London and will be happy to meet withyou or your team to have a more detailed discussion.
NHS Londonwill also be further developing the IT enabler for Healthcare forLondon, which will be used to develop a new IT strategy for the NHS inLondon that will help us jointly address the IT challenges emerging fromthe reconfiguration of services.”
Isthe NPfIT in London officially in tatters? – IT Projects Blog
LondonIT Programme slashed – E-Health Insider
TheNPfIT Is Dead. Long Live The Summary Care Record – IEEE Spectrum.
NHShopes fade on records solution – FT.com