The NHS and Fujitsu are expected to sign a new memorandum of understanding as they continue to renegotiate important parts of a £896m contract signed under the NHS’s National Programme for IT, NPfIT, in January 2004.
The two sides were expected to have concluded talks at the end of March, with the result that Fujitsu would either quit its 10-year contract on the NHS’s National Programme for IT, or sign a renegotiated “contract reset”. Computer Weekly has learned that the contract reset has not yet been signed and the two sides are to enter into a new Memorandum of Understanding for 90 days.
A previous memorandum of understanding was signed in July 2007 and expired on 31 January 31 2008, with the result that the two sides reverted to the original, obsolete contract.
The new MoU may allow some trusts to resume NPfIT plans which were put on hold because of uncertainties during the contract reset.
The MoU will expire at around the time the Department of Health announces the results of two reviews into the NHS. In 2007 the Health Secretary asked Lord Darzi to conduct a “once in a generation review” of the NHS which is due to be published in June 2008.
Lord Darzi has said that “more work is now needed to ensure that the Connecting for Health programme delivers real clinical benefits and I will be considering in the second stage of my review how best to achieve this.”
The second review of the NPfIT is by Mathew Swindells, director general, information and programme integration at the Department of Health. He is working on an NHS “Informatics Review” with David Nicholson, Chief Executive of the NHS, and Hugh Taylor, permanent secretary at the Department of Health.
In recent weeks the talks between Fujitsu and the NHS have focused on closing a gap of hundreds of millions of pounds, the gap representing the difference in price between what the NHS was prepared to pay for changes, and the price sought by the supplier. That gap has narrowed significantly but by no means completely. It appears the NHS will have to forfeit some of its requirements and Fujitsu will charge extra but not as much as some officials had feared.
What won’t be centrally funded in the contract reset? Wiltshire Primary Care Trust has reported that “under the current Contract Reset initiative the options for the delivery of Community Health Systems are limited”.
“The current proposal from Fujitsu offers the Cerner Millennium product as the core community system, with the option for Primary Care Trusts to adopt the RiO system (for an additional cost) to support Community peripatetic workers in line with the London programme model.
“It is clear from the product road map that full functionality to support community health models will not be available prior to 2010, and on past performance this is an ambitious timescale. There is wide recognition from PCTs across the Strategic Health Authority that this will fall far short of their business requirements.”
If Fujitsu signs the contract reset the NHS is likely to get some important concessions, but it’s unclear whether these will be enough to win the hearts and minds of clinicians.
NHS South Central reported in February that, against the background of the Audit Commission’s having undertaken a review of the NPfIT – the second in the same financial year – there were several “very challenging issues”. These included:
– the “risk that opportunities for clinical engagement on the contract reset and any revised approach are limited”.
– although the Southern Programme for IT Management Board is the decision-maker in respect of the specification and scope of the ‘contractors technical solution’ linked to the contract reset process, the Management Board does “not have the authority to ensure its achievement in practice and is limited to making recommendations”.
– if the agreed technical solution from contractors is greater than the financial envelope it “may still not go ahead unless the Treasury agrees additional funding on terms that remain in line with the original OJEU procurement”.
-although governance arrangements are clear at the strategic health authority level, for higher tiers there is less clarity. “The SHA needs to cover itself, bearing in mind it has no rights under the contract, by clarifying governance and decision-making arrangements.”