Praise for CIO Connelly's NPfIT plans for the south - but why rush?

All credit to the Department of Health’s CIO Christine Connelly for allowing trusts in the south of England to use central funding to buy from a range of hospital systems.

Her decision puts the Department on the front foot for a change: trusts will be able to buy from a range of suppliers listed in the Additional Supply and Capability and Capacity [ASCC] framework contract, which was let by NHS Connecting for Health.

When Fujitsu was the NPfIT local service provider for the south, the Department expected trusts to buy from that company only. Fujitsu and the DH parted company last year.

But …

Connelly’s decision has a catch: she is insisting that trusts bind themselves contractually to buy systems before the end of the financial year – 5 April 2010. It appears that central funding is not guaranteed after this.

As one commentator on E-Health Insider’s site says:

“I can’t believe that the South …could possibly get together a coherent and credible list of the requirements in terms of applications and timescales of each of the 28 “acutes”, never mind the community and other Trusts, to enable an overall specification of requirements to be produced let alone communicate those requirements and seek, receive, and evaluate proposals from bidders by the beginning of April 2010.

“And where does each Trust’s Business Case process fit into this?”

Shouldn’t Connelly stick to what’s doable?

It would be better for Connelly to choose three or four suppliers of patient administration systems and allow a group of trusts – say six to ten – to install these over the next year and base further deployments on the success or otherwise of these.

As it is, the rush to sign up for deployments flouts the most fundamental tenet of project management: more time spent early on avoids vast amounts of wasted time later.  

Connelly’s timetable breaches the first rule of project management

The insurer Hiscox, which deals with claims over IT project failures, has “commencing work too early” as its number one on a list of 5 common causes of IT project failures.

Hiscox says:

“Commencing work too early

“- Often, both parties are keen to begin the project before the necessary due
diligence has taken place.

“- This can result in problems much further down the line and, in fact, extend, rather than shorten, the length of the project.


Will suppliers cope?

There’s also a question of whether suppliers can cope with large numbers of deployments in the south.

This is indeed a concern of Connelly’s. As part of the National Programme for IT, Connelly held a “market awareness” event for the southern region (South West, South Central and South East Coast strategic health authorities) on 24 November.

Before the event Connelly wrote to ASCC suppliers saying that they will be “required to demonstrate that they have the necessary operational capability, capacity and financial standing to deliver this scope during the procurement process.”

What the new procurements will cover

The ASCC procurements which start in January will cover:

Patient administration systems
Community services
Child Health Services
Urgent Care
Order communications and results reporting
E-prescribing systems
Pharmacy stock control
Screening and surveillance
Integrated care pathway and care planning
Health Care professionals services
Clinical integration and systems integration service
Clinical document management services
Critical care services

Connelly wants only proven technology which works in the UK

Clinical applications, said Connelly in her letter, are required to meet the following critieria (which establish that the applications are already installed and working):

–    currently in clinical use in a modern health system with similar characteristics to the NHS  in England
–    has a future development plan in place
–    has functionality appropriate to the care setting
–    satisfies any relevant integration requirements in terms of integration with a) national systems, b) departmental systems, and c) systems/processes in other care settings

The 40 of so suppliers at the market awareness event were asked to confirm in writing that their products and services conformed to the criteria if they proposed to demonstrate them at the event. The Cerner Millennium system and iSoft’s Lorenzo are among the ASCC options for trusts in the south.

A warning from history

The story of the NPfIT has been one of leaden delays punctuated with bouts of excessive activity and excitement.

Connelly’s deserves praise for her decision to give trusts in the south a choice of their main systems – but the NHS is unlikely to benefit from another bout of frenetic activity which could be a form of chasing phantoms.

Deploying  systems quickly because the money is there now, and may not be after 5 April, highlights one of the differences between public and private sector IT: a private company is unlikely to rush a major buying decision because the money may be taken away otherwise.


Top 5 causes of IT project failures – an insurer’s view based on claims – IT Projects blog

New health IT leaders with joint salaries of 400k – IT Projects blog

I’ve worked for the NHS so don’t tell me to love it – Will Heaven

Kingston hits go-live date with Cerner – E-Health Insider

Health officials accused of censorship over Cerner system – Australian health IT

Attempted suppression of Cerner report – Informaticopia

South asked for buy systems by April –