Trust chief execs pressed to buy NPfIT systems from CSC or BT?

Are trust chief executives being subjected to pressure through personal contracts to buy from CSC or BT?

Health officials are pressing the boards of NHS Trusts in the south of England to buy from BT or CSC, which are out-of-area local service providers to the National Programme for IT [NPfIT].

The pressure comes after the announcement of the departure from the programme of Fujitsu, the NPfIT local service provider in the south.

But the pressure is being strongly resisted by some boards of foundation trusts which have more freedom than other trust boards to buy what they want, provided they make a good case for doing so.

The pressure is coming from some executives at strategic health authorities who are asking NHS trust boards in the south of England to buy from one of the two remaining local service providers, BT or CSC. BT sells the Cerner Millennium Care Records Service and CSC the “Lorenzo” system from CSC.

SHAs have taken over part of the responsibility for the NPfIT from NHS Connecting for Health under the NPfIT Local Ownership Programme – NLOP.

If most trusts in the south buy from BT or CSC, it could push to the fringe the idea of choice for hospital boards. NHS Connecting for Health’s Additional Supply Capability and Capacity framework deal allows NHS trusts with strong business cases, and which are prepared to fund the purchase without a Whitehall subsidy, to have mini-competitions and invite bids from a range of suppliers without having to go through full EC tendering procedures. 

Before the announcement of the withdrawal of Fujitsu, trusts were under pressure to buy from the local service provider, in part because it could levy contractual penalties – non-deployment charges – against the Department of Health if hospitals failed to install LSP systems. That’s no longer the case in the south  – because Fujitsu is working out its notice.

Now the pressure on chief executives of trusts to buy from CSC or BT may be partly political.

I asked NHS Connecting for Health whether the chief executives of trusts have in their personal contracts financial incentives to meet obligations under the NPfIT.

The question had to be repeated when CfH did not answer. Then the response was that my question had been passed to the Department of Health – which decided not to respond.

In answer to the question of whether trusts in the south are being put under pressure from the centre to make commitments to buy Lorenzo or Cerner, a spokeswoman for Connecting for Health said “no”.


There are suggestions that some boards of NHS trusts, which are understandably cautious, are at odds with their enthusiastic chief executives who want to go live with NPfIT systems earlier than some directors would like. Politics shouldn’t come into it. Trust boards should go live when they’re ready, and when the staff are ready, and when the product is ready. It’s even being said that some trust boards are under pressure to go live with very limited, reduced-functionality NPfIT systems, with small numbers of end-users, which would enable ministers to continue to claim that implementations are progressing well.

It’s a pity that the programme has become so politically sensitive that boards may go live prematurely with NPfIT systems – or with systems that are of little consequence. It may be worth remembering that the main purpose of the national programme was to make a difference to patients rather than ministers or senior officials.


Guidance for Foundation Trusts on co-operating with the NPfIT – Monitor [the regulator for Foundation Trusts] document

Guy’s and St Thomas’ NHS trust steps ahead of NPfIT – Computer Weekly, 2007 

South may be split between CSC and BT – E-Health Insider

NPfIT lessons from South Africa – June 2008