Papers obtained under the Freedom of Information Act reveal risk of compensation claims
The NHS is in danger of not meeting its commitments under the multibillion-pound contracts signed by the health service's chief executive Nigel Crisp, according to papers released under the Freedom of Information Act.
The contracts were between Crisp and the multinational computer companies that were appointed local service providers (LSPs) to the national programme for IT (NPfIT). They bind the NHS to provide about 200 staff on loan, free of charge to LSPs, to help them make a success of the NPfIT.
The LSPs expect top-tier staff, such as IT directors, change management specialists, project managers and business realisation professionals, to join them. But local NHS organisations have so far been unable to provide sufficient people to the companies.
A failure to do so could leave the NHS in breach of contract and liable to pay millions of pounds in compensation to the LSPs. In total the contracts under the NPfIT are worth more than £6bn.
The health service faces a general shortfall in IT skills, which board papers from trusts around England reveal is seen as one of the principal risks to the successful delivery of the national programme.
The director general of NHS IT, Richard Granger, has said about 10,000 skilled IT staff from the private sector are needed to implement the NPfIT. Yet papers from local NHS boards of directors show that significant numbers of NHS IT staff have already left to join LSPs, the national programme or other organisations associated with the NPfIT.
The staffing issue also highlights the risks to NHS trusts of clauses in contracts they were not involved in negotiating or signing and have not seen.
A paper for a meeting of directors of the Bristol South and West Primary Care Trust on 24 February said, "No NHS staff in the Southern Cluster have been allowed by the NPFIT to see the contracts the NPfIT has signed with Fujitsu Alliance [their LSP]."
The released papers show that some NHS organisations are now calculating the potential cost of meeting claims for compensation from suppliers for not supplying staff. There are also discussions within the NHS over where liability would lie with hard-pressed trusts fearing their budgets could be raided to pay compensation.
The NPfIT has set up a "supplier attachment scheme" to encourage employees to join the local service providers. Despite this, the shortfall in NHS people joining suppliers remains - in part because employees earn only health service salaries but work alongside supplier staff who may in some cases earn more than twice as much.
One paper released to Computer Weekly by South Devon Primary Care Trust under the Freedom of Information Act said, "Take up of the supplier attachment scheme has been slow to date, raising concerns about the financial impact on the Cluster, and its constituent organisations."
In the North West and West Midlands NHS organisations are expected to provide local supplier CSC with up to 50 staff. The company has taken on one part-time and two full-time IT professionals under the scheme.
Suppliers and NHS organisations are trying to overcome the problem. CSC said it did not want to invoke penalties on the NHS. Fujitsu, the LSP in the south of England, declined to comment. Both organisations have offered flexible working arrangements for NHS staff that join them on a temporary basis.
In the South Devon area, NHS managers are considering hiring clinical analysts who could join the LSPs. Minutes of the South West Peninsula Programme Board in January said clinical analysts were being recruited and there "may be the opportunity to fill some of the managed employee positions as part of that process".
But as the fight to meet contractual obligations to fill posts continues, internal discussions are under way about where liability for any shortfall lies.
The NPfIT shows no sign of directly shouldering the responsibility. Separate minutes of the South West Peninsula Programme Board, released to Computer Weekly, said, "It was noted that the NPfIT has suggested that this liability rests with the Southern Cluster, and thus is a potential financial risk to its constituent NHS organisations."
Commenting on the uncertainty over staffing, an NPfIT spokesman said major projects consume large amounts of IT human resources, and that there was a shortage of talent available within healthcare IT generally.
"In total, the national programme has a requirement to place some 200 NHS IT staff with the LSPs. The requirement is different across the clusters, the exact nature of the skills and posts required is not yet defined by each LSP and therefore not all posts are filled.
"The initiative has great merit in ensuring that valuable NHS knowledge is available within the LSPs and has also helped to lower LSPs' costs. There is currently no contractual dispute on this issue and, in the context of an enormous programme, it is unlikely ever to become a significant financial or contractual matter."