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NEWS


Not much new can be said about the problems with the National Programme for IT – but it is important now to look to the future, the Government insists. Adam Hewitt reports.


CSC could get more time to deliver iSoft’s Lorenzo programme to trusts in the North, Midlands and East of England areas according to a report by the Government’s Major Projects Authority (MPA), which holds open the prospect of continuing with the much-criticised software.


The MPA, part of the Cabinet Of- fice, published its Programme As- sessment Review of the National Programme for IT (NPfIT) in June to a select few, but it was only de- classified for general circulation (with some redactions) at the end of September.


It focuses on the past failures, cur- rent disputes and future options regarding the NPfIT and especially the Local Service Provider (LSP) contracts, while also pointing to the success stories, including the N3 Network, the Spine, NHSmail, PACS and Choose & Book.


The problems


But, on the first page of the report, under ‘key findings’, the MPA is clear that both the philosophy and the delivery of the programme over- all have been found wanting.


It says: “The view of a single all- encompassing service which de- livers full integration does not line up with the needs of clinicians on the ground and should be simpli- fied to fit the current and future environment.


“The NPfIT…has been criticised as ambitious and unwieldy; poorly served from over-selling and over- promising by suppliers; and not providing clear value for money. It has also not delivered in line with the original intent as targets on dates, functionality, usage and lev- els of benefit have been delayed and reduced. The suppliers for


3/5th of the country in terms of local service provision have exited their contractual terms or had their con- tract terminated leaving at least one significant dispute.”


The report contains a number of recommendations on the most difficult controversy: the two re- maining LSP contracts, with BT and CSC, and especially the fu- ture of the Lorenzo roll-out, by iSoft, now part of CSC.


Lorenzo


It says: “In the NME (North, Mid- lands & East of England region) there is still a significant degree of uncertainty both about the plan- ning of implementations and also the capability of the solution. The 4 key trusts chosen to implement the Lorenzo solution are in very differ- ent situations. University Hospitals Morecombe Bay is close to sign-off whilst Pennines Trust has stated its desire to leave the programme.


“Birmingham Women’s Hospital Trust is being held back by one is- sue which views have suggested are about a difference of opinion with the Supplier believing that they have met the Deployment Verification Criteria (DVC) whilst the Trust is not happy about the level of functionality delivered. CfH expect to resolve this differ- ence of opinion soon. The current implementation is rolling out Loren- zo 1.9 which is a long way short of the full functionality of the contract- ed solution which has 4 stages of functionality and is intended to be rolled currently out to 221 trusts.”


Plain English


It continues: “If there is to be any consideration of continuing with the Lorenzo development a tightly controlled time and agreed limits should be set to agree a plain Eng- lish agreement covering all neces- sary aspects of activity and obliga- tion both in terms of development and deployment and certainty on both the allocation of the obliga-


10 | national health executive Sep/Oct 11


The Government used the publica- tion of the report to further damn the NPfIT, which has come in for heavy criticism from the NAO and Parlia- ment’s Public Account Committee already this year. It announced “an acceleration of the dismantling of the NPfIT” because it “has not and cannot deliver to its original intent”.


Health Secretary Andrew Lans- ley said: “We will be moving to an innovative new system driven by local decision-making. This is the only way to make sure we get value for money from IT systems that better meet the needs of a modernised NHS.”


The future


The report also looks ahead to the NHS post-reforms and considers the potential shape of the IT market, saying: “LSP contracts have poten- tially constricted the health care systems market in England and there has been little development of new generation systems due to the lack of free demand. In the future the market should be encouraged to develop products which can meet the needs of connectivity and interoperability for the NHS.


“The future shape of reforms in the NHS should be reflected in a new form of provision from a regulated competitive market for IT systems.”


FOR MORE INFORMATION The redacted MPA report is at www.tinyurl.com/ CabinetOfficeMPAreview


tions and the consequences for fail- ure to agree.


“This should include full under- standing on how historic balances and sums as yet unpaid will be treated.”


It also includes many other condi- tions, including dates, plans, sign- off arrangements and the chain of responsibility.


Politics


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