Health CIO Christine Connelly faced difficult questions in the House of Commons yesterday on a new deal the Department of Health plans to sign any day now with CSC.
She was before the Public Accounts Committee which yesterday was chaired by Conservative MP Richard Bacon who is well informed on the state of the NHS IT programme, NPfIT.
The meeting was on delivering the cancer reform strategy. Near its end Bacon took the opportunity to question Connelly on the plans of the Department of Health to sign a memorandum of understanding with CSC.
Bacon is concerned that the Department is so anxious to keep CSC in the NPfIT that it will pay CSC for deployments of iSoft's “Lorenzo” that trusts have no intention of installing. He believes that the Department’s officials might have convinced themselves that many more trusts will install Lorenzo than actually will.
Indeed some trusts that are on the Department’s list as installing Lorenzo have already decided on other systems.
At the committee hearing yesterday Bacon asked Connelly how many trusts the Department expects to cover under the new memorandum of understanding with CSC.
At first Connelly gave no direct reply. She said:
“There’s one overall exercise going on across government which is look at all IT suppliers and contracts we have. As part of that, each department that holds a significant contract with any IT supplier has been asked to look at that contract.
"The other exercise is around the National Programme where we were challenged to reduce the overall costs of the Programme. Within that, we had originally a plan that would have reduced the cost of the CSC contract by around £300m.
"The new coalition government asked us to go further and look for savings of £500m. The way we expect to achieve those savings are first of all to look at the functional points that are delivered by CSC in that contract and the number of trusts that they deliver to.”
Eliminating from the contract the delivery of, for example, GP systems will help save £500m she said.
Bacon returned to his original point. “How many hospital trusts do you think will take Lorenzo?”
“I don’t know off the top of my head,” replied Connelly. “I am sorry. I didn’t bring that with me in terms of today.” [The hearing was on the Department's cancer reform strategy].
Bacon asked his question again.
“We expect the total number of trusts to come down by about 35. I cannot tell you whether that’s all acutes [acute hospitals] or whether some of those are community trusts. I would need to check,” said Connelly.
Bacon asked: “How many hospital trusts who might be in that universe have already signed contracts to take alternative systems, that have decided Lorenzo is not suitable for them?”
Connelly replied: “I don’t know that. What I can tell you is that in the summer we went out to all the trusts through the strategic health authority and asked each trust to confirm whether they intended to take the systems offered under the CSC contract. Not all the systems are Lorenzo. There is an ambulance system and TPP is offered.
"So we asked all of those trusts to confirm their position and they did. We reduced our expectation of the number of trusts we would have by about 35 as a result of that exercise.”
“You reduced it by 35 out of how many?” asked Bacon.
Connelly: "The original number of trusts in the contract - my recollection is that we have about 222 trusts covered by the CSC contract - and we would expect to reduce that by about 35.”
Bacon's letter to Connelly
Today Bacon wrote to Connelly asking about the penalties the Department of Health will face if NHS sites refuse to install Lorenzo under the commitment in the Memorandum of Understanding with CSC.
This is Bacon’s letter:
Dear Ms Connelly
NEGOTIATION OF MEMORANDUM OF UNDERSTANDING WITH CSC
Further to our discussion yesterday at the Public Accounts Committee, I am writing to you to seek greater clarification on the points you made about the Memorandum of Understanding which the NHS is currently negotiating with CSC.
It is my understanding that a number of acute hospital Trusts that have indicated that they might be prepared to take iSoft’s Lorenzo system will not be able to do so for operational reasons. Indeed, I understand that many Trusts have actually made alternative arrangements to take systems from other suppliers on the basis that there is very little evidence that Lorenzo will offer the functionality which they require.
There is therefore a large disconnect between the optimistic assessment of the Department of Health as to how many Trusts will actually want Lorenzo and the reality.
My question to you is: If you sign the Memorandum of Understanding with CSC and then it turns out that - as a result of the recent reduction in scope for Lorenzo and the well-documented difficulties in deploying it smoothly at larger Trusts - hospital trusts refuse to take Lorenzo because it is not adequate for their needs, what is the financial exposure of the NHS and the Secretary of State?
MP for South Norfolk
Member of the Public Accounts Committee
Public Accounts Committee hearing - questions of Connelly about the CSC deal are about two minutes before the end of the hearing