Whitehall officials are to launch a son-of-NPfIT procurement for IT suppliers, covering hosting, software, and deployment at up 28 “acute” trusts in the south of England.
As in the early days of the NPfIT, between 2003 and 2006, there will be an emphasis on what NHS Connecting for Health calls “rapid deployment and rollout allowing speedy benefit delivery”.
CfH says the plan is for multiple suppliers and contracts to allow NHS information to be shared across the south.
But several supplier representatives who attended an “initial supplier plenary meeting” run by NHS Connecting for Health say the scheme is confusingly complicated, lacks pragmatism and has little or no chance of success.
Although contracts will be signed by trusts, NHS Connecting for Health will arrange the choice of suppliers; and it has drawn up plans to mix up the companies that supply software, hosting facilities, deployment and integration.
Supplier representatives say the plans are more complicated than under the NPfIT, in which it proved impossible to manage one local service provider for the south of England [Fujitsu].
Under the new Connecting for Health plans, a trust may have multiple suppliers, working under central coordination and governance, within a complexity of legal arrangements, service level agreements and accountabilities.
Doomed to fail?
Everyone I spoke to about the new arrangements said the plans are “doomed to fail”.
They said the initial supplier plenary meeting was characterised by unclear answers to their questions - which was, they said, a hallmark of working on the national programme.
NHS Connecting for health has promised to listen to supplier concerns - and a further meeting is due to take place this week between potential suppliers and CfH to help improve arrangements.
Why a CfH-managed centralised procurement?
But suppliers say one question they are reluctant to ask CfH - in case it jeopardises their relationship with officials - is why CfH and the DH are running the procurement instead of leaving it to trusts to buy what they want and, if they wish, choose a single main supplier and one contract covering software, hosting and deployment.
Under the CfH plans there will be arranged marriages between suppliers, whether or not they have worked together before. Although acute trusts can buy outside of the “son-of-NPfIT” arrangements, they may not receive central funding.
Some protection for taxpayers
There are protections in the new arrangement for taxpayers because suppliers will not be paid until a deployment is accepted by the trust. Payment will be made on the basis of suppliers - all of them at a particular installation - successfully meeting a milestone.
Thereafter suppliers will be paid on the basis of “per active user” charges per month, the idea being that trusts pay only for the use of the systems.
But if the procurements fail, or are delayed, local deployment and training costs will be lost, and IT implementations at trusts could be delayed by years, as has happened with some NPfIT planned deployments.
Concessions to suppliers to encourage them to bid?
If there are not acceptable bids in each of the competition categories - application, hosting and deployment - CfH will consider the bidding unviable.
To encourage large suppliers to bid in all three categories, contractual concessions are possible, with more risks passed back to taxpayers and NHS Connecting for Health, though the emphasis will be on proven commercial off-the-shelf software.
Contracts kept confidential
The contracts need not be published, despite coalition announcements that all contracts over £10,000 will be published. CfH can claim that the contracts are being awarded under an ASCC framework deal that pre-dates the coalition announcement on publishing contracts.
No mention of the Cloud, open source or innovation
There is no mention in the CfH procurement plans of open source software, open data standards, G-Cloud or data centre rationalisation. There are no references to the announcements by Downing Street and the Cabinet Office on new open standards and procurement rules for IT.
There is no mention either of the government “skunkworks” that Downing Street has announced to “assess and develop faster and cheaper ways of using ICT in government”.
More data centres, not fewer?
Also absent at the initial supplier meeting with CfH was any mention of data centre rationalisation or efficiency cuts. It appears that the plans will increase the number of data centres - and associated electricity costs.
Where is the money coming from?
The main funding for the new contracts - which could amount to hundreds of millions of pounds over four years - will come from NHS Connecting for Health and the Department of Health.
A settlement of the legal dispute with Fujitsu - the former local service provider for the south - will be funded elsewhere within government. This leaves CfH with unallocated funds from the Fujitsu LSP contracts - money which remains in the CfH kitty despite government spending cuts and the premature ending of IT contracts within some departments.
Another jargon-ridden scheme served up on Powerpoint?
In a speech on Labour’s handling of the NHS in 2008, David Cameron referred to central IT mismanagement and criticised the “shoddy jargon-ridden schemes served up on Microsoft Powerpoint”.
One irony of the initial supplier plenary meeting was the use of IT business jargon on a scheme that was served up on Powerpoint slides. Each slide was marked “Commercial in Confidence”.
Contract awards by mid-Winter 2011
About 25 supplier representatives were at the meeting. CfH said the plan was to award contracts covering up to 28 acute trusts by “Mid-Winter 2011”.
The plans are for acute trusts to contract for the “clinical 5” - patient administration systems, scheduling, clinical documents, electronic prescribing, clinical desktop and OCS.
Although the scheme will be depicted as a local one, NHS Connecting for Health will handle evaluations of bids, pricing, performance management and service level specifications, performance monitoring, security policy requirements, disaster recovery and business continuity, information governance, overall implementation plan, testing procedures, service management regime, dispute resolution procedures, change control procedures, audit and record, charges and service deductions, invoicing procedures, financial model, compensation on termination, exit, service transfer and step-in arrangements, due diligence, representations and related provisions.
When the NPfIT began to fail as a national scheme, the NHS Chief Executive David Nicholson launched the oxymoronically-named National Local Ownership Programme, which also failed.
Now there is a scheme for IT in the South of England that is as complicated as anything devised under the NPfIT or NLOP. It'll be good news to Connecting for Health's lawyers and consultants who'll be cushioned from the putative demise of the NPfIT; and it will help maintain CfH's reputation as a large, centralised IT authority, but it confirms that the Department of Health learns nothing from history. You cannot pretend to devolve decisions to trusts while managing nearly everything centrally.
Trusts are being told they can make their own decisions - providing they do everything CfH tells them to do, which is a lot.
Does CfH as a large central IT organisation need to exist? While it does, it will continue to make work for itself. This son-of-NPfIT scheme is an example.