Supplier Problems - Others
From Nhs It Info
BT Takes Second Penalty In NHS Programme (4 Oct 2004)
MCN Direct Newswire
http://www.conferencepage.com/mcndirect/issues2004/mcndirect041004.asp#4
"BT's services business, which is the biggest supplier to the programme, admitted the NHS withheld £300,000 in July - around 30% of the monthly payment on the national application service provider contract - because BT failed to meet a target of 99.8% availability for the national data spine."
Secrecy of NHS contracts begins to unravel (10 May 2005)
Computer Business Review
http://www.cbronline.com/article_news.asp?guid=3CC199E8-47F7-4A54-A5F8-B889DCC6EDA5
"The UK National Health Service's enormous IT overhaul is beginning to show signs of strain, only 18 months after the NHS signed deals worth a total of GBP6bn ($11bn) with a number of vendors. So far though, it is the suppliers rather than the UK government that are looking decidedly unwell. The companies involved are being gagged by some totalitarian-style privacy rules, but news of problems is beginning to surface. Accenture was forced to reveal earnings shortfalls from its NPfIT (National Future Information Technology) contracts, Tata Consultancy Services blamed delays in its NHS work for its recent revenue shortfall, and a new UK law threatens to expose the details of the deals. . . Controversially, the government has deemed it necessary to demand that suppliers keep secret the details such as delivery deadlines of the contracts, hoping to avoid the bad publicity it has suffered previously. So far, very little is known about the structure of the deals, but this could change. The Freedom of Information Act came into full effect at the beginning of the year, which gives the public greater access to government-held information, and may well be invoked to force the NHS to reveal some of the details of the contracts. In March, a leaked memo revealed that the government has put pressure on NHS executives to refuse requests for information under the act, while it considers publishing some details of the contracts."
BT risks losing NHS contract (13 Jul 2005)
Computing
http://www.computing.co.uk/computing/news/2139734/bt-risks-losing-nhs-contract
"BT must start meeting its London NHS commitments or risk losing its £996m Connecting for Health (CfH) contract, says NHS IT director general Richard Granger. In an exclusive interview with Computing, Granger acknowledges that there are considerable implementation problems in the capital, and blames the supplier's handling of subcontractor IDX."
Tata blames NHS National Programme for IT for revenue slowdown (22 Aug 2005)
The British Journal of Healthcare Computing & Information Management
http://www.bjhc.co.uk/news/1/2005/n508002.htm
"Tata Consultancy Services, a key supplier of data-migration services to the National Programme for IT in the NHS in England (NPfIT), has blamed delays in implementing the National Programme across the whole country for a slowdown in its revenues from its European operations."
ComMedica closes diagnostic imaging business (23 Feb 2006)
North Mersey Connect Portal - I & M T News
http://www.northmerseylis.nhs.uk/news/shownews.asp?id=3608
"ComMedica Limited, the UK-based developer of Picture Archiving and Communications Software has announced that it is closing its diagnostic imaging software business. The company has announced a 'significant restructuring', including the closure of its diagnostic imaging software business, resulting in over 100 redundancies at its Woking office and elsewhere. ComMedica said the move followed the Department of Health's decision to suspend deployment of CSC's ComMedica/Kodak PACS/RIS reference solution for the North-West and West Midlands region."
NHS trusts pay millions in fines to suppliers of delayed IT system (6 Jun 2006)
The Guardian
http://www.guardian.co.uk/uk_news/story/0,,1790952,00.html
"NHS trusts are being made to pay multimillion-pound penalties to computer suppliers because of a clause in contracts for the health service's £20bn IT scheme. Arrangements disclosed today by the magazine Computer Weekly show the government committed trusts to provide 200 staff to work with the computer companies to devise the best possible systems. In southern England the NHS was unable to meet an obligation to second 50 full-time employees to the Japanese-owned Fujitsu Corporation. The trusts will now have to pay Fujitsu £19m."
NHS IT costs hospitals dear: Fujitsu scores £19m compo (6 Jun 2006)
The Register
http://www.theregister.co.uk/2006/06/06/nhs_contract_chaos/
"More bad news for the UK government's NHS IT programme - cash-strapped health authorities are having to pay millions in compensation to Fujitsu and CSC . When contracts were first set up by central government, NHS trusts promised to provide staff to help work on the new systems. But according to reports, health authorities in the south of England have failed to find enough people so they have to pay Fujitsu $19m compensation. The south of England was supposed to find 50 staff to work at Fujitsu. The Department of Health told the Guardian: 'An agreement has been reached to buy out the liability at a cost of £19m in 2006-07 as NHS trusts have decided not to supply the staff resources.' In the north west and west Midlands, the NHS is contracted to provide 50 staff but is struggling to find enough people. Part of the problem is that NHS staff will be paid their standard salary even after moving. The staff were supposed to go to CSC, which is entitled to £6.9m every year for the 10 year term - or just under £70m. Health trusts are looking at ways to buy their way out of the ageements, according to documents seen by Computer Weekly which has more details here. . . Government IT projects either fail because of overambitious, and under-achieving, suppliers or because of incompetent and feckless civil servants. Rarely do they manage to do such damage to both suppliers and customers before anything is actually delivered."
http://www.theregister.co.uk/2006/06/12/npfit_talks_back/ (Response from CfH)
http://www.theregister.co.uk/2006/06/13/letters_1306/ (Readers' responses)
Cerner predicted to replace GE in London (13 Jun 2006)
e-Heath Insider
http://www.e-health-insider.com/news/item.cfm?ID=1937
"An analyst report from the US has said that there is a high probability that clinical software firm Cerner will replace GE Healthcare as main the supplier of clinical systems to the NHS in London. If a change does occur it is likely to initially result in further delivery delays to modernising NHS IT systems in the capital, as part of the late running £6.2bn NHS National Programme for IT (NPfIT). BT is understood to have been examining options for a replacement for IDX since the beginning of the year due to the difficulties in delivering the system to NHS trusts in the capital. In the past 30 months BT has implemented the software at just one hospital trust. . ."
Less than 1.5 per cent of electronic prescriptions seamless (23 Jun 2006)
e-Heath Insider
http://www.ehiprimarycare.com/news/item.cfm?ID=1962
"E-Health Insider has learned that of the 1.6m electronic prescriptions issued by the Electronic Prescription Service, just under 30,000 have been seamlessly sent and received all the way through to dispensing. Out of the 1.6m scripts created electronically by GPs, just 29,386 have then been sent over the NHS spine, received and called down by a local pharmacist for dispensing. Of those called down, 26,676 have been dispensed to patients. This means that less than 1.5% of electronic prescriptions issued are actually being managed electronically end-to-end by the initial version of the EPS -- which still involves the printing of a paper prescription. . . The major efficiency benefits of the national EPS system are only likely to be possible when the majority of scripts generated are entirely electronic. This is a goal that remains a long way off. In a typical week the NHS dispenses 13.7m prescriptions."
Inside the NHS Connecting for Health project (7 Jul 2006)
Computer Business Review
http://www.cbronline.com/article_cbr.asp?guid=0FD865FC-2602-4606-80D8-6A00FF41A833
"Richard Granger, director general of IT at the National Health Service, not only hit back at critics of the $10bn Connecting for Health (CfH) project last month, he also claimed that there is an 'essential dishonesty' between IT services vendors and their customers. Granger singled out major NHS contractor Accenture for particular criticism, and said that the project's detractors have failed to appreciate the enormous complexity of the program. . . He added that there remained an, 'essential dishonesty between the IT industry and the consumer, with the IT industry still trying to claim that there's a scientific basis behind its estimations of the costs involved in outsourcing projects, when practical experience shows that there isn't."
NE trust faces clinical systems conundrum (20 Jul 2006)
e-Health Insider
http://www.e-health-insider.com/news/item.cfm?ID=2015
"A mental health trust board formed from three merged organisations has been advised to stop using a clinical information system supplied under the National Programme for IT on part of its new territory and use another single system across the whole trust. Northumberland Tyne and Wear NHS Trust board members received a paper on options for clinical information systems (CIS) which has been leaked to E-Health Insider. Board members were recommended to continue negotiation with CSE-Servelec for its RiO mental health system and to support the development of detailed plans to implement RiO, which is already used in part of the trust. NTW is not alone in its deliberations over strategy to fill the gap between the arrival of national programme solutions and the expiry of existing IT contracts. In December 2005 Norfolk and Norwich NHS Trust, located in the Eastern cluster of the national programme, decided to shelve implementation of an interim PAS system. In the same month Tees and North East Yorkshire NHS Trust, a mental health trust, also postponed an Accenture implementation of iSoft iPM. South West Yorkshire Mental Health Trust has also gone outside the NPfIT programme to procure a new integrated clinical system, as an 'interim solution'."
IMS signs contract with BT for London trust (17 Aug 2006)
e-Health Insider
http://www.e-health-insider.com/news/item.cfm?ID=2075
IMS MAXIMS Plc today announced that it had signed a three year contract with London local service provider, BT, to supply its web-based clinical software to Barking, Havering and Redbridge NHS Trust (BHRT). . . A BT spokesperson told E-Health Insider that the deal for IMS at the east London trust was not long term: 'This is a time limited, interim arrangement The plan is for BHRT to migrate to the strategic solution in due course.' . . . The announcement of the deal further confuses the picture of how the £6.2bn Connecting for Health NHS IT programme is now to be delivered in London. In December 2003 the DH awarded BT a £996m 10-year contract to modernise NHS IT in the capital. To date it has installed core patient administration software at one acute trust - Queen Mary's, Sidcup. BT's clinical software provider is currently GE Healthcare, but the company has made clear its intention to switch to Cerner. A contract has yet to be completed."
When Bill met Tony, seeds of a grandiose scheme were sown (26 Aug 2006)
The Guardian
http://business.guardian.co.uk/story/0,,1858787,00.html
"When Bill Gates met Tony Blair at Downing Street in 2001 the seeds were sown for the hugely ambitious plan to transform the NHS with the power of computers. Mr Gates, the billionaire software pioneer, had just written a book about how IT could transform economies. The prime minister, determined to reform Britain's public services, was hooked. Just one year later, representatives of Mr Gates's Microsoft empire attended a seminar at No 10 at which the NHS's £12bn IT programme was conceived. A core principle of this grandiose plan was that it should never rely on a single computer contractor and that the work should be carried out by global players. It is a measure of the crisis that these principles have been sacrificed and the NHS finds itself heavily dependent on one contractor, iSoft, a British-based specialist formed only in 2000. . . To create this system, the Department of Health in 2002 appointed Richard Granger, a former management consultant whose last project was the London congestion charge, as IT director at a salary of some £250,000. . . In placing contracts, Mr Granger says that he consciously structured the procurements to attract global players back to the NHS. He divided the NHS in England into five regions: the north-east, the east, north-west with west Midlands, the south and London. Each placed a 10-year contract worth about £1bn with a prime contractor to install standard systems. . . NHS Connecting for Health, the agency set up to run the programme, says that the choice of subcontractor lay entirely with the prime contractors, which carry the risks. . . In this arrangement, the NHS's safety net was always to have a backup supplier if one failed. The first to fail was IDX. In the south of England, Fujitsu has replaced IDX with Cerner. Last month, London followed suit. Hence the importance of iSoft, which although it has so far delivered only the first basic models of its hospital system and has financial troubles, is still seen by the NHS as the star performer, especially in its partnership with CSC. Mr Granger likens his relationship with suppliers to that of a polar explorer with his huskies: he once warned companies that weak performers would be fed to the strong. His problem is that he is rather short of huskies to shoot."
BT gets only £1.3m for two years' NHS work (28 Aug 2006)
The Guardian
http://business.guardian.co.uk/story/0,,1859650,00.html
"BT has been paid just £1.3m for the first two years of its work introducing new computer systems across GP practices and hospitals in London, despite spending an estimated £200m-plus of its own cash. The company insisted last night it would not be forced to follow competitors and write down the value of the London NHS contract in its accounts. Three years ago, BT announced it had won a £996m 10-year deal as lead contractor to design, deliver and operate next-generation computer systems in the London area as part of the NHS's £6.2bn nationwide IT overhaul. At the time, it was heralded as a landmark deal for BT by chief executive, Ben Verwaayen. He said: 'These wins are BT's biggest ever, and evidence of the new face of BT truly emerging. This is BT taking on world-class competition on its own territory, and winning.' Last month, again, BT chairman Sir Christopher Bland, who received his knighthood for services to the NHS, told investors: 'BT has achieved some notable successes on its NHS National Programme for IT contracts.' But it has emerged that for the first two years of its London contract, BT has been paid by far the least of any of the NHS's lead contractors - just £1.3m. This is believed to reflect the extent to which the NHS thinks BT has met its delivery targets. A spokesman for BT said it was perfectly normal for revenues to be slim at the start of a lengthy contract. 'There is a lot of investment up front, but the profitability comes towards the end.' But the NHS's other lead contractors, operating similar-size projects around the country, have all been paid at least 20 times more than BT over the same period. . . . BT's reputation in London took a heavy blow earlier this year when it emerged that a child health computer system it designed and installed in several primary care trusts had many shortcomings. The system failed to hold correct data on whether babies had routine health checks, vaccinations, visits from health visitors and assessments for special needs. A spokesman for BT insisted many of the problems related to inaccurate paper records and said the trouble had largely been rectified."
BT faces watchdog inquiry into work on NHS computer revamp (29 Aug 2006)
The Times
http://business.timesonline.co.uk/article/0,,9076-2332472,00.html
"BT is facing a fresh inquiry into its work on the NHS's ambitious IT upgrade, amid growing concerns about the £12.4 billion project.The National Audit Office (NAO), the parliamentary watchdog, said yesterday that it may undertake a fresh examination of the mammoth NHS IT upgrade project, on which BT is one of four main suppliers. Another supplier is the troubled software group iSoft. The threat of further scrutiny followed the revelation in a parliamentary answer that BT has been paid just £1.3 million for about two years' work on one £996 million contract. Though the group insisted yesterday that this was in line with its expectation of laying down investment initially with revenues coming through later, some analysts speculated that the tiny size of the payments could reflect delivery failings by BT. The developments will increase pressure on BT to provide further details about the project's progress when it updates investors about its global services division ' the arm that supplies telecoms and IT services to business ' next month. The NHS work, worth in total more than £2 billion over ten years, is one of the biggest contracts in the division."
British Telecom ... And the £1billion con-tract (15-28 Sep 2006)
Private Eye
"Now that the Financial Services Authority (FSA) has decided to investigate one of the companies involved in the multi-billion pound NHS IT project, iSoft, over presenting dodgy figures to the stock market, will it dare take a look at another of the big players, BT? The Eye has already questioned BT's performance on the troubled programme . . . On the largest and most crucial part, its £996m contract for the London region, up to March this year it had received just £1.3m for installing only a fraction of the IT systems it should have, while its expenditure on the deal is likely to have exceeded £200m. Yet its accounts up to 31 March 2006 showed no losses from the project. Then last month BT ditched the software contractor it had been using as it shed all this cash, IDX, casting doubt as to whether its huge costs were, as its accounts would have it, "work in progress" and not money down the drain. . ."
Healthy Competition (11 Sep 2006)
New Statesman
http://www.newstatesman.com/200609110041
"A more innovative approach to IT could have prevented the NHS records fiasco. The recent announcement that the Financial Services Authority is investigating iSoft, the troubled computer software company charged with delivering a large part of the new, centralised patient records system for the National Health Service, is just another sorry episode in the government's Connecting for Health initiative. In June 2005, Fujitsu, winner of the contract for southern England, changed horses midstream and dumped its software supplier. BT, the national telecoms provider, which owns the London contract, followed suit last month. And in July the Computer Sciences Corporation suffered an outage at its Maidstone data centre that left clinicians in the north-west and West Midlands stranded without computerised patient records for three days. . . Partly why we feel so powerless when our computers crash is that most of us are locked in to services provided by a monopoly supplier. Remarkably, it's the same at state level: familiar company names appear regularly in the news, because governments are flogging the same dead horses. Government IT contracts are often so tight that only huge companies will touch them. In the case of the NHS, the decision to pay on delivery for a highly complex system meant smaller, potentially more innovative producers could not take on the risk of tendering. Rather than nurturing a competitive ecosystem, such practices entrench the position of monopoly suppliers, regardless of actual past performance. The demand for centrally controlled systems is another hurdle. The most successful information pool is the internet - essentially a decentralised network run on open standards - yet governments persist in demanding control from the centre, and allow contractors to keep their standards hidden. If the government used its leverage as the largest spender on IT in the UK to demand that suppliers forfeit their intellectual property rights, they could open their code to smaller innovators. Managed correctly, such a move could change public IT for ever: rivals could salvage botched projects, and smaller producers could develop additional, specialised tools that plug in to the system."
Delays to NHS computer system could cost taxpayers £40bn (1 Oct 2006)
The Observer
http://politics.guardian.co.uk/egovernment/story/0,,1885133,00.html
"The company charged with rescuing the NHS's troubled IT system has consistently failed to meet its deadlines for introducing the project across the health service, The Observer can reveal. Last week Computer Sciences Corporation (CSC) was awarded a £2bn contract to take on a bigger role in overseeing the implementation of the Connecting for Health system, the biggest civilian computer project in history which is supposed to electronically link all doctors' surgeries and hospitals. But government hopes that CSC will prove the £12.4bn project's salvation have been hit by news that the company has itself experienced huge problems in implementing even the most basic parts of the project. According to its original business plan, obtained by The Observer, CSC was contracted to install new computer systems to 32 acute hospitals by April 2006. However, according to the NHS, only eight of the hospitals had received the basic 'administrative' systems by that date and the company had failed to deliver any working clinical systems - the key part of the project which is supposed to record a person's medical data electronically. . . Critics suggest the eventual cost to the taxpayer of fixing the system's myriad problems will push the total bill for Connecting for Health to in excess of £15 bn. Some have suggested it will rise to as much as £20bn - enough to fund 40,000 nurses for the 10-year lifetime of the contract. . . 'This just replaces one regional contractor with another which has less experience,' said Richard Bacon, a Conservative MP who sits on the Public Accounts Committee. 'By passing the baton to CSC with indecent haste, the government has missed a golden opportunity to think again and to give more control to hospitals locally. I feel very sorry for hospitals who will have to put up with more delays and with systems that just don't work properly.' IT experts predicted the system's delivery could be completed on time and on budget only if it was scaled back. They warned patients' health could suffer unless problems were resolved soon. 'This is about more than taxpayers' money, this is about people's lives,' said Stephen Critchlow, chief executive of Ascribe, an IT company that supplies computer systems to hospitals."
CSC says it will implement iPM at Bradford in six months (18 Oct 2006)
e-Health insider
http://www.e-health-insider.com/news/item.cfm?ID=2205
"Bradford Teaching Hospitals NHS Foundation Trust, which had gone outside the NHS National Programme for IT to procure for a new patient administration system, has come back into the fold. The trust has signed a deal with Computer Sciences Corporation (CSC) to implement iSoft's iPM in just six months, in a deal underwitten by NHS Connecting for Health. Having abandoned its procurement the trust is now dependant on CSC successfully installing iPM more rapidly than it has previously managed. Should this not be achieved NHS Connecting for Health has pledged to meet the extra cost to the trust of paying for continued support of its existing Siemens IRC system. . ."
Fujitsu under spotlight for NHS failures (24 Oct 2006)
The Guardian
http://business.guardian.co.uk/story/0,,1929770,00.html
"Fujitsu, one of the lead contractors on the NHS's troubled £6.2bn IT upgrade, has installed only three patient-administration systems in two-and-a-half years on the project. It has recently all but frozen further installations while it struggles to fix problems at these sites. Fujitsu's problems are the latest blow for the health service's ambitious IT upgrade, the biggest non-military project of its kind in the world, which has been dogged by delays and contract disputes. Concern about the Japanese consultancy's work has until now been eclipsed by fears over Accenture and iSoft. . . In addition to these other challenges, health service IT bosses have become increasingly concerned about Fujitsu's progress on installing patient-administration systems. In March 2004, having signed a £900m 10-year contract, Fujitsu said it would have the systems up and running in 17 acute trusts, 36 community trusts and eight mental health trusts by this April. But by April Fujitsu had managed only one installation, at Nuffield Orthopaedic, a small acute trust in Oxford. Two months later, Fujitsu promised it would install 12 further systems in acute trusts by the end of this month, but it has added only two more so far and NHS IT bosses now privately admit the target will not be met. Fujitsu's installation programme has been paralysed by problems at the first three trusts to receive the systems. Nuffield Orthopaedic, Fujitsu's first acute trust project, recently said it blamed problems with its computer systems after it lost its top-level three-star performance rating and was assessed as "weak". In a "serious untoward incident" report to the Strategic Health Authority weeks after the Fujitsu system was installed last December, the trust said disruption caused by the installation could have put the safety of patients at risk. Concerns over Fujitsu installations have led to planned "go-live" dates at hospitals across the south of England - the region for which Fujitsu is lead contractor - being repeatedly put back, sometimes with just a few days' notice for staff. A spokesman for Milton Keynes, which has twice had its go-live date delayed, said Fujitsu was "sorting out the odd glitch", but the installation has now been postponed with no new date set. . ."
QMS to ditch IDX for Cerner in 2007 (16 Nov 2006)
e-Health Insider
http://www.e-health-insider.com/news/item.cfm?ID=2270
"Queen Mary Sidcup (QMS), the only London trust to have received a new hospital IT system under the NHS computerisation scheme, will now have to replace it less than a year after the system became fully operational. QMS first switched on IDX's Carecast system after a fraught implementation in November 2005, but it has taken until October 2006 for the system to become fully operational and integrated with Choose and Book. But following the November 2005 implementation, BT, the local service provider for London, stopped work on further hospital PAS installs. For most of 2006 BT has been locked in negotiations with Cerner and GE Healthcare, which in January purchased IDX. Last week BT finally announced that it had replaced GE Healthcare with Cerner and would now offer Cerner's Millennium as its clinical software for the acute sector. Kate Grimes, QMS chief executive, has exclusively confirmed to E-Health Insider that her trust will now replace IDX Carecast with Cerner Millennium in 2007. . . The planned switch will mean that the trust will have had to go through two full PAS implementations in less than two years. Last month Grimes told a health IT conference how disruptive the implementation of IDX has been for the trust, to the point of creating a severe financial risk to her trust. One of the biggest problems for QMS was that following go live last November it took almost another year for Carecast to be become Choose and Book compliant. The system was only finally integrated last month... QMS says that it only learned that Carecast was not Choose and Book compliant last July. . ."
System C issues profit warning as NPfIT slows (18 Jan 2007)
e-Health Insider
http://www.e-health-insider.com/news/item.cfm?ID=2428
"System C Healthcare has issued a profit warning citing a dramatic slowdown in deployments under the NHS IT programme as a result of a three month "hiatus" during the handover from Accenture to CSC. A spokesperson for System C told EHI: "The hand-over from Accenture to CSC caused a significant hiatus in activity for us during that period. With the hand-over now complete, the amount of work is increasing steadily, but we know now that the ramp-up will not be as fast as we expected." They added: "This means that in the time left to us in our current financial year, we won't be able to make up the shortfall in our numbers ' hence the need for profits warning to the City." System C is one of the main companies implementing computer systems as a sub-contractor to the local service providers (LSPs) delivering the £12bn NHS National programme for IT (NPfIT). In its trading statement the company said "System C continues to operate in challenging conditions in our core English market". The firm indicated that the slow down stemmed from the protracted contract wrangles last year between NHS Connecting for Health and one of its prime contractors, Accenture, eventually resulting in Accenture's replacement by Computer Sciences Corporation. . ."
Fitter, healthier, more productive (15 Mar 2007)
The Guardian
http://technology.guardian.co.uk/weekly/story/0,,2033496,00.html
"Britain's medical practitioners are making lifesaving technological advances at local level - by effectively ignoring the costly NHS IT programme . . . As you walk into the waiting room of Thornley House Medical Centre in Hyde, Cheshire, the first thing you see is a giant plasma screen inviting you to apply to view your medical records on the web. Meanwhile, at Queen Alexandra hospital in Portsmouth, nurses routinely enter patients' vital signs into handheld personal digital assistants. . . In Hyde, the revolution in healthcare information may have even more profound consequences. It is the first practice in the world to invite every patient to inspect their electronic health record and, if they want, to have it available online. . . Two triumphs of the £14.6bn NHS programme for IT? Hardly. Electronic medical records at Hyde and Portsmouth may be achieving what the national programme, conceived five years ago this spring, is setting out to do. But they are independent efforts, happening not because of the national effort but almost despite it. While Hannan and Smith and other pioneers dotted around the country have patients' full clinical details available at the touch of a button, the much-vaunted NHS programme is only now about to start loading basic clinical details on to the care records "spine". These will contain only the allergies and current prescriptions of patients at a few primary care trusts. Next week the annual Healthcare Computing conference in Harrogate will buzz with accusations that the national programme has held back progress. There are two reasons behind this charge. First, under the £1bn contracts signed early in the programme, hospitals have to replace their administrative systems which record patients' details with systems from centrally chosen suppliers. As this involves considerable local effort for little benefit, progress is painfully slow. The second problem is the potential threat to confidentiality arising from making records available on a national scale. . ."
Update: Fujitsu shock £1.2bn loss driven by problems in UK (20 Mar 2007)
ComputerWorld UK
http://www.computerworlduk.com/management/it-business/supplier-relations/news/index.cfm?newsid=2302
"Problems at Fujitsu Services, the UK subsidiary of Japanese computer giant Fujitsu, have played a key part in shock forecast losses of £1.2bn for the 2006 financial year. Today's profits warning, made at the end of the business day and ahead of a public holiday in Japan, came after years of problems with Fujitsu Services, which holds a number of high-profile public sector contracts. Fujitsu Services is a lead contractor for the southern region of the NHS's £12.4bn IT programme. It is also an important IT provider to HM Revenue and Customs where its £930m outsourcing contract has been absorbed into the Aspire contract held by Capgemini. The Japanese computer giant, which had earlier forecast profits of £238m, said it now expected to record a loss on devaluation of its stock in Fujitsu Services. . . Fujitsu's relations with the NHS National Programme for IT (NPfIT) were strained last month when Andrew Rollerson, its healthcare consultancy practice lead, spoke out at a conference to discuss implementation of the programme, warning of a 'gradual coming apart of what we are doing on the ground'. The slow progress of NPfIT in the southern region where Fujitsu Services is the lead contractor was recently revealed in a parliamentary written answer that showed the firm had completed just £27m worth of work ' less than 10% of the £287.5 paid out to contractors in the other four regions. . ."
NHS pours £100m into finding additional software suppliers (29 Mar 2007)
The Guardian
http://politics.guardian.co.uk/publicservices/story/0,,2045089,00.html
"NHS bosses charged with delivering the much-delayed £6.2bn IT upgrade to health trusts throughout England have launched a £100m-plus drive for "additional" IT suppliers to meet "immediate business needs". Separately, the Guardian has learned that the Australian group IBA Health is close to abandoning talks over a potential all-share takeover of cash-strapped software supplier iSoft, which is contracted to provide systems for 60% of the NHS's troubled National Programme for IT (NPfIT). The decision by NHS bosses to seek new suppliers is a significant move away from the troubled NPfIT, which has been running for four years, mired in delays and software setbacks. Concern has been mounting among clinicians and trust executives that the NPfIT has become over-reliant on software sub-contractors iSoft and Cerner and the suitability of their systems. The two firms have been blamed in some quarters for delays. Official tender documents were filed with the European Union yesterday, stating: "The [NHS] anticipates that, as a result of immediate business needs and projects planned, services ... will be procured at an early stage following the establishment of a framework." The framework, the papers said, would "assist with the success and delivery of the NPfIT". However, "it is not intended" that this would conflict with existing NPfIT contracts. Industry insiders and some NHS sources were at a loss to explain how some of the items sought would not come into conflict with contracted NPfIT agreements. They include maternity, A&E and patient administration systems. Richard Bacon MP, a member of the public accounts committee, said: "It is a tacit admission that the current approach is not working. More clarity is needed about ... how fast people in the NHS will actually be able to acquire new systems from these suppliers". A number of trusts have become so disillusioned with the NPfIT delays that they have begun buying their own IT systems outside the programme, forgoing central NHS funding. Meanwhile, it is believed iSoft will remain in talks with at least one other party should IBA end takeover discussions. IBA is thought to have been unable to win the backing of US firm CSC, through which iSoft is a NPfIT supplier."
Atos Origin suspended from NHS contract (13 Apr 2007)
ZDNet UK
http://news.zdnet.co.uk/itmanagement/0,1000000308,39286700,00.htm
"Atos Origin has insisted it will continue to work with the Department of Health and the NHS despite the suspension of a key health service contract. Ultrasound and medical imaging services, which were being provided by the IT consultancy, were suspended on 20 March after NHS North West claimed that "operational issues had led to incomplete patient information being included and delays in reporting diagnoses". The crisis deepened last week when it was revealed that there were technical as well as administrative problems with Atos Origin's service. Up to 900 patients from areas including Manchester and Liverpool may now have to be called back to hospital to have their scans repeated. The problems arose during a contract that expired at the end of March. A follow-on contract due to start in April has now been shelved for the time being. A spokesperson for Atos Origin said on Friday that the consultancy had "taken the decision to stop accepting referrals for all diagnostic examinations while a full process review takes place. [Atos Origin, the Department for Health and the NHS] continue to work together in preparation for service delivery scheduled to commence in the coming months". Atos Origin is also developing Choose and Book, the appointments system that is one of the major elements of the National Programme for IT (NPfIT). NPfIT is the largest civilian IT project in the world and will bring together the UK's hospitals and GPs all on one network which shared access to patient information."
NHS chief exec pledges to help resolve CRS issues (5 Jun 2007)
e-Health Insider
http://www.e-health-insider.com/news/item.cfm?ID=2753
"NHS chief executive David Nicholson has told Milton Keynes Hospital NHS Trust that they can count on his full support in resolving the problems they encountered in April after going live with the Millennium Care Records System provided by Fujitsu. In April 79 members of staff from the trust signed a letter outlining their frustrations at the Millennium CRS system, describing the system "awkward and clunky" and stating: "In our opinion the system should not be installed in any further hospitals. Problems cited included incidences of lost records. To help rebuild confidence and get a first hand picture on 14 May NHS chief executive David Nicholson and IT director Richard Granger visited the trust. "Mr Granger and Mr Nicholson gave the Trust their full support resolving issues related to CRS. The Trust is committed to working with CfH to improve CRS," a spokesperson told EHI. NHS Connecting for Health said in April that there had been some "unacceptable problems" with the new system installed at Milton Keynes which "require immediate attention". Prime contractor Fujitsu said there had clearly been "some high impact problems". The trust's finance director Rob Baird was quoted as saying: "The service to our patients in some areas has diminished in this period. At the moment we have quite a confused situation and it's like everyone had started a new job". Since early April Fujitsu and Cerner have had a team working on site at Milton Keynes to resolve the problems. . ."
NHS trusts seek software outside NPfIT (3 Aug 2007)
Computer Weekly
http://www.computerweekly.com/Articles/2007/08/03/226007/nhs-trusts-seek-software-outside-npfit.htm
"NHS trusts are going outside the £12.4bn National Programme for IT (NPfIT) to find software to manage patient tests, it has emerged. Computer Weekly has seen board documents from three trusts showing that they are looking outside the programme for software to manage doctors' requests for radiology and pathology tests, a function known as "order communications". Trusts were expecting this functionality to be part of the NPfITs patient administration systems. United Bristol Healthcare now plans to install a third-party system to cover this functionality. The trust will go live with the second version of the Millennium patient administration system next year, but does not plan to use the system for order communications. . . North Bristol NHS Trust said it had bought an alternative product to handle order communications, following delays of more than two years for Millennium. The trust said it expected to go live with R1 next year, but it does not plan to use the system for order communications. Concerns have also been raised by clinicians at Worthing and Southlands NHS Trust about whether the first release of Millennium, known as R0, will support order communications. Despite going live with the first release of Millennium, the trust said it would continue to use manual processes for order communications. . . The Department of Health set the requirement for patient administration systems, and contracted service providers to build these systems with suppliers of their choosing. Fujitsu said it did not believe trusts were seeking an alternative to Cerner for order communications. Steve Isherwood, head of marketing for health at Fujitsu, said that since last year, there had been a lot of discussions over order communications and resolution over how it had been deployed. "R1 and R0 have order communications as part of their functionality. If there are any issues on any areas, we will work with the trusts on these issues. We will identify the issues and provide solutions and resolutions for them," he said. Cerner said the order communications functionality was part of its product, but it declined to comment further. . ."
Contract 'reset' underway in the South (9 Aug 2007)
e-Health Insider
http://www.e-health-insider.com/news/2940/contract_'reset'_underway_in_the_south
"The new NHS programme director for the NHS IT programme in the South of England says she is not happy with the core patient administration system delivered so far, and confirmed that a far-reaching 'reset' of contracts has been launched. Sarah Elmendorf took up the new post of programme director at the Southern Programme for IT earlier this summer. Already she has acquired a reputation for straight talking and demanding results in a hurry. In an exclusive interview with EHI she spoke candidly of the problems with Cerner's Millennium patient administration system, as provided by local service provider Fujitsu: 'I am not happy with what has been delivered thus far, but with the focus of Cerner, Fujitsu, the NHS and ourselves, we can get an acceptable baseline PAS.' She added: 'The NHS needs a good PAS and an excellent clinical system quickly. For this to happen the interests of the NHS Fujitsu and Cerner need to be fully in alignment.' Her appointment, the three southern SHA's creation of a Southern NHS IT programme and decision to hit the 'reset' button on contracts are proof power shifting from the centre. But it was the centre, in the shape of Connecting for Health, which originally negotiated local service provider contracts, and remains 'the owner of the contract and the commercials'. To get change through the Southern NHS IT programme will need CfH's co-operation. Only at the end of the current reset period will it be clear whether NPfIT Local Ownership Programme (NLOP) is made of straw or whether the reins have either been surrendered or wrested from the centre. Before taking up the new role in June Elmendorf was the CIO for South Central SHA. Previously she held senior IT positions in telecoms and banking, roles in which she says the focus was always on 'delivery' and staying close to customers and suppliers. She confirmed to EHI that one of the first steps taken by the Southern Programme for IT has been to 'reset' the contract with Fujitsu the culmination of mounting pressures and NHS frustrations over many months. This is a far reaching review of the detail of Connecting for Health's contract with Fujitsu, including revisiting the requirements of what is to be delivered and how and when this is done. Elmendorf suggested the current 'reset' may just be the last opportunity to get NPfIT to work for the NHS. A previous contract 'reset' was completed in November 2006, but failed to draw a line under implementation problems and delays. The difference this time is that it the process is being led by SHAs and trusts. . . Priority areas requiring immediate attention in Millennium include: outpatients, waiting lists, A+E and reporting. . ."
Some NPfIT PAS systems barely used (21 Aug 2007)
e-Health Insider
http://www.e-health-insider.com/news/2972/some_npfit_pas_systems_barely_being_used
A number of Connecting for Health funded patient administration systems (PAS), installed in primary care and community trusts, are only being used by a handful of staff months after installation, according to official figures seen by EHI Primary Care. Internal figures, prepared by local service provider (LSP) CSC Alliance, show an average number of monthly users of just one for North Staffordshire, less than 20 for Cambridgeshire PCT, South Essex and Bedfordshire and Hertfordshire health community, and less than 50 for Dudley, Fylde Coast and North Cheshire. Usage figures for PAS systems in the North, Midlands and East Programme for IT show that, in several cases, less than 20 staff are using the CfH supplied PAS system each month. CSC is responsible for delivering new IT systems to three-fifths of the English NHS. Latest CfH figures report that it has installed 99 NPfIT versions of iSoft's iPM PAS system, mostly in its original North West and West Midlands cluster. The majority of the systems have been installed in PCTs, community and mental health trusts. . ."
Future of centralised NHS IT in doubt as BT 'resets' contract (22 Nov 2007)
ComputerWorld
http://www.computerworlduk.com/management/government-law/public-sector/news/index.cfm?newsid=6336
BT has completed the renegotiation of its £1bn contract to deliver new computer systems to the NHS in London, in another sign that the centrally managed model for the health service's £12.4bn National Programme for IT (NPfIT) has had its day. NHS IT agency Connecting for Health had originally kept a tight central grip on contracts for the huge IT overhaul, under its combative director general Richard Granger. But in July, Granger announced he would quit his post by the end of the year - and the Department of Health has not advertised for a replacement. Instead, the management arrangements of Connecting for Health and NPfIT are being reviewed by NHS chief executive David Nicholson, while the lead contractors for the programme are involved in renegotiating their deals to enable a more locally tailored approach that meets the needs of strategic health authorities and trusts. A BT spokesperson confirmed that the new contract for the London region would establish a "best of breed" approach to the software it supplies rather than a rigid one-size-fits-all model. Negotiations had begun in summer 2006, when BT sought to switch the patient record system it supplied from one supplied by IDX to Cerner's Millennium product, he said. But the new deal had been completed this summer, after the advent of the NPfIT local ownership programme (NLOP) - which transferred responsibility for the delivery of NPfIT from Connecting for Health to SHAs. A Connecting for Health spokesperson insisted that the renegotiation of the BT contract should be described as a "reset", adding: "The contract reset is a normal repeatable commercial process to ensure the detail of the contract reflects the progress to date, current priorities and deployment plans for the future." Another "reset", relating to "changes in development methodology and deployment" was under way with Fujitsu and CSC - lead contractors for the South, and North and Eastern regions - the spokesperson said. But in September Lester Young, NHS account director for Fujitsu, confirmed that his company was expecting to sign a new contract with the NHS and would even be open to changing the original output based specifications for NPfIT set by Connecting for Health in 2003. Changes to the contract - which is ultimately held by the health secretary on behalf of the government - would "deal with the differences" between what strategic health authorities in the southern region want and the requirements set out nationally by Connecting for Health, Young said. It is unclear what the new contracts will mean for the overall cost of the NPfIT programme. The Connecting fro Health spokesperson said: "The original value of the contracts for the same services remain unchanged. However, when additional requirements are identified in conjunction with the NHS then any additional charges will either be funded separately or funded from within the original contract value, depending upon the particular need and the work required."
N Yorks GPs protest over system choice (27 Nov 2007)
e-Health Insider Primary Care
http://www.ehiprimarycare.com/News/3258/n_yorks_gps_protest_over_system_choice
"GPs claim their PCT is acting outside the GP Systems of Choice initiative by outlining a plan to encourage all practices to move onto the local service provider solution TPP's SystmOne. North Yorkshire and York PCT 's IM&T strategy states that the introduction of SystmOne will be "actively promoted and supported by the PCT" giving consideration to the objectives of the strategic health authority, the principles of GPSoC and the best interests of patients. . . The strategy says around 80% of the 102 practices covered by the PCT currently use the GP system EMIS with only four currently using SystmOne but outlines the SHA plan to see 100% of practices in the region on TPP by 2011. Dr Brian McGregor, a GP in York and a director of district's LMC, said the committee first heard about the strategy at a liaison meeting with the PCT at the beginning of this month. It went before the PCT board for approval five days later. He told EHI Primary Care: "First of all we believe it is factually incorrect as it presents SystmOne as the NPfIT solution when our understanding is that this is only an interim solution and the ultimate aim is for practices to move onto Lorenzo primary care. That could mean practices that move to SystmOne having to go through a second change. "We also think it's not for the PCT to promote one system over another which is something for practices to decide for themselves." Dr McGrgeor said the LMC feared that practices would be forced into changing systems against their will and said it was "even more galling" that a local primary and secondary care intranet in the York area, linking EMIS practices with York District Hospital, was already delivering the vision of primary and secondary care linked services that the strategy involved. Dr McGregor said the intranet, set up two or three years ago, now delivers 1000 plus letters sent electronically direct to patient records every day and access to a shared care record was planned soon as well as possible links to the intranet for practices using other GP systems. . . Dr McGregor said GPSoC documents issued to all practices include a statement that those signing up to GPSoC are committing themselves to migrate to the fully integrated LSP solution when that is available. He said the LMC's advice to practices was not to sign the document until that statement had been removed. . ."
NHS records system delays cost CSC £5m (7 Jan 2008)
Computer Weekly
http://www.computerweekly.com/Articles/2008/01/07/228759/nhs-records-system-delays-cost-csc-5m.htm
"Services supplier CSC has paid penalties of about £5m following delays in the deployment of patient administration software across several NHS trusts under the National Programme for IT (NPfIT). The disclosure undermines claims by NHS Connecting for Health and the Department of Health in a briefing paper to the prime minister in February 2007 that "much of the programme is complete, with software delivered to time and budget". NPfIT regional minutes seen by Computer Weekly show that CSC has made penalty payments following delays in rolling out software in the North, Midlands and East of England, where it is the NHS local service provider. . . CSC is due to supply NHS trusts with iSoft's Lorenzo patient administration and electronic record system under the NPfIT. CSC has worked with trusts to deploy limited interim versions of iSoft's patient administration systems following delays in the "strategic" Lorenzo releases, which could provide joined-up health systems across England. . ."
Fujitsu may quit NHS National Programme for IT (22 Jan 2008)
Computer Weekly
"The board of an NHS trust has learned of a "significant" risk of Fujitsu ending its £900m contract to supply and implement hospital systems across southern England as part of the National Programme for IT (NPfIT). A withdrawal would add to delays in installations of NPfIT systems, deepen scepticism among doctors over whether the programme is feasible, and could indicate that the NPfIT is in deeper trouble than widely thought. In 2006 Accenture withdrew as a local service provider, making provision for write-offs of about £230m. Fujitsu and NHS Connecting for Health, which runs part of the NPfIT, and the Department of Health are discussing a contract "reset", which involves a renegotiation of large parts of the £896m deal signed in 2004. The contract is not due to finish until 2013. Computer Weekly understands that there are differences of views over the cost of the requested work which amount to tens of millions of pounds. If an agreement over price cannot be reached, Fujitsu has the choice of seeking to reduce the amount of work and risk it is being asked to take on, absorbing any extra costs or withdrawing. The Royal United Hospital at Bath has warned of a series of risks to its planned go-live of NPfIT systems this spring. It has categorised as "significant" a risk of "further delays if Fujitsu ceases to be the local service provider for the South [of England]". The trust's staff are involved in the contract reset. To mitigate risk, the trust would have to establish an effective working relationship with Fujitsu sub-contractor Cerner to "ensure satisfactory continuity in the event of Fujitsu's contract ending", said Richard Smale in a paper to his board, which he wrote as head of information services at Royal United Hospital. Fujitsu is known to be a tough negotiator and, according to a National Audit Office report, it threatened to withdraw from the Libra contract to supply a national case management system for magistrates courts. In the end, the value of Fujitsu's Libra contract was increased from £146m to £232m and it was reduced in scope, with the government's agreement. A spokeswoman for Fujitsu declined to comment on whether it may cease to be the South's local service provider, or that in the contract reset negotiations there are differences of views over the cost of the requested work of tens of millions of pounds. The spokeswoman said, "We cannot comment on ongoing commercial negotiations." NHS Connecting for Health made a similar comment."
Some NPfIT "major issues" - did the PM get a full briefing in 2007?(17 Jan 2008)
Computer Weekly - Tony Collins' IT Projects Blog
http://www.computerweekly.com/blogs/tony_collins/2008/01/some-npfit-major-issues-did-th.html
"Some of the major NPfIT issues identified by Helen Bellairs, Chief Executive, Western Cheshire Primary Care Trust, seem at odds with a briefing paper to the prime minister in February 2007. Helen Bellairs is a local senior responsible owner of the National Programme for IT [NPfIT] in the NHS. Under NLOP, the NPfIT Local Ownership Programme, all chief executives of primary care trusts in England have been appointed senior responsible owners. It means they may be held accountable for failures and realising any benefits of NLOP and the NPfIT. In a briefing paper to the North West Strategic Health Authority NPfIT board, Helen Bellairs outlined what has been achieved locally; and she identified six "major issues" with the NPfIT. Some of the issues have a general significance to the national programme. The paper referred to the Lorenzo product supplied by iSoft - now owned by Australian company IBA health - and CSC, the NPfIT local service provider for the North, Midlands and East of England. . .
- The continuing delays in the availability of the Lorenzo system, which undermine the credibility of the whole of National Programme for Information Technology. In the meantime, existing suppliers continue to develop their products, which make it even harder to persuade Trusts to move onto Lorenzo.
- A lack of confidence in how strategic instances are going to work in practice. It is very hard to see how a large database across the whole of Cheshire and Merseyside will work when all hospitals and community settings are on it. This needs to be addressed through strong governance and general interaction between the Local Health Communities.
- The lack of confidence created by repeated undelivered promises. An example of this would be the recent failed upgrade in Morecambe Bay.
- The lack of a clear strategy in relation to the sharing of clinical data in relation to i) meeting organisational requirements ii) information governance issues and iii) the technical infrastructure to support it.
- There is widespread dissatisfaction at the local level with the performance of the National Service Desk (Fujitsu). Despite escalation of these issues, no discernible improvements have been identified. This issue has been addressed to some extent by the formation of the shared Cheshire and Merseyside Service Desk, but this would not have been required if the National Service Desk delivered what they promised.
- The lack of clinical functionality in the current patient administration system from CSC means that clinicians are disengaging from the programme and looking elsewhere for clinical solutions. . ."
Minister defensive over Cerner NPfIT NHS sites (4 Feb 2008)
Computer Weekly - Tony Collins IT Projects Blog
http://www.computerweekly.com/blogs/tony_collins/2008/02/minister-defensive-over-cerner.html
When advisers to ministers write replies to Parliamentary questions they have no legal duty to be candid. Within reason they can say what they like. So for them answering written Parliamentary questions may be no more challenging than playing tennis with the net down. Indeed, when asked about the NHS's National Programme for IT [NPfIT], ministerial advisers can use Parliamentary replies to make light of the concerns of clinicians and others. And this is what happened when Worthing MP Peter Bottomley put a question about Cerner sites to Ben Bradshaw, who's the latest in a series of ministers to be put in charge of the NPfIT. Cerner's "Millennium" software will be used to help NHS staff administer hospitals and keep records on the care and treatment of patients. It's due to be installed at hospitals across London and the South of England as part of the NPfIT. Bottomley asked Bradshaw what representations he'd received from clinicians in hospitals about Cerner Millennium go-lives. Bradshaw's reply in January 2008 suggested that clinicians are concerned only about things such as the number of keystrokes to carry out certain functions. . . There have been some successes with Cerner go-lives. Barnet and Chase Farm Hospitals NHS Trust, for example, now has near a real-time overview of when beds are vacant and where. The reality, also, is that at some hospitals where Millennium has been installed there have been protracted difficulties, not necessarily through any fault of NHS trusts or Cerner, or the local service providers, Fujitsu and BT. The Audit Commision, in the latest annual audit report on Weston Area Health NHS Trust, referred to the implementation of what it called the Cerner National Care Records System. The Commission said that remedial work continued for months. It said: "Significant problems with the implementation of the Cerner system have resulted in poor data quality and a lack of robust information...Weston Area Health NHS Trust was included within the first deployment of the Cerner National Care Records Service (NCRS) and implemented the NCRS system in October 2006. However, it was soon recognised that the system was not providing the services required by the Trust and that significant remedial work would be required.Over the last nine months the Trust has been working with the suppliers and the SHA to resolve these issues..." Bradshaw's reply gave no hint that an independent organisation such as the Audit Commission had deemed as "significant" problems arising from a Cerner implementation. . . Buckinghamshire Hospitals NHS Trust went live with the Cerner Care Records System on 25 September 2006. More than a year later, in November 2007, the trust's board was told of some of the day to day difficulties. On the matter of keeping track of patients with MRSA and C Difficile, the Care Records System was "not working consistently" although Fujitsu, the supplier of Cerner's Millennium system in the South of England, was working on a fix. . . Avon, Somerset and Wiltshire NHS Cancer Services has said that "Current opinion regarding Cerner is that it will not support cancer data collection and reporting requirements for at least 5 years, possibly nearer 10 years." And NHS South Central reported in November 2007 that "Deployment problems at those sites that have implemented the [Cerner] system has created concern amongst those organisations in the deployment pipeline. Regular communication is now taking place to rebuild confidence and keep organisations up-to-date with progress on the contract reset." . . It has been said before but if ministers and officials continue to play down the problems of NPfIT implementations they'll carry on alienating clinicians and other NHS staff whose support they need to make a success of the programme. Ministers and NHS Connecting for Health, which runs part of the NPfIT, do not need to put the programme in a zoo enclosure marked "Say kind things only - this enclosure is for the worried and nervous". . .
NHS multimillion pound IT: the risks (20 Feb 2008)
Channel 4 News
http://www.channel4.com/news/articles/society/health/nhs+multimillion+pound+it+the+risks/1613452
"It's costing millions but the new NHS computer system in London and southern England poses a risk to patients say some consultants. The new NHS IT system is causing serious concern among clinicians. Last summer, the then boss of the National Health Service IT system, Richard Granger, candidly admitted he was "ashamed" - saying some of the hospital software was "appalling". Seven months on, Channel 4 News has spoken to clinicians who are seriously concerned about the system. NHS bosses insist the software being installed in hospitals to manage all the information on every patient who walks through the door will bring huge benefits. It's a key part of the £12bn NHS computer project, Connecting for Health. With electronic medical records and on-line scheduling of treatment and tests, it's meant to save time and improve efficiency. But the reality for some has been rather different. Consultants we have talked to in a number of trusts paint a disturbing picture. They talk of repeated delays in getting the system up and running. And far from making things more efficient, they say that hundred of thousands of pounds have had to be spent to employ extra staff to make it work. In one hospital they have had to abandon many of the system's functions because they believe it could be putting patients at risk. In southern England and London, the NHS is buying and modifying off-the-shelf software from the US company, Cerner. The new patient information system has already been introduced into 13 hospitals across London and the south. It has not impressed some consultants who've used it. Chris Taylor decided to speak out because of her experience in one hospital. She concluded patients might be at risk after she found the system couldn't do simple things like print labels for blood samples quickly. She said: "It happened on more than one occasion; I was walking around the department with a handful of blood samples in my hand afraid of putting them down because I didn't want to get them mixed up with the samples that others had in their hands which were equally unlabelled because the system couldn't cope. "So if you are asking me whether it puts patients at risk? Yes, it does, because sometimes you must not delay treatment." We put her concerns to Connecting for Health's national clinical director for the new hospital system, who is himself an accident and emergency consultant at a London hospital. Dr Eccles said: "Well that needs to be investigated and interestingly has not been escalated. I am unaware of that. "We do have a very clear escalation policy for any issue that offers risk to patients. It is unacceptable to leave patients at risk and we don't do so." Cerner, who makes the software, told us: "The Cerner Millennium solution has passed all... testing and assurance requirements." As for speed, Cerner said it had conducted performance tests with satisfactory results. Another trust where the Cerner system has run into trouble is at the Royal Free Hospital in north London. The system was due to be up and running at Easter - that's next month - but at the end of January the chief executive wrote to all staff in an email that start-up had been delayed until May. He said: "The trust was not prepared to accept a system that is not yet demonstrated to be fit for purpose." The Royal Free says the delay is frustrating, but not uncommon for programmes of this scale and complexity. They told us it was caused by the need for more testing of computer programs that provide extra clinical functions beyond the basic patient administration system. For some hospitals, too, the new system has led to extra costs. In just three of the 13 trusts with it - Taunton, Worthing, and Winchester - extra staff and other costs add up to around a £1m. The pressure is now on Connecting for Health to show that IT in the NHS brings real benefits. But the opinions of some doctors who've experienced the systems are making that difficult. Chris Taylor added: "Given that the system has been in some form implemented in hospitals for over a year and that there have been entire consultant groups who have raised their concerns, almost protests, it is beyond comprehension that this system, in its current form, is now being implemented. It just really is beyond comprehension. I have no other word for that." The stakes, then, couldn't be higher for the future of the NHS IT programme. Because unless the problems with the new hospital system are resolved soon, the chance of realising genuine longer term benefits of IT in the NHS could be in jeopardy."
Millennium remains a 'challenge' at Worthing (4 Mar 2008)
e-Health Insider
http://www.e-health-insider.com/news/3525/millennium_remains_a_'challenge'_at_worthing
"The chief executive of Worthing and Southlands NHS Trust has said in a letter to staff that the Cerner Millennium system installed six months ago by Fujitsu continues "to be a challenge across the trust". In a letter posted on the trust's intranet, Stephen Cass, told staff: "All staff - whether you use the system or not - will be aware that the new care records system - or Cerner - is continuing to be a challenge across the trust." Cass added he was aware of the difficulties staff faced in using the system: "I know the ongoing issues are causing difficulties and adding to your workload." The trust's Millennium R0 was installed by Fujitsu in September 2007. At the time in the months since the go-live has consistently been described as the best implementation yet of Cerner Millennium under the NHS IT programme. In his letter, Cass says that the trust has invested in extra functionality and training resources, to help staff get used to the system. "As an organisation, we have put in additional resources to improve the system's functionality. The trust is also making additional resources available for training and support," he wrote. He stressed that as Millennium is the chosen software for the whole of the Southern NHS the trust had no alternative but make it work: "There is no going back for us - and we are committed to making it [Millennium] work." In February the trust came under scrutiny from Channel 4 News when Dr Patrick Carr said it had been abandoned in the hospital's A&E department: "Every process we used to do by hand seemed to take longer using the Cerner solution." Problems with Millennium are also acknowledged in a letter written by Candy Morris, chief executive of the South East Coast SHA, sent to local MP, Peter Bottomley who had raised questions about problems with Millennium. Morris told the MP that the functionality 'deficiencies' have resulted in Connecting for Health (CfH) asking Fujitsu to explain why implementation dates continue to slip for trusts in the South. "Following the deployment project, whatever the ultimate gains, further deficiencies in functionality have emerged. We are very mindful of these. You may be aware that NHS Connecting for Health with the support of the three SHA chief executives in the South of England has escalated the issue with Fujitsu in relation to their failure to deliver key implementation milestones in their work for the Southern Programme for IT. Negotiations continue, and there are no rose-tinted glasses. We await Fujitsu's remediation plan," she told the MP. EHI contacted staff working at trusts live in the South live with the Millennium R0 solution and found a number were still experiencing difficulties with the software. One anonymous member of the Somerset Health Informatics Service, responsible for Taunton NHS Trust, told EHI: "It's not been as easy an implementation as we hoped it would be. Staff have found the Cerner system difficult and tedious, and there have been a series of complaints arising from the deployment. We have had to bring in outsourced floor walkers to deal with the disruption, and help clinicians get used to the Cerner solution. They added: "We have had a team of people working on this for over two years, testing and retesting the system to make sure that it does what we need it to, and to some extent it is making a difference, but it doesn't surprise me that Worthing are still experiencing functionality deficiencies." A senior nursing staff member at Surrey and Sussex meanwhile told EHI: "Worthing followed our lead in deploying Millennium after the solution was signed off three months after deployment and given a great review in E-Health Insider when they did so. In reality, we have had difficulties and the system isn't the great clinical management asset we needed. It still has some real problems in generating information which nurses need - especially when it comes to printing. The SHA are well aware of our problems and hopefully Mr Bottomley will look to take action on this." In her letter, dated 26 February, Morris told Bottomley the Southern Programme for IT's contract reset with local service provider Fujitsu was still under negotiation. According to health minister, Ben Bradshaw, the next Southern Programme of IT site to get the system will be Bath Royal United Hospital NHS Trust in May, though the trust were unable to confirm this to EHI. . . Cerner and CfH had not responded to questions by the time of publication."
Plans to replace legacy NHS systems put on hold (7 Apr 2008)
Computer Weekly
"Hospital executives have put plans to replace legacy systems on hold after protracted negotiations between the NHS and Fujitsu, its main IT supplier in southern England. Computer Weekly has learnt that several trusts have delayed plans for new systems under the NHS's National Programme for IT (NPfIT). Although training of staff in the systems has continued in some areas, some trusts have been unable to set go-live dates. Fujitsu and the NHS have been negotiating for more than nine months on a "contract reset" to allow for changes in the NPfIT since the 10-year, £896m deal was signed in January 2004. A memorandum of understanding, which allowed the NHS and Fujitsu to operate as if a revised contract were in place, expired on 31 January, and the two sides have reverted to the original deal. The renegotiation of parts of the contract has involved secretary of state for health Alan Johnson and Fujitsu's parent organisation in Japan. Talks on the reset were due to finish last November. They were then expected to be complete by the end of March, but there is still no word on whether a deal has been agreed. Officials working on the NPfIT had announced in 2006 that St Richard's Hospital in West Sussex would go live with an NPfIT care records service in October of that year. But the Royal West Sussex NHS trust confirmed last week that it had been unable to set a date for implementation. The contract reset was one of the uncertainties. The trust's board also wants to learn from a go-live of the Cerner Millennium care records service at Worthing Hospital, where it said there had been "issues concerning functionality". The board of the Southern Programme for IT - part of the NPfIT - has reported that, "The operating plan for the delivery of the care record service deployments for 2008 is being reviewed to take account of local deployment verification and detailed planning, and the current position on contract reset." NHS Connecting for Health, which runs part of the NPfIT, and Fujitsu declined to comment on the contract reset."
All eyes on the NPfIT go-live at Barts? (18 Apr 2008)
Computer Weekly - Tony Collins' IT Projects Blog
http://www.computerweekly.com/blogs/tony_collins/2008/04/all-eyes-on-the-npfit-golive-a.html
"Some staff at the Barts and The London were without their new systems, delivered under the NHS's National Programme for IT, for half an hour on Tuesday during the busy morning period when many patients come into hospital. . . Barts is a particularly complex installation. It's the oldest hospital in the UK, founded in 1123, and is spread over several sites. But that's not the reason its go-live has a potential importance which goes beyond London. It's because of a re-negotiation of parts of a £896m contract signed in 2004 under the National Programme for IT [NPfIT] between the Department of Health and Fujitsu. The so-called "contract reset" leaves ministers with a decision on whether to pay Fujitsu a significant extra sum. It's possible a deal will be done. Or it's conceivable that Fujitsu will quit, gradually handing to a different main supplier for the NHS in the south of England. A Memorandum of Understanding between Fujitsu and the NHS is understood to have been signed, which gives ministers another 90 days to decide what to do. The Department of Health is understood to be seeking to enlist the support of Downing Street and HM Treasury in securing the extra money. But the question is: what will happen after the 90 days? This is why the go-live at Barts has some potential significance. With the help of BT, the local service provider for London, Barts has installed LC0, a version of Cerner's Millennium system, which been tailored for use by the London Programme for IT. There's interest in the NHS in Barts because, if Fujitsu announce a gradual withdrawal from the NPfIT, who would replace it? Just as CSC took over Accenture's contract as an NPfIT local service provider in the north of England, BT could take over Fujitsu's contract as the local service provider to the south. In which case eyes are turned towards BT's challenging installation at Barts. If everything settles down quickly at Barts and Fujitsu quits the NPfIT, BT could slide into position as one of the two remaining NPfIT local service providers for the whole of England, CSC being the other. But serious problems at Barts or at two other London trusts that are planning to go live this side of summer, could affect BT's chances of taking over from Fujitsu. . ."
Worthing says Cerner's functionality 'inferior' (28 May 2008)
e-Health Insider
http://www.e-health-insider.com/news/3795/worthing_says_cerner's_functionality_'inferior'
"The chief executive of Worthing and Southlands Hospitals NHS Trust has said the Cerner Millennium care records system is still suffering from 'inferior functionality', leading to 'significant level of discontent among clinicians'. Attempts to install manual and electronic workarounds - where possible - have already cost over £2m of extra spending, with a further £1m now required by the trust. The Cerner CRS system was provided by Fujitsu as part of the £12.7 billion NHS IT programme. Workarounds have had to be installed for nurse handover reports, establishing a separate patient database for A&E and a data warehouse to allow statutory reporting. As a result, Worthing - which had been hailed by Fujitsu as a flagship site - has already had to borrow £2m from West Sussex PCT to cover 'extra expenditure incurred as a result of the Cerner implementation', on extra staff and software, straining the relationship with its main customer. Despite these extra investments Worthing's chief executive has said the trust is "still unable to satisfactorily capture, record and bill all activity", which was "contributing to contractual difficulties" with the PCT. . . Problems with the system include: staff being unable to effectively locate and track patients or case notes, no facility to record A&E procedures or provide fit for purpose discharge summaries, no capability to track and monitor 18-week waits, serious problems with correspondence, no provision for printing and annotating patient lists, and no ability to print off specimen labels. . ."usable.
NHS hit as Fujitsu fired from IT project (28 May 2008)
Financial Times
http://www.ft.com/cms/s/0/41dbc5f0-2cf3-11dd-88c6-000077b07658.html
"The NHS's £12.7bn programme to provide every patient in England with an electronic care record suffered a severe blow on Wednesday as the project fired one of its key suppliers after failing to resolve a wrangle over the contract. Ten months of renegotiations with Fujitsu, which holds the £896m 10-year contract for installing the record across the whole of the south and west of England, have broken down, according to both the company and the NHS. . . The breakdown is a blow to the programme, although its defenders will argue that the contract structure of having an original four big suppliers is likely to work as BT or CSC is likely to step in. But the breakdown can only further delay a programme whose core product - the electronic record - is already running more than four years late. . ."
Fujitsu's £896m NHS IT contract to be terminated (28 May 2008)
e-Health Insider
"NHS Connecting for Health is to terminate the £896m contract with Fujitsu to upgrade NHS IT systems across the South of England after the IT services giant withdrew from contract re-set negotiations. Negotiations to 'reset' the Fujitsu local service provider contract have been underway since July 2007. Senior NHS staff in the South of England were told of the news today, after last ditch attempts to broker a deal failed last Friday with a final unsuccessful effort made on Tuesday. By withdrawing from the contract re-negotiations Fujitsu placed itself in breach of the original contract signed. In a statement NHS CfH told E-health insider: "Regrettably and despite best efforts by all parties, it has not been possible to reach an agreement on the core Fujitsu contract that is acceptable to all parties. The NHS will therefore end the contract early by issuing a termination notice." In a statement to EHI Fujitsu said: 'Fujitsu Services can confirm that we have now taken the decision to withdraw from the National Programme for IT (NPfIT) contract re-set negotiations with NHS Connecting for Health as we did not feel there was a prospect of an acceptable conclusion. The NHS has advised us that they intend to end the contract early by issuing a notice of termination. The Fujitsu statement added: "For the moment our work on the contract reverts to the terms of the original programme. We will work closely with the NHS to provide a smooth transition to the new arrangements.' CfH has begun a crash programme of working up contingency arrangements. The agency said it acknowledged the work Fujitsu had done and "commitment to smooth transition arrangements", but stressed it had to "protect the interests of the taxpayer and preserve the basis of contracts which ensure payment on delivery. Gordon Hextall, the chief operating officer and interim director of programme and systems delivery for CfH, said in a letter today to trust chief executives in the South: "There are no immediate implications for live sites and Fujitsu Services Ltd will continue to support these Trusts to current service levels in line with the contract. We are working co-operatively and constructively with Fujitsu Services and the NHS to review the overall arrangements for providing systems to the sites that have not yet gone live with Cerner Millennium."
Fujitsu's departure from NPfIT leaves project floundering, experts say (29 May 2008)
Computer Weekly
"The National Programme for Information Technology, the NHS's flagship project to produce a national networked information infrastructure for patient care, could become the government's biggest IT disaster yet, experts have said. Their comments came after Fujitsu walked away from negotiations on a "more flexible" contract to supply an electronic patient record system to hospitals in the south and west of England. Martyn Thomas, who represents the UK Computing Research Committee (UK CRC), a policy committee for computing research in the UK that consists of computer science professors at 23 leading universities and an expert witness in IT-disaster court cases, described the national programme as "a train wreck in slow motion". Speaking in response to the news, Thomas said UK CRC had warned the parliamentary select committee on health several years ago that the NPfIT "was exhibiting signs of failure" and called for an independent review to identify ongoing risks and ways to manage them. Thomas said Richard Granger, then head of the NPfIT, and his successor, David Nicholson, had accepted the comments, but had been overruled by ministers. MP Richard Bacon, who sits on parliament's Public Accounts Committee, said Fujitsu's refusal to sign a renegotiated contract was an opportunity to give back to local trusts the right to buy what they liked. "The original approach of handing over monopolies to a handful of local service providers was never going to work and has been shown not to work," he said. Bacon warned against handing Fujitsu's contract over to the other two main suppliers on the project, CSC and BT. It was a way to screw things up completely, he said. "This whole thing was built on the detailed patient record system. We have not seen much yet, but we are already four years late and £4bn in." Bacon and Thomas both noted that the successes claimed for the programme, such as the ability to send digital X-rays over IT networks, were not part of the original NPfIT, and in fact preceded it. Thomas said the X-ray system was part of the argument for the programme made to the then prime minister, Tony Blair. . ."
Where now for NHS National Programme after Fujitsu exits? (29 May 2008)
Computer Weekly
Only 10 days ago a deal aimed at rescuing the NHS's National Programme for IT in the south of England seemed imminent. Officials and Fujitsu had spent nearly a year negotiating changes to a 10-year contract worth £896m, signed in January 2004. The two sides had agreed a deal in principle. Papers were ready for signing by David Nicholson, the chief executive of the NHS, who is also the predominant senior responsible owner of the £12.7bn National Programme for IT (NPfIT). But at what one NHS official said was the "59th minute of the eleventh hour" Fujitsu informed Nicholson that it was withdrawing from the negotiations. The NHS responded decisively, by terminating Fujitsu's contract. The NHS had threatened to terminate the contract even during the "contract re-set" negotiations. Nevertheless, the way Fujitsu withdrew has taken many in the NHS by surprise. . . Why did a proposed deal collapse? NHS officials believe that Fujitsu's board in Japan decided to intervene. The board was concerned that Fujitsu's potential losses on its NPfIT work, as one of three local service providers to the NHS, could be much greater than its directors had thought at first. Fujitsu is the monopoly supplier of Cerner's Millennium care records service, which is mandated to be the main hospital system for the south of England. Now that Fujitsu is withdrawing as the local service provider for the South, and trust boards do not have the freedom to buy elsewhere, uncertainty has been piled onto uncertainty for the boards of NHS trusts. Some in the NHS say this is a characteristic of the NPfIT as a whole. "We are into a period of turmoil. There are the exit arrangements with Fujitsu to manage, especially for the early-adopter sites, and there will probably be some months of discussion about what we should do. There is no uniformity of view within the NHS on that," one official said. There are several options. One is for the government to give trusts the freedom to buy care record systems from other suppliers, under Connecting for Health's Additional Supply Capability and Capacity (ASCC) framework, which came into force recently. This would give trust boards in the south of England the option of buying the Millennium system directly from Cerner - rather than from Fujitsu as the middle-man. Or they could choose to buy from another accredited Care Records Service supplier. Most IT executives in the NHS are expected to favour this option, particularly if the software is funded centrally irrespective of what ASCC choice the trust makes. Other options include passing Fujitsu's work to one or both of the two other local service providers, CSC and BT. But both of these suppliers have had serious difficulty delivering a national strategic system to the NHS. Some NHS staff believe that Cerner can be made to work across the UK. It is a successful product in the US and elsewhere. But others are concerned that Millennium is a client-sever system rooted in the 1990s. NHS staff need extensive training to use it. It is not as intuitive as, say, an online banking system. There are also wider concerns among some officials that the NPfIT itself is dated in concept as well as practice. Since the programme was announced, trusts have become subject to competition for patients from private companies and even within the health service, particularly foundation trusts. They want IT to give them a competitive edge, which makes them less inclined to favour systems chosen for them centrally. . ."
NHS bosses may not replace contractor after Fujitsu's walkout (30 May 2008)
The Guardian
http://www.guardian.co.uk/society/2008/may/30/nhs
"NHS bosses may not appoint a replacement for Fujitsu as one of three regional contractors leading the health service's troubled £12.7bn IT systems overhaul following the Japanese firm's decision this week to walk away. This is being called for by disaffected trusts across the south of England who want to pick their own suppliers. It would be a big blow for BT which had been seen as favourite to replace Fujitsu because it is already lead contractor for the neighbouring London region and is deploying the same software package, Cerner Millennium. BT has said it wants the Fujitsu contract, but many medics and IT workers within the NHS remain deeply sceptical about the suitability of Millennium, a US product, for Britain's hospitals. NHS Connecting for Health, the body which oversees the National Programme for IT, was last night weighing up whether to go with BT or to allow trusts to select their own suppliers. . . A report this month by the National Audit Office revealed that just 13 Millennium systems had been deployed in acute trusts, nine of them in the southern region. In several cases trusts have withheld payment, something they are only supposed to if systems are not working properly. The Lorenzo software package, earmarked by CSC for the Midlands and the north of England, remains in development phase. It was originally supposed to start being rolled out in trusts from April 2004, but the development schedule has slipped repeatedly. Early versions of Lorenzo are now promised to go live in some hospitals this summer, but many experts believe that deadline will also be missed. Despite its considerable success building an IT "spine" and nework designed to link National Programme systems across the country, BT has had a mixed track record running the care records services contract for London. By the end of March it had deployed just four patient administration systems in acute hospital trusts out of 32 in total. Last month it added Barts to the list, but this deployment is already believed to be suffering serious data collection and reporting problems. A spokesperson for Barts last night denied there were serious concerns. "The system is largely working as intended and gradually becoming embedded into normal operations." Proceeding without a lead contractor for the southern region would mark an end to the original vision of a centrally orchestrated programme - the largest non-military IT project in the world - which the NAO this month confirmed was already running at least four years late. . ."
Leading article: Another tragedy of errors (30 May 2008)
The Independent
"In almost any enterprise, the news that management has plans to install a new computer system tends to be