Suppliers urged to rescue failing NHS ICT programme
bjhc&im May 2007 The healthcare-software industry has
welcomed as “long overdue” the report on the National Programme for IT
published last month by the House of Commons Public Accounts Committee
(PAC). One of the report’s conclusions is that the Programme is unlikely
to deliver any significant clinical benefits before the existing
local-service-
provider (LSP) contracts expire, and urges the Department of Health to
hold ‘crash’ talks with its prime suppliers in order to rectify current
problems. In effect, the report requires the DoH to:
- allow secondary care trusts and others to procure their own PASs
and clinical systems, so as to get essential hospital systems up and
running as fast as possible;
- negotiate with its lead suppliers to agree a realistic delivery
timetable;
- require suppliers to solve the chronic skills and capacity
shortages that are plaguing delivery; and
- keep a close eye on suppliers’ finances and step in if they get
into difficulties.
Having taken nine months to see daylight, the report was said to
be out of date by the Department of Health. But in fact it had been
given the Committee’s recommendations months ago and has already
acted on them, according to healthcare-ICT expert Phil Sissons, a
former consultant for NHS Connecting for Health, the DoH agency
directing the course of the NPfIT. Key examples are the NPfIT Local
Ownership Programme (NLOP), and the recently announced catalogue of
additional accredited suppliers. Sinead Quinn, Healthcare Manager
of the supplier association Intellect, backed these moves. “Bringing
in additional suppliers is bound to improve matters, given that the
Programme has turned out to be much more difficult than was
expected”, she told bjhc&im. “But these new suppliers would really
welcome more clarity of policy, rather than having to work with LSPs
and trusts in unofficial ways.”
The report’s other requirements are more problematic, however.
Roger Wallhouse of consultancy Health Sys-tems Solutions said that
the proposed “pragmatic rescheduling” of the NPfIT was long overdue.
“The Programme has never been realistic, since it was always driven
by political expedients”, said Mr Wallhouse. He would want to see
the renegotiation process “kept free from political intervention and
to ensure that the UK healthcare-software suppliers have a
signifiant voice”. What LSPs and suppliers need above all,
Wallhouse claims, is “a stable environment to shoot at, with the
minimum of change being imposed from the centre”. Working and
supported PAS installations should be built upon where possible, or
if not then replaced with a non-LSP system of the trust’s choice.
“By freeing up the choice of systems, the manpower issue can be
alleviated”, he said. And according to Phil Sissons, negotiating a
new delivery schedule is “not just a matter of speeding up
struggling suppliers”. He told bjhc&im that adding new supplier
capacity to push the Programme forward “would stretch the limited
skills and resources of partner NHS trusts who already have plenty
of other targets to meet ... It has to be a joint effort.” Mr
Sissons also dismissed any likelihood that the Government would be
able to spot suppliers’ financial troubles in time to act. “They
wouldn’t want to go by market rumours, and the only alternative is
to wait for the company’s annual report, which is several months
too late”. However, Wallhouse rejected the entire concept of
financial pressure on suppliers. “The root cause of suppliers’
financial problems is the ridiculous notion that the NHS and the
taxpayer are protected by these onerous contracts”, he said. Instead
of this “risk transfer” approach, there needs to be a move to a
risk-sharing basis. “If smaller suppliers are to be encouraged to
engage, then the NHS must foster a contracting environment in which
they can receive payments along the way, not just when software has
been installed and accepted as functional.” Will suppliers change
their strategic direction as a result of the PAC report? “Unlikely”,
according to Sissons. Rather, its main use will come if political
recriminations break out over the NPfIT’s failures. “The report
might provide ammunition for the Programme’s opponents”, Mr Sissons
told bjhc&im. “It’s much blunter than the National Audit Office
report published a year ago, in fact it’s the report that NAO should
have published then.”
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