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Monday, June 09, 2008

The UK National E-Health Program – A Lot is Going On!

Two major items of news regarding the NHS program in the last couple of weeks.

First we had

NHS IT four years late and over budget

OUT-LAW News, 16/05/2008

The NHS IT project, one of the world's largest public sector IT programmes, is already four years late.

By John Oates for The Register. This story has been reproduced with permission.

Parts of the project are progressing well and some savings have already been seen but Summary Care Records, a key part of the project, are now unlikely to be widely rolled out until 2014 or 2015, rather than the original target of 2010.

Progress has been measured by the National Audit Office. It warned: "The scale of the challenge in developing and deploying these systems in the NHS has proved far greater than expected, and the timescales... originally agreed... proved unachievable."

The Report said: "For the Care Records Service, the original timescales proved to be unachievable, raised unrealistic expectations and put confidence in the Programme at risk." It said the project still "appears feasible".

Two of the five early adopter Primary Care Trusts have begun uploading patient records, two years late. The other three are running publicity campaigns to inform patients, but have not yet started uploading data.

In the North, East and Midlands Summary Care Records will be run using iSOFT's Lorenzo software - which is not yet available.

Lorenzo should get its first release this summer before a full roll-out in autumn of this year. The NAO warned: "Until Lorenzo is available and has started to be deployed, there remains a particular uncertainty over timing in the North, Midlands and East."

The NAO also warned that these plans to roll out Lorenzo "may prove over-ambitious" and called for rigorous testing in pilot areas before wider deployment. The NAO also called on the Department for Health to develop better reporting on how the programme is progressing and how much it is costing.

More here:

http://www.out-law.com/page-9125

The full report is available as a pdf here.

There is also a very detailed discussion of all the points made found here:

Highlights of National Audit Office NPfIT report

These are excerpts from today's report [16 May 2008] by the National Audit Office on the NHS's National Programme for I.T

Much has been published by Connecting for Health on the achievements so far of the NPfIT. The excerpts here highlight some of the important lessons to be learned from the challenges of implementing the NPfIT.

Full text here:

http://www.computerweekly.com/blogs/tony_collins/2008/05/highlights-of-national-audit-o.html

Finally there is also a fully referenced article available.

National Audit Office reviews the NHS National Programme for IT

16 May 2008

The National Audit Office (NAO) has published a review of progress in the NHS National Programme for IT since 2006 [1].

The NAO says that all elements of the Programme are advancing and some are complete, but the original timescales for the electronic Care Records Service, one of the central elements of the Programme, turned out to be unachievable, raised unrealistic expectations and put confidence in the Programme at risk.

The report concludes that the original vision remains intact and still appears feasible. However, it is likely to take until 2014-15 before every NHS trust in England has fully deployed the care records systems, four years later than planned.

In the North, Midlands and East area, the software has taken much longer to develop than planned, so some trusts have had to take an interim system. Completing development and deployment of the system and introducing it in this area "are significant challenges still to be addressed". In these regions the software to be deployed is iSOFT’s Lorenzo. The NAO says the the delays are attributed in part to an underestimation by all parties of the scale and complexity involved in building a new system from scratch.

Full article here:

http://www.bjhcim.co.uk/news/2008/n805023.htm

References

1. The National Audit Office. The National Programme for IT in the NHS: Progress since 2006. London, The Stationery Office. May 2008.
(Vol 1) : www.nao.org.uk/publications/nao_reports/07-08/0708484i.pdf

The National Audit Office. The National Programme for IT in the NHS: Project Progress Reports. London, The Stationery Office. May 2008.
(Vol 2): www.nao.org.uk/publications/nao_reports/07-08/0708484ii.pdf

2. NHS Connecting for Health Additional Supply Capability and Capacity (ASCC) website: www.connectingforhealth.nhs.uk/industry/ascc

Other valuable URLs are as follows

Patient records cause four-year NHS IT delay

http://www.computing.co.uk/computing/news/2216788/nao-care-records-holding-npfit

and

NHS must learn lessons on centralised patient records

http://www.computing.co.uk/computing/news/2215906/connecting-health-learn-lessons

Second we have the news that the almost £ One Billion contract to deliver systems has been cancelled.

See the following reports:

Cerner watches as England cancels Fujitsu contract

By JULIUS A. KARASH

The Kansas City Star

England’s National Health Service is terminating a contract with FujitsuServices Ltd. that includes North Kansas City-based Cerner Corp. as a subcontractor.

“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,” NHS said on its Web site. “The NHS will therefore end the contract early by issuing a termination notice.”

Fujitsu in 2005 named Cerner to replace IDX Systems Corp. as a subcontractor on the southern England segment of a $24.5 billion project to computerize English health records. The deal was expected to provide Cerner with $410 million to $490 million in sales.

More here:

http://www.kansascity.com/382/story/640829.html

and here:

Fujitsu’s £896m NHS IT contract to be terminated

28 May 2008

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 but broke down.

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 CfH contract.

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."

More here:

http://www.e-health-media.com/news/3798/fujitsu%E2%80%99s_%C2%A3896m_nhs_it_contract_to_be_terminated

Comment.

It is hard to know what the fuller implications of all this is. The current Prime Minister is under some political pressure at present and this sort of instability cannot be helping him and more importantly assuring that there is continuing commitment to getting this done – despite the problems.

We will have to wait and see how this play out over the next few months.

David.

1 comment:

Anonymous said...

Fujitsu and Cerner can't get their act together in the UK!

I sense this does not vie well for Cerner in Victoria's HealthSmart Project.