NPfIT – A storm in a teacup?

This week healthcare IT has hit the headlines not only in the trade publications we all know and love but also on a national scale across the world.

The media frenzy around the National Programme for IT in the NHS over the past ten days is perhaps a symbol that now many, many people realise that healthcare IT is much bigger than a PC in a doctor’s room.

Throw in a National Audit Office (NAO) report that damns the £11.4 billion programme as being poor value for money for the taxpayer, a Public Accounts Committee hearing, which results in a very bad tempered exchange between the NHS chief executive and a member of the NAO, and healthcare IT gets just that little bit more interesting.

This week’s hearing did not allow for the key suppliers, CSC and BT, nor the civil servants responsible for the programme, NHS chief executive David Nicholson and the Department for Health’s director general for informatics Christine Connelly, to leave the room with their heads held high.

CSC gave a robust defence of its position, maintaining that it had provided the ‘foundations’ for a country wide EPR (Electronic Patient Record) and that any new deal would adjust to the clinical needs of the NHS. Meanwhile, BT said that its newly signed contract had not ripped off the NHS by charging higher prices than it would have paid if it had bought software ‘off the shelf.’

But although, CSC and BT received a grilling, the companies seemed to get off more lightly than Sir David Nicholson and Connelly who were subjected to almost two hours of questioning.

Whilst the pair were repeatedly asked whether the programme was too ambitious and if they thought it was value for money, Connelly bullishly refused to accept that there had been any money wasted as suppliers were only paid once they delivered the systems.

Meanwhile, Sir David Nicholson struggled to stay quite so calm, when pushed on the value of the BT contracts and through a red face and raised voice said the NAO’s findings were ‘nonsense.’

So although the hype around all this has brought a new found excitement to health IT, where does this leave us now? The BT contract was done and dusted several months ago, is it really likely to be affected? Probably not.

The focus appears to be much more on how these reports and hearings can affect the deal with CSC, which again seems little chance of being canned.

Not only did Connelly say that terminating the contract could cost more than honouring it (which would clearly make the DH the bad guys to the taxpayers), but an alleged leaked document from the Cabinet Office claims that the renegotiated CSC contract which is now on the table, will see the scope of the Lorenzo electronic patient record scaled back, the volume reduced and it implemented in a much more modular way. No real surprises there…

So although NPfIT still has to get through the hurdles of the major projects review and the Treasury and Cabinet Office need to sign off on any new deals, it seems that very little has changed from several months ago and that very little can really stand in NPfIT’s way.

But at least for now, the excitement continues…

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