IT services supplier Computer Sciences Corporation (CSC) has had to pay penalties totalling around £5m for late delivery of patient administration software to NHS trusts in the North Midlands and East, under the NHS National Programme for IT (NPfIT).
The scale of the penalty payments accumulated by CSC for late delivery of PAS software are detailed in a paper from the North West Strategic Health Authority NPfIT board.
The November paper states: “With regard to the arrangements for managing financial consequences arising from deployment delays, it was noted that to date, approximately £5m of penalty payments from CSC had accrued across NME [North Midlands and East].”
The NME Board said that it had been decided for the time being to retain the sum centrally “rather than distribute to individual SHAs or purchase additional services of that value from CSC”.
CSC declined to comment on the scale of any fines, saying they related to confidential commercial arrangements.
The North West NPfIT board report goes on to state that not only are there continuing delays to the strategic Lorenzo software to be provdided by CSC, but also delays to updates, or ‘maintenance releases’, for the existing iSoft iPM PAS software being offered by CSC.
Against this background, and the limitations of the PAS on offer, further NHS trusts are baulking at taking iPM.
“Delays in PAS maintenance releases were having a knock-on effect on the implementation of the programme. There were recognised limitations with the interim PAS system (iPM) and trusts were increasingly reluctant to switch from their existing systems to iPM.”
The report says that these concerns are reducing confidence in the overall programme and CSC’s eventual delivery of its replacement to iPM, Lorenzo. “These problems in turn were reducing confidence in the programme as a whole and raising questions about whether the strategic solution to be delivered (Lorenzo) would be effective.”
Similar concerns are also raised in a minute provided to the North West NPfIT board setting out the major issues faced in delivering NPfIT in Cheshire and Merseyside. “The continuing delays in the availability of the Lorenzo system, which undermines the credibility of the while National Programme for Information Technology. In the meantime, existing suppliers continue to develop their products, which makes it even harder to persuade trusts to move to Lorenzo.”
The Cheshire and Merseyside minute goes on to identify repeated delays and missed deadlines as another major issue, describing “the lack of confidence created by repeated undelivered promises...”
The document also highlights limited clinical functionality as a further concern. “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.”
Commenting on progress of Lorenzo development CSC told EHI: "The Lorenzo development is continuing on plan and we are in the final stages of agreeing the roll-out of this new platform with the first release being available in 2008. The new Lorenzo platform is being delivered in four releases which offers greater flexibility and earlier access to clinical functionality."
CSC added that Connecting for Health have visited the development centre in Chennai and "remain pleased with progress".
The LSP says deployment of the software will be to a set of early adopters who have been working with CSC since earlier 2007. "These are the local health communities of South Birmingham, Morecambe Bay and Bradford & Airedale. We have been actively demonstrating Lorenzo to clinicians and managers across our regions and have received extremely positive feedback."
© 2007 E-HEALTH-MEDIA LTD. ALL RIGHTS RESERVED.
Sisyphus is now an IT Contractorunknown 375 weeks ago
You have to have sympathy for developers of NpfIT. If you consider how long it took to sign off the original Output Based Specification Document let alone version 2 and then factor in the drive for Intergrated Care Pathways combining Patient Choice under Choose and Book with compliance to National Service Frameworks.... It is inevitable that the build will be out of sync with healthcare provision.
There are considerable numbers within Local Health Care communities who buy in to the intergrated IT solution that has been promised and following the move to NLOP and the resoloution of Capacity and Capability in Nov 2007 it is down to the LHC's and and the Design Build and Test teams to be innovative and forward thinking in the requirements being submitted to the LSP's.
Healthcare is a dynamically evolving service, however check out the BMJ, Royal Colleges websites etc and there is a clear flavour of where clinical improvements and reasearch studies are driving healthcare.
In essesnce like it, loathe it or indifferent CFH and NpfIT are here to stay and people should engage and make demands of thier NLOPs for the applications and clinical functonality that they require.
I would also suggest that if the targets and prioirities of the DoH were less media driven and of a more durable nature then there would be time for healthcare providers and LSPs to design, build, test and deploy functional modules within the lifetime of a DoH dictat.
Please consider that to build a PC/Console game your looking at 24+ months of development and NpfIT is delivering a Nationwide IT system linking in Primary and Secondary care plus social services and Allied Health Professionals and the Patients (Healthspace) whilst trying to intergrate a business model that provides patient choice and healthcare pathways that deliver favourable outcomes that are clinically and fiscally effective whilst delivering a service that reaches the expectations of the Public.
5 million and ?unknown 375 weeks ago
So CSCA get fined 5 million for late delivery of PAS.
What happens if Lorenzo is further delayed? Or when it is delivered is full of bugs or gaping holes in functionality, which need fixed at early adopter sites, leading to roll-out being delayed.
Presumably CSCA get fined again. One big question - What is the back-up plan, if Lorenzo is not delivered or suitable for full deployment?
Fines actually don't give us the systems we need.
Hope NME have a back-up plan!
(Post edited by EHI)
Complexityunknown 375 weeks ago
Such simplistic views are at the heart of why NPfIT has got us nowhere fast. CRM systems might manage the flow of widgets, and even patients as activity or products (and I know of one hospital in Spain that has spent a long time and lot of money putting a SAP soluition in).
But firstly, government is forever changing what information they require (and the latest priority was often not captured before), and secondly and more importantly, the long overdue vision was to replace and augment the paper supporting clinical decision making.
One of the reasons many of us have stuck at it through this hell is because supporting the clinical process is hugely challenging and fascinating. Patients with multiple, unresolved and partially diagnosed conditions are hugely complex, and I doubt standard CRM systems would even begin to scratch the surface.
This is not a perculiarly British problem, but presents a worldwide challenge. CfH appear extremely pompous about how ground-breaking NPfIT is, but actually healthcare organisations across the globe are pitted to solve parts of the problem.
Oracle (Who own Siebel) and the other big players you mention only appear to join the party when they think there is lots of money to be made. IMHO the real progress comes from hospital and University departments, and from small suppliers who truly understand the complexities.
The real problem with NPfIT was an attempt to industrialise the process without understanding how complex it was, or bothering to work properly with users.
Why didn't they use a enterprise CRMcowboyted 375 weeks ago
I work as a Enterprise Architect in many industries. I am mystfied to why a Enterprise CRM ws not used instead of isoft lorenzo.
CRM(Customer Relationship Management) in the Business Arena manges customers. It manges sales(orders), Support, Channel management...
Case Management and automated and manual business processing is supported.
The companies who deliever these products are Oracle, IBM or SAP... These products are already on the market and have been there for the last 10 years.. Siebel(from Oracle) has 5.6 million users worldwide and has fair bit experience in healthcare in the EPR space...
Why buy vapourware when a products already exist...
Far better ways to spend £5Munknown 376 weeks ago
Lawyers, PR consultants, Management consultants.
There is no way that this money will be reinvested in real IT for clinical staff.
And these pressures increase the gulf between what the LSPs are prepared to commit to, and systems that the NHS so badly needs and could have incrementally developed over the last 5 years.
Contract Reset in the South is still not finalised, now was that September. CfH don't seem able to even bring in paper exercises on time, and the delays will most likely be about how much extra money the LSP can extort to deliver only part of the original vision.
Poor Contractunknown 376 weeks ago
Will be interesting to see if this cash is actually spent on something the long suffering users in the NHS actually want. Surely this is a chance to get CSC to provide some value here. The big question is will the NME board ask the Trusts what they want ? or do the ivory towers remain even after NLOP ?
then and nowunknown 376 weeks ago
In support of the last comment - the problem isn't really CSC, or even our old friend iSOFT, its the contractual structure that nobody can understand. Consider:
Then - Customer (Trust) buys service from Supplier
Now - Customer has unwritten and unenforceable "understanding" with NHS contracting organisation (possibly through a couple of extra layers of SHA bureaucracy), who buys service from management company, who subcontracts to supplier
At every level of this structure the voice of the user gets progressively weaker and so suppliers work to the letter of the contract. A contract that - as pointed out above - the customers are not grown up enough to see
(Post edited by EHI)
Vapor Wareunknown 376 weeks ago
So, you go to market in secret. You do a deal behind closed doors to buy a system that doesn't exist for an organisation that doesn't know what it wants. You cloak the whole exercise in spin and complex jargon that nobody understands. You enter it all into an impenetrable contract. You base budgets on guess work and finally you try to manage the whole thing from the centre without any contact with the grass roots. Is there seriously anybody out there who expected this to work? This project didn't have any credibility to lose.