Outline of new CSC deal takes shape

Negotiations on the terms of a potential new deal with local service provider CSC have been completed, NHS chief information officer Christine Connelly has told eHealth Insider.

Any new deal though remains contingent on a review of the National Programme for IT in the NHS by the Cabinet Office’s major projects review group, which is expected to last a week.

Approval of a new deal will also require joint Cabinet Office and Treasury approval.

Assuming any new deal survives these steps unscathed it would then have to be approved by the Secretary of State for Health. 

Connelly spoke to EHI the day after she was grilled by the Commons’ public accounts committee on the National Audit Office’s third report on the National Programme for IT in the NHS.

She said her aim was to get a new deal with CSC agreed to deliver benefit to NHS organisations. If signed, the terms of the proposed new deal are expected to deliver savings considerably in excess of the £500m already earmarked, but not yet delivered, from the current £3.1 billion CSC deal.

She denied the assertion by Labour MP Margaret Hodge, chairman of the PAC, that CSC had the Department of Health over a barrel. “No, we’re not. I think that is an over-simplistic view of the world, in view of interoperability and market choice.”

However, she said a new memorandum of understanding, if signed, would “be very different from the existing deal.”

Connelly also said it would be very different from the MOU that was taken off the table when CSC failed to hit its February deadline to get iSoft’s Lorenzo into a fourth early adopter site, Pennine Care NHS Foundation Trust. “That was a very serious change. This is not the same deal on offer.”

Connelly said the new focus is on delivering flexible, modular bite size modules based on the Clinical 5; although these still require a larger module – a base care records platform - on which to operate.

“The focus is on Clinical 5 and departmental systems and as a consequence we will be taking money out of the contract. Because, for instance, CSC is not putting Lorenzo into Pennine Care they have lost a year of money.”

Connelly said the new MOU is also unlike the deal signed with BT for London in 2010, which cut the number of hospitals that will get Cerner Millennium from 31 to 15.

“The BT deal does not provide a guide,” she told EHI, adding that any new CSC contract would not reduce the volume of delivery to hospitals in the same way as the BT deal did.

Connelly gave a heavy hint that a new CSC deal is likely to recast the role of ‘interim’ systems to give them a long-term role; a path that has already been followed with CSC’s installations of SystmOne from TPP.

Potentially this could see many of the 87 iSoft iPM systems for which CSC has already been paid being used as a basis for future development, possibly with future slices of Lorenzo.

“We’ve certainly said that where we have a system that supports care, such as iPM, and the trust wants to keep it, we will not be forcing them to rip and replace. CSC has already been paid for implementing iPM. If they are willing to support it for longer then we would want to keep it.”

This new modular world is to be knitted together with much more interoperability. A second interoperability toolkit is promised, and a move to a far more ‘networked’ health service.

Primary care is removed from the CSC MOU, however. “I will tell you that we will remove the requirement to deliver more GP systems, although the 1,800 systems already delivered by CSC will stay. The remainder will be delivered through GP Systems of Choice.”

Connelly said ambulance systems would stay in a new CSC deal. No mention was made of mental health, although there have been suggestions that this could also be dropped.

Turning to money, Connelly said that one of the points she and NHS chief executive Sir David Nicholson had been trying to get across to the PAC was that the acute systems component of NPfIT, though hugely important, only accounts for 20% of total NPfIT spend.

She also stressed that suppliers don’t get paid if they don’t deliver. However, she acknowledged that the failure to deliver promised systems to hospitals had major consequences for the health service and carried a huge opportunity cost.

“That is the thing we are most disappointed by. A lot of people talk about the money, that is protected, but the solutions have taken a very long time to deliver. For us those delays mean that there are many trusts out there that really need this capability and have not yet received it.”

NB. Copy revised from initial edit by EHI at 16.46 on 24.05.11 to clarify that a new CSC deal has not been completed