The National Programme for IT (NPfIT) has stated that it is 'concerned' about statements made by primary care systems supplier EMIS in a bulletin to customers this week entitled 'The truth about EMIS and the National Programme for IT'.
In the response, issued today, the programme refuted EMIS's claims it has been frozen out of the programme, that Local Service Provider (LSP) contracts do not offer value for money, or that GP choice of systems is only being paid lip-service.
On the charge that EMIS has been deliberately frozen out of the programme it says: "EMIS asserted that individual LSPs have excluded EMIS or offered it unfair terms. Over the last year, NPfIT has spent a considerable amount of time trying to facilitate a situation whereby EMIS could and would enter into sub-contracts with the LSPs."
NPfIT describes the claim the NHS told LSPs not to negotiate with EMIS as "groundless... NPfIT does not accept this as that assumes that, following the award of contracts to the LSPs, NPfIT staff were in a position to direct the LSPs about with whom they should negotiate. In practice, so long as the sub-contracts entered into conform with the provisions of the main LSP contracts, then the LSPs have discretion as to whom they choose as their subcontractors."
Turning to specific claims made by EMIS regarding negotiations with the LSPs for
The programme similarly rebuts EMIS's assertion that the contracts proposed in the firms' negotiations with Accenture, the LSP for the East and North East clusters, were uninsurable. NPfIT points out that this has not been an issue for over 200 sub-contractors in the programme, including other contracted GP system suppliers: "Which have been able to secure what they consider to be adequate insurance cover to protect their positions and comply with their contractual obligations."
"NPfIT therefore rejects the suggestion that EMIS has been offered prejudicial terms," says the statement.
The rebuttal also claims EMIS's interpretation of the 'Guidance for Existing Suppliers' is incorrect, saying that while the "generality of existing NHS IT systems" will be superseded over time by the new Care Records Services, the supplier guidance makes clear that "GP Clinical Systems have a different status".
The programme quotes section 4.2 of its August 2004 guidance to existing suppliers: "Practices may continue to use their existing GP clinical systems (Non-LSP systems), subject to such systems maintaining NCRS compliant status. This is in keeping with the BMA and RCGP ‘Guidance for GP practices in relation to the NPfIT’ published in April 2004." An updated version of the existing supplier guidance is promised shortly.
Turning to the claim that its LSP contracts do not offer value for money saying, the programme says: "There is no doubt that the LSP contracts do offer excellent value for money".
In its briefing, EMIS extrapolated the costs of NPfIT as a minimum of £11 a year per patient. EMIS claims that, once implementation and support costs are added in, this figure could rise to as high as £51 per person. The EMIS briefing compared these figures with the 76p per patient per year it says it costs, including support and implementation, to provide an EMIS primary care system.
NPfIT says such a comparison "is like comparing apples and pears" with the LSP contracts requiring the LSPs to deliver "a far greater range of new systems for patients’ benefit than simply isolated GP systems, including, for example, hospital patient administration systems, hospital departmental systems, mental health systems, picture archiving systems…"
On the claim that compliant GP systems not included in LSP contracts will be disconnected from the Spine, the programme is similarly emphatic. "EMIS also incorrectly assert that it is 'fiction' that 'there is no NPfIT plan to disconnect compliant GP systems from interoperating with the spine'. It is a fact that there is no such plan."
It adds that "Practices may continue to use their existing GP clinical systems (non-LSP systems), subject to such systems maintaining NCRS compliant status."
The statement, however, ends with an apparent olive branch to EMIS: "There is still genuine scope for EMIS to sub-contacts with LSPs. Within the constraints of the existing contractual arrangements with the LSPs, NPfIT staff remain ready to facilitate this process."
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