Primary Care systems supplier EMIS has issued its customers with a briefing about its relationship with the NHS National Programme for IT, claiming it has been frozen out of the National Programme with GPs penalised if they wish to retain or move to EMIS systems.


While the document, entitled ‘Fact not Fiction’, says that EMIS remains fully supportive of NPfIT, it also epeats EMIS’s contention that it was “excluded” from offering its software in the London and Southern clusters, despite Fujitsu having been keen to do a deal. It adds that the contracts presented to EMIS by Accenture in the two northern clusters were “untenable and uninsurable by anyone in the open market".


Speaking to E-Health Insider, Sean Riddell, deputy managing director of EMIS, said the issue of contracts was a “red herring" when compared to the clear thrust of the programme towards standardised systems rather than ensuring existing system are interoperable with new systems on the way.


“It’s not about whether EMIS signs or not.  For 50% of the country it’s not down to us, we won’t be offered due to a decision made by an LSP or the NHS." 


“Who is it within the NHS that can make these blanket decisions?  In London the LSP just said that we don’t have to offer any further choice.  While in the South we had an acceptable negotiated position with the LSP but it was ruled out by the NHS Southern cluster team."


The EMIS deputy MD said that a national programme based on rip-and-replace was of existing systems was “nonsensical, high-risk and does not represent value for money."


The ‘Fact not Fiction’ briefing note also questions whether the national programme represents value for money, saying that according to NHS IT director general Richard Granger the programme will cost 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.


“This is an incredulous amount of money,” Sean Riddell told E-Health Insider.  “Why was it necessary to go for centralised procurements that cost billions and have a huge level of risk associated with them?"


EMIS contrasts these figures with the 76p per patient per year it says it currently costs, including support and implementation, to provide an EMIS primary care system.


A major part of the problem, Riddell contended, is that the large consultancy firms that advise the Government and civil servants on IT policy push for large centralised systems they are familiar with, and subsequently wind up with the contracts to implement the very same systems.  “Who advises Government on what direction they should be going? It’s the large consulting firms, and they are the ones who benefit," said Riddell. 


He argued that instead of monolithic centralised systems based on vast data repositories, of the kind the national programme has procured, the preference should be for “high resilience and interoperability based on distributed processing."


The ‘Fact not Fiction’ document goes on to state that it is untrue all GPs will get a fully funded system of their choice under NPfIT, in line with the commitment made in the new general medical services (nGMS) contract.  “GPs have a choice in some areas of one system and in other areas of one and one yet to be written,” said Riddell. “The guidance just isn’t being followed…"


The EMIS guidance also stresses that NPfIT will not support connections to the Spine for compliant GP systems other than those offered by LSPs.  Interfaces, it claims, will only be provided as an interim measure for Choose and Book and Electronic Transfer of Prescriptions but not for the core NHS Care Records Service (CRS) application.


Riddell added: “Existing suppliers in primary and secondary care will not be able to connect to the Spine for the NHS CRS and if you cannot connect to the spine for NHS CRS it kills all choice."