Plans for a catalogue of ‘additional systems suppliers’ covering a wide range of specialist clinical systems are in the final stages of being drawn up by Connecting for Health (CfH), the agency responsible for delivering the £12.4bn NHS National Programme for IT.
E-Health Insider understands that the supplier catalogue plans being drawn up may cover all major departmental systems and clinical specialities, together with areas such as A+E, maternity and theatres. Services such as acute data migration and infrastructure are also thought to be covered.
Sources indicate that the plans – being termed Additional Systems Capacity and Capability (ASCC) – are at an advanced stage of development. "Granger’s [Richard Granger, head of CfH] team are working on it at the moment and trying to work out the details," one senior source told EHI. "It’s in the pipeline."
EHI understands that if negotiations are completed the plans could potentially due to be unveiled within weeks with an OJEU (Official Journal of the European Union) procurement, similar to that now underway for GP Systems of Choice (GPSoC).
CfH told E-health Insider: "Yes. NHS Connecting for Health is currently formulating an OJEU in support of the “Supplier Catalogue” announced by Richard Granger in October 2006. It is anticipated that this “Additional Services Capability and Capacity” (ASCC) OJEU will be issued during March.The GPSoC model, based on systems having to meet interoperability criteria and deliver broadly defined levels of functionality is thought to provide the template for the new catalogue."
The plan would appear to be for local service providers (LSPs) Fujitsu, BT and Computer Sciences Corporation to continue to provide base patient administrations systems into which into which "best of breed" specialist clinical and departmental systems meeting clearly defined interoperability standards would then be plugged. This would be a significant departure from the strategy of single standardised systems that has previously been pursued by CfH.
While details of the plans have yet to be widely shared with specialist clinical suppliers there is mounting industry speculation that an additional supplier and services catalogue is under development, with a new approach to working with ‘additional suppliers’ is being drawn up. How this could be squared with LSP contracts and how it would be funded remain big unknowns.
The introduction of a supplier catalogue, comprising best of breed solutions, to meet the areas not being met by LSPs is understood to be one of the key recommendations likely to be contained in the report being drafted up by the House of Commons Public Accounts Committee.
Potentially, the ASCC supplier catalogue could offer a lifeline to specialist clinical suppliers. Most were effectively excluded from the NPfIT programme three years ago when CfH chose to award contracts predicated on four local service providers delivering integrated care record systems meeting most of the requirements of the major clinical communities.
Plans for a catalogue of additional suppliers were first announced by Richard Granger six months ago, in which the original intent appeared to be to have additional capacity or options on call should contracted suppliers be unable to deliver.
In a 5 October interview with Computing Granger said: "I want to refresh our store of contingency," and explained "There are restrictions placed on public bodies around options available legally in the event of things going wrong, but I want a catalogue of places I can go to."
This ‘spares’ approach now appears to have evolved into a full blown interoperability strategy. EHI understands that the need for the new approach has only been accepted by CfH’s leadership reluctantly. "Yes, it’s been heavy weather. It’s come through gritted teeth," one anonymous insider said, who indicated that the move had been dictated by the Department of Health.
They added: "CfH has discovered it has disgruntled customers. It has to become more relevant." However, they also pointed out that a catalogue approach did not mean a free-for-all as in most specialist clinical areas there was one dominant supplier and a challenger.
The pressure for a new approach has built due the limited success LSPs have had first in delivering PAS systems on a ‘cookie cutter approach’ – delivering standardised systems one after another. Even more striking has been the failure of LSPs and their software partners to develop and then deliver promised specialist departmental and clinical systems or equivalent functionality through their CRS solutions.
As a result many NHS trusts – including independent foundation trusts – have grown increasingly impatient waiting for promised new and replacement clinical systems such as maternity, theatres, cardiology, oncology. In areas such as maternity some have begun to vote with their feet.
An anonymous senior supplier told EHI: "The reason they are doing it is simple, there are huge gaps in the current catalogue of services offered by LSPs."
In addition to struggling to meet the original CRS objectives the programme is coming under increased pressure to deliver systems that support policy priorities such as 18-week wait targets or integration between health and social care, and delivering care outside hospitals.
One senior industry figure told EHI. "This looks to have been triggered by the GPSoC OJEU," which he said had effectively sounded the death knell for the single CRS solution approach that had been pursued by CfH.
He pointed out that in London, BT has already announced that it is now going for a "pragmatic" and "de-risked" best of breed approach with Cerner in acute, CSE-Servelec in community and mental health, with INPS in primary care.
The industry source concluded that if a second OJEU for additional suppliers and capacity is now issued "the whole supplier community would be very interested", but wryly noted that "additional capacity is a very broad term."