A series of collaborative NHS IT procurement projects for electronic patient record (EPR) systems in the South West had the plug pulled last week by local management after they failed to secure national funding from the National Programme for IT in the NHS (NPfIT).

The Shires and Pan-Bristol procurements predated the National Programme and had been originally trailed as exemplars of a new collaborative approach to NHS IT procurement, designed to deliver standardised clinical systems cost effectively. The Shires project alone had involved 11 different NHS trusts covering a population of three million in Dorset, Somerset and Devon. The pan-Bristol and Weston consortium covered four NHS trusts in Bristol and Weston-super-Mare.

The decision came after the National Programme made clear it will not provide funding for projects deemed outside the scope of the NPfIT, and that “no special cases” would be permitted. According to an NPfIT spokesperson the “no special cases” policy was agreed following discussions between the National Programme and the four lead Strategic Health Authority (StHA) Chief Executives in England with responsibility for IT.

“The national procurement for IT in the NHS focuses on affordability and value for money… The National Programme is not in a position to provide assistance to South West, Shires and Pan-Bristol, above and beyond this level,” a National Programme spokesperson told E-Health Insider

“In this context NPfIT has sought to continue to provide the Shires procurement with as much support as possible whilst also endeavouring to treat the Shires’ funding requirement equitably in the context of other parts of the country and their local needs,” the spokesperson added.

However, in the case of the Shires collaborative procurement the decision to end the project came at the eleventh hour, only after the project board had reached the final selection of its preferred supplier following a painstaking three-year procurement process.

The final Shires short-list was based on two consortia led by Schlumberger-Sema and Logica. However, on Thursday night suppliers were informed that the procurement would not proceed any further after central funding had not been secured.

“We hadn’t actually let the contract but did hear about the funding on the day we had fixed the meeting to make the final selection,” said Martin Carter, head of communications at Dorset and Somerset StHA. He stressed though that much of the work from Shires had been incorporated into the development of the new, national Integrated Care Records Service (ICRS).

For the many local NHS staff who had invested a huge amount of time and effort into the Shires and pan-Bristol projects over the past three-years – laboriously agreeing common requirements and then specifying and selecting systems – the decision is likely to be a huge disappointment. Many trusts have already appointed EPR managers, project and implementation staff.

It also represents an extremely serious set-back for those suppliers that had heavily invested in bidding for contracts. Neil Jordan, head of healthcare for Microsoft (not involved in the Shires procurement) called the timing unfortunate. “Those that spent a lot of money bidding will now have to justify that cost internally.”

The CEO of a health systems supplier said it was sensible to stop the Shires procurement in light of development of the National Programme but questioned why it had happened so late in the day. “This is a decision that could have been made a long time ago.”

He added: “There is a painful lesson for the National Programme here – you are dealing with independent local organisations, and the only power the National Programme has is to control national funds.”

The developments in the South West follow the abandonment last month of the Blackberd collaborative EPR project in Birmingham and the Black Country, and another joint procurement by three Bolton hospitals, after it was made clear by the centre that these projects were not seen to fit within the National Programme and would not receive national financial backing.

A source close to the National Programme told E-Health Insider that all the collaborative procurement projects in question had included assumptions about the perceived availability of funds from the centre. “The assumption was that they would be bailed out.”

The source added that with the beginning of the new financial year it had been made clear that central funds from the national programme would not be made available to support projects such as Shires.

In November 2002 health minister Lord Hunt met with the StHA Chief Executives for the South West and committed to consider what additional assistance may be appropriate and provided to support the local project.

The NPfIT spokesperson said the National Programme had subsequently provided significant support to the project. “This includes financial advice and expertise from Partnerships UK, funded by NPfIT, design expertise, general procurement advice and legal advice around contractual matters.”

The spokesperson added: “Unfortunately suggestions from NPfIT around phasing of functionality, acceleration of the delivery of benefits and the need for general infrastructure upgrades to be funded from baseline local funding, have not been productive.”

All funding for local IT development in the English NHS will have to come from the £200m of National Programme funding due to be allocated to StHAs this year on a pro rata basis. Funding is only expected to be released once the National Programme and local StHA CIOs approve local IT investment plans that meet NPfIT goals.