A US market analyst report obtained by E-Health Insider predicts that clinical applications vendor Cerner will win two of the Local Service Provider (LSP) contracts about to be awarded by the National Programme for IT (NPfIT), with two more going to iSoft, and one to IDX.

Overall the 11 November SunTrust Robinson Humphrey document, suggests that Cerner is offering the best overall proven technology solution, and is best placed to win LSP contracts to be awarded by the NPfIT, but predicts that political considerations will ensure that contracts will be shared around to help spread the NHS’ risk exposure and for political expediency.

With the award of the first two LSP contracts, due to be announced on 24 November, the report predicts that London will go to the IBM/Cerner consortia as the lower risk option: “We believe IBM/Cerner will win London, as it is, in our opinion, the epicentre of the NPfIT, which we believe makes it the highest risk cluster… Granger recognizes that if any cluster is to go well, it must be London.” 

Accenture Alliance, including Accenture, Microsoft, Siemens, Avanade and iSoft, are meanwhile tipped to win the LSP contract for the North East, Yorkshire and Humber.  Factors cited include “Microsoft’s strong ties to literally everyone” and both the “home field advantage” and “politically positioned nature of iSoft”. 

The report goes on to predict that IBM will win the national contract for ‘Data Spine’, together with a separate national contract for Electronic Transfer of Prescriptions (ETP).  BT is tipped to pick up the ‘N3’ contract to provide the NHS with a broadband network. 

In the second wave of LSP contracts the South East and South west is predicted to be carried by Fujitsu Alliance, consisting of Fujitsu, PricewaterhouseCoopers, Tata Consultancy Services and IDX, offering an IDX solution.  

The East and East Midlands is forecast to be another Cerner victory with the contract going to the Cerner-led alliance of Cerner, Schlumberger-Sema, Serco, HP and Tata Consultancy Services.

The West Midlands and North West contract meanwhile is predicted to fall to the BT/iSoft consortium, helping to ensure the NHS spreads its risk exposure, and notes the report “…it could be politically problematic if BT is not involved in any one cluster”.   

So will the predictions come to pass? In all honesty it’s doubtful that anyone other than Richard Granger knows for sure at this stage.

One line in the report neatly sums up the difficulty of making hard and fast predictions: “The politics among other dynamics are playing such a role that it’s anyone’s guess at this point, especially since our sources seem to indicate that Granger is giving everyone the sense that they have won.”

What is clear is that final negotiations, particularly on prices, are going down to the wire.  The consensus is that Granger has proved an extremely canny operator who seems certain to strike good deals on behalf of the NHS.

But will IBM and Cerner win quite as big in the first wave as predicted by SunTrust Robinson Humphrey?  If you wanted to be absolutely certain that you could successfully implement in London then awarding the same firm the London LSP and national ‘Data Spine’ contracts could make sense – but is it really politically feasible?  The NPfIT is of course about the whole English NHS not just London.

With the withdrawal of Patient First Alliance in the North East, Accenture looks like a reasonably safe bet; while IBM/Cerner still appear to be a strong candidate for London.  It should also be remembered that the NPfIT initially had a tough time convincing other consortia to even bid against IBM/Cerner in London.

But if BT failed to win London or “Data Spine” the only cluster it would be left bidding for would be the North West.  As the only British-led LSP would BT really be allowed to wind up empty handed? Conversely, if IBM/Cerner failed to win London the only cluster IBM/Cerner would be left bidding for together would also be the North West.

For what its worth E-Health Insider’s prediction is that initial contracts will be spread around, and in this scenario awarding BT the contract for “Data Spine” would meet the requisite criteria of spreading risk while also being politically acceptable.

What seems clear is that even after systems testing and pricing negotiations have been completed the NPfIT contract decisions will prove extremely political and deeply inter-twined.