Lorenzo: the clinical software for 3/5 of England
Lorenzo: the clinical software for 3/5 of the English NHS

The contract for delivery of the core strategic clinical software meant to be delivered by the NHS IT programme in three-fifths of the English NHS is being re-negotiated, with talks due to run until the end of 2007.

At the centre of the contract revisions are further changes to the delivery schedule for iSoft’s late-running Lorenzo software.

The contract negotiations are occurring between iSoft, its prime contractor Computer Sciences Corporation (CSC) and NHS IT agency, Connecting for Health (CfH).

A spokesperson for CSC confirmed to E-Health Insider that contract revision negotiations are occurring. A parallel but separate set of contract negotiations are also underway in the South of England with local service provider Fujitsu.

CfH confirmed that a contract discussions are underway with all three local service providers.  "A similar ‘reset’ process has taken place with other Local Service Providers."  

E-Health Insider has learned that plans for the delivery of the much-delayed Lorenzo software, last said to have been due in mid-2008, is at the centre of the negotiations. Isoft first promised to deliver a version of Lorenzo to the NHS by the end of 2004.

Many revised delivery schedules later, the most recent stated CfH plans had called for iSoft to deliver its new Lorenzo software in two releases. CSC was to get the first of two Lorenzo releases from iSoft by the end of 2007 and start installing the software at NHS sites by mid-2008.

But new plans are now being negotiated to break Lorenzo into four releases, with a scaled back first release for early 2008 and further releases to come at dates yet to be agreed.

Alan Spours, chief information and knowledge officer for NHS Northwest told E-Health Insider that the move was a positive one for the NHS, offering the possibility of key clinical functionality arriving earlier than it otherwise would. "A lot of us felt that Lorenzo arriving in just two releases was a bit much, we didn’t want to have to implement everything in one fell swoop."

He stressed that under revised plans the first phase of Lorenzo would contain a lot more clinical functionality, and deliver it slightly earlier than previously. Spours said Lorenzo release one would have clinical content including "orders, results and clinical documentation".

The NHS Northwest CIO said that under the revised plans the aim would be to have "three early adopters by April/May 2008".

Details of the revised Lorenzo plans also come in board papers for NHS North West "CSC have put forward a release strategy for the strategic software product Lorenzo, leading to software being released to the NHS in four phases rather than two." The date for release one is projected "as early as April 2008", rather than June 2008.

The papers state: "Releases 2-4 are expected to be delivered later than originally planned, and CSC is expected to confirm revised timelines shortly."

The revised approach is described as a positive development that "will reduce the risk around delivery to CSC, but is also welcomed by the NHS as it will provide a more flexible approach to deployment across the Northwest."

Contract revisions are expected to last up to four months: "The new approach will require a revision to the existing contract with CSC, and it is envisaged that this will be undertaken in the next 3-4 months." It says that revisions to the contract will be "ultimately signed off by the NME [North East Midlands] Programme Board".

CSC’s late delivery of software is described as a problem for trusts across the Northwest, leading to delays. "The NHS still has issues with regard to CSC delivery of software and maintenance upgrades in 2007/8, and as a consequence a number of planned deployments in the areas of Child Health, Acute PAS [Patient Administration Systems] and clinical applications will experience delays."

Similar problems, even extending to descriptions of the software to be delivered by CSC, are also reported in Yorkshire and the Humber Strategic Health Authority. In a September board paper the SHA says the top risks identified by the National Programme Executive Committee are: "Delivery of LSP product descriptions and delays to some LSP products". The paper adds: "SHA has insufficient clarity on LSP contractual commitments."

Spours told EHI that after a lot of delays Lorenzo may yet prove worth waiting for. "There’s been a lot of very positive feedback from those close to the action and delivery of this product", but he predicted that such a positive impression "will take a bit longer to get through to the grass roots".

The NHS Northwest CIO summed up: "The product is potentially is fantastic, but the proof of the pudding is in delivery."

Jon Hoeksma