BT has confirmed that it is ‘well underway’ with its ‘best of breed’ approach, after completing contract renegotiations with Connecting for Health in the summer.

A BT spokesperson confirmed to E-Health Insider that the transition had been made ‘some time ago’, but was unable to say exactly when the transition was made.

BT Health’s managing director, Dr Patrick O’Connell, told the Financial Times newspaper, that the contract renegotiation had been completed over the summer, moving the local service provider from the “one size fits all” approach to a “best of breed approach”. Making the shift “required some renegotiation,” he added.

EHI exclusively revealed BT’s desire to switch to the best-of-breed approach in April when the LSP confirmed they would deploy a different version of the Cerner Millennium software to the one being deployed in the South of England.

At the time, BT told EHI: “This specification was agreed between BT and NHS London to meet the special and specific requirements of our London trust community and reflects the fact that, in London, we support many more major teaching hospitals and use different products for non-acute care settings.”

By June this year, BT were confident enough with their new strategy to talk publicly about it. Dr O’Connell spoke about the new strategy to EHI, as well as when giving evidence to the Health Select Committee, and when presenting at the Smart Healthcare conference in London.

In its written evidence to the Commons Health Select Committee enquiry, BT said: “The switch to Cerner together with a strategy of providing an integrated solution employing Cerner (acute), InPractice [INPS] (primary care) and RiO (community and mental health) removes risk from the delivery strategy by moving away from a ‘single vendor’ strategy, and uses products that the NHS has deployed and trusts in the field. The execution of this revised strategy is proving successful.

“In particular, great progress has been made in mental health and community health care settings, with half of all London’s mental health trusts having new IT systems installed. Two trusts in London (Newham and Homerton) deployed upgrades to their Cerner systems last year. There are plans to go live at Barnet and Chase Farm in the summer and two further deployments are planned later this year. Comprehensive plans have been agreed with NHS CfH [Connecting for Health] to continue this programme of work across all care settings in 2008 and beyond.”

Also in June, Dr O’Connell told EHI exclusively that this best of breed interoperability approach offers the greatest prospect for success, ensuring that “all your eggs aren’t in one basket” while keeping competition and providing a route for innovation and future developments.

Since then, BT has made good progress with its London deployments, implementing their first new Cerner Millennium patient administration systems in Barnet and Queen Mary’s Sidcup.

They have also implemented the RiO mental health system in 60% of the mental health trusts in the capital.

Publishing their interim results this month, the company said: “BT’s work as part of the NHS National Programme for IT (NPfIT) continues to gain momentum. In London, where it is rolling out new IT systems to hospitals, clinics and GP surgeries, BT has now delivered significant capability to 75 per cent of trusts. It has now installed two Acute Cerner Millennium Patient Administration Systems at Barnet and Chase Farm Hospitals NHS Trust and more recently at Queen Mary’s Sidcup NHS Trust.”

No figures were disclosed to the FT, though Connecting for Health reportedly said “the original value of the contracts for the same service remains unchanged.” BT’s local service provider to London contract is for 10 years and worth £996m.

Where “additional requirements” were identified, any additional costs would “either be funded separately” of from within the original £3.8 billion of service-provider contracts, the FT report claims.

The newspaper also reports that CfH admits that the change to delivery structures “would require a change in the payment schedule.”

Connecting for Health’s press team said they were working on a response, which they would send out as soon as it was authorised.

Fujitsu and CSC said their contract resets were still ‘ongoing’ with ‘commercial negotiations’ under negotiation.