Fujitsu, local service provider for the Southern Programme for IT, is not yet contracted to supply a GP system but £105.9m is to be spent to include such a requirement, the latest National Audit Office report reveals.

The NAO investigation into the national NHS IT programme found that the project was running at least four years late but that overall the costs of the programme have not spiralled out of control and its objectives remain achievable.
The report provides an insight into the current state of play with GP strategic solutions. It states that there is currently no contract for a GP strategic solution in the South and that the GP solution for London is under review. The Northern Programme for IT is currently supplying TPP’s SystmOne as an interim solution which it plans to integrate with Lorenzo as its strategic solution when it becomes available.

The NAO report shows that CSC, LSP for the North, Midlands and East Programme for IT, had deployed SystmOne to 703 GP practices by the end of March this year with plans to deploy 204 more by the end of March 2009.

Fujitsu, who last year told E-Health Insider that INPS was its chosen GP system, have deployed no GP systems and do not have a contract to do so. In London the NAO said LSP BT had chosen INPS as its solution after originally contracting with IDX to supply a GP system to all GP practices.

The NAO report adds: “However, it was recognised at the time that, as the GP market in London was dominated by another supplier (EMIS), an alternative strategic GP solution might be required.”

The report says the GP solution is being reviewed as part of the renegotiation of the BT contract in London which is expected to lead to contractual changes by June 2008.

The NAO says an estimated £105.9m will be spent on including an integrated GP solution into Fujitsu’s contract for the south.

It adds: “Unlike the contracts for London and the North, Midlands and East, the original contract for the South had included no requirement to supply an integrated GP solution.”

The report says GP Systems of Choice (GPSoC)was introduced in response to GPs’ concerns about choice of system and also as there were delays to the delivery of LSPs’ integrated solutions. It says the GPSoC framework will initially run for two years and may be extended for a further two years.

It adds: "The assumption is that by the time the contracts expire, the Local Service Providers will have delivered their integrated GP solutions. Depending on the rate of take-up of the integrated solutions, the Department will need to decide whether the framework should be re-tendered to ensure continuity of service."

In other parts of the report the NAO, which is focused on implementation of care records system in acute trusts, the authors look at usage of Choose and Book. The NAO says usage has been “lower than expected” with only 6.7 million bookings made by January 2008 against an original forecast of 39 million.

 On the Electronic Prescription Service the NAO report shows that no pharmacy or GP systems have achieved technical accreditation for release two of the service.

In the acute sector the NAO found that the delivery of electronic patient records to hospitals is unlikely to be completed before 2015, five years later than originally planned.

It adds: “ There is considerable uncertainty about when the care records system will be fully deployed and working across the country” and warns that the roll-out plans for Lorenzo “may prove over-ambitious”.

It says the programme has proved far more challenging than initially envisaged, and “the original timescales proved to be unachievable, raised unrealistic expectations and put confidence in the Programme at risk”.

Responding to the report the BMA said Connecting for Health should learn from the lessons outlined within it.

Dr Chaand Nagpaul, GP negotiator with responsibility for IT said: “It is clear from the NAO report that the setting of unrealistic deadlines has been very damaging to National Programme for IT. Slipping deadlines for new IT systems and the premature release of systems that are not fit for purpose has been deeply frustrating for NHS staff leaving many doctors thoroughly disillusioned with the programme.”

He said the major challenge for local health organisations would be to create an environment that fosters the commitment and confidence of staff.

He added: “In addition, there is much to be done to inform the public about electronic patient records. The adoption of consent to view system, as recommended in the recent independent evaluation by University College London of the Summary Care Record may go some way improving the public awareness of electronic patient records.”


Comment and Analysis: Lessons Learned