The Audit Commission has told the three strategic health authorities in the south of England they face increased risks following the termination of Fujitsu’s NHS IT contract.

In May, Fujitsu’s £1.1 billion local service provider contract was terminated after it walked away from protracted contract renegotiations.

Alternative arrangements have not been agreed, although an interim agreement with Fujitsu covering the “live eight” sites that have taken Cerner care record systems has just been extended to May 2009.

In a warning in the annual audit letters to South Central, South East Coast and South West SHAs, the district auditors warn: “Given this uncertain situation, the National Programme for IT in the NHS remains a key risk for the SHA.”

In his annual audit letter to NHS South Central, the lead SHA on NPfIT in the south, the district auditor says: “The SHA needs to reassess the risks associated with the termination of the Fujitsu contract and develop and implement an appropriate action plan.”

Identical advice is given to NHS South West in its annual audit letter, which notes: “This recommendation is new and has not previously been reported to the SHA. Consequently, it is the only recommendation in the action plan.”

NHS South East Coast confirmed to E-Health Insider that it had received the same warning in its annual audit letter. Tad Mattus, the SHA’s chief information officer, said: “It’s not an analysis of the individual SHAs – it’s a piece of work on the LSP contract.”

Mattus said the Audit Commission’s warnings were correct: “Obviously, when you misplace an LSP the risk does go up.” He said NHS South East Coast was well advanced on developing an action plan which would be completed by March 2009.

The reports provided to the South West and South Central SHAs say “considerable doubts” about the ability of Fujitsu to deliver systems were first raised in the 2006/07 audit. “We therefore planned a further health community review of the NPfIT programme as part of our 2007/08 audit but this was deferred pending the outcome of the contract reset.”

The NHS South Central report says the uncertainty persisted in April 2008, when the Audit Commission again reviewed its arrangements for managing NPfIT within the Southern Cluster.

Despite the uncertainty, actions were agreed with the Audit Commission to ensure clinical engagement, clarification of the governance arrangements for the proposed contract reset and how revisions and changes to the systems were to be controlled. But these planned actions were overtaken by events.

“The SHA was making progress in these areas when, in May 2008, NHS Connecting for Health were unable to conclude a contract reset with Fujitsu and terminated the contract,” says the NHS South Central report.

The report goes on to state that an alternative solution is unlikely to occur before December 2008. “We’re working on making sure the south is in a better place than it was at the end of the Fujitsu contract,” said Mattus. “Most trusts have a pretty good idea of what they are doing.”

He said there were no dates available for when implementations would begin again in NHS South East Coast. However, he said the initial priority would be community and mental health, delivering “Next Stage Review compliant systems.” In the acute sector, the emphasis is likely to be on extending existing systems and fully using functionality already available.

Mattus said one advantage of Fujitsu’s departure had been to give local NHS organisations and health communities the chance to look under the bonnet and assess the solutions being offered by the two remaining LSPs; “the first time we’ve been able to do this since 2003.”