Reporter Sarah Bruce talks to Andrew Spence, CSC’s director of healthcare strategy, about Lorenzo, primary care services and the company’s achievements since it took over from Accenture as local service provider for the North, Midlands and East three years ago.

In April this year, director general of informatics Christine Connelly gave England’s two remaining local service providers two options.

Demonstrate significant progress with the ‘strategic’ electronic patient record systems that they are due to deliver under the National Programme for IT in the NHS or see the programme’s approach reconsidered.

Connelly made it clear that she “would not rule out” terminating the contracts of Computer Sciences Corporation and BT if they failed to get iSoft’s Lorenzo into a care setting by November and an acute trust by March, and Cerner’s Millennium into another London trust by November.

Unsurprisingly, there has been a great deal of debate ever since on whether the deadline will be met. However, Andrew Spence, the man in charge of healthcare strategy for CSC, says that he doesn’t understand why there is so much focus on Lorenzo when the company is hard at work implementing equally important systems in primary care.

“I don’t understand why Lorenzo is the only thing that is covered by the media, when that’s about 50% of the work we do. We also have a huge presence in primary care,” he says.

Delivering in primary care

Speaking at CSC’s London offices at St Mary Axe – better known as “the gherkin” – Spence says that since it took over from Accenture as local service provider for the North, Midlands and East of England, there has been significant progress in primary care.

“The 400 staff that came out of Accenture contract meant that the CSC Alliance inherited a really deep knowledge of primary care,” he says.

Deployment has “carried on at more or less the same pace” as it was going during the mid-part of 2006, just before CSC announced that it would take-over Accenture’s contract, but Spence sees this as a positive thing.

“We picked up that primary care team and rolled out SystmOne into GP practices, community care, child health and prisons and we’ve been pushing it into some new places as well such as hospices,” he says.

“The relationship with [IT system supplier] TPP and CSC has got consistently stronger over the past two and a half years. You’ll see that we’ll be deploying SystmOne to the 1,000th GP practice this month, which is a very significant milestone.”

Spence goes on to praise CSC’s and TPP’s work in making SystmOne the national solution across prisons in England and for delivering a single share record to more than 12m patients.

“It’s being rolled out in all sorts of places and in some small community hospitals, which is exactly the vision that the national programme had at the outset. I think has been a real success.

“SystmOne is probably the most widely deployed product under the national programme, and it barely gets a mention.”

Spence says that SystmOne is TPP’s product, although he adds that nature of the work the two companies do together means that CSC has had a small role in its development.

“The next release will enhance the functionality for mobile workers – people who tend not to work in a fixed location – so that could make the solution a lot more accessible to a much broader range of users,” he says.

Focus on Lorenzo

Still, Spence cannot avoid the topic of Lorenzo, even in a primary care context, given that all eyes will be on NHS Bury to see whether it goes-live with release 1.9 by the November deadline.

Spence says that he is “confident” that it will. “It’s progressing very well. The trust, SHA [Strategic Health Authority], CfH [NHS Connecting for Health] and CSC are confident that it will go live on time,” he adds.

Asked about the element of Lorenzo that was specifically intended for GPs – Lorenzo GP – Spence says it is not an immediate priority.

“Lorenzo GP is one of the modules of Lorenzo that is in our contract. It is in the later part of the development schedule, so we haven’t been putting the same focus on Lorenzo GP as we have the current functionality we’re due to deploy,” he says.

Asked whether SystmOne could eventually replace Lorenzo, Spence says: “That’s for the NHS to choose. If all of the GP practices that we’re contracted to deploy systems to want to take SystmOne, then ‘yes’ is the simple answer.

“GPs can choose to stay with EMIS or InPractice, and if they do that then that’s terrific. The important thing is that GPs have a system that they want.”

Away from Lorenzo, Spence spends much of the interview discussing innovations that CSC is working on for secondary care. He stresses the need for interoperability and for getting more information to clinicians, both to improve the quality of services and to improve efficiency.

Telehealth and telecare are often mentioned as technologies to drive savings in the community and primary care arena. But asked whether they will become part of CSC’s strategy, Spence says: “I think we’re very keen not say ‘telehealth is the latest band-wagon, lets jump on it.’

“We want to be sure that if we do jump on the bandwagon, we bring something of value and to date we haven’t quite found what that added value is. Clearly we don’t want to loose focus on Lorenzo either.”

After all, then, Spence says that Lorenzo will continue to be CSC’s main priority. Once it is rolled-out further, the company will look at more ways to interoperate and innovate within the NHS.

“At the moment we are ruthlessly focused on getting Lorenzo out and getting the confidence in the product,” he says. “Then we can move forward with other projects that we are working on.”