A deal to cut hundreds of millions of pounds from the National Programme for IT in the NHS by cutting back the scope of its main electronic patient record software is set to be signed, if CSC can deliver Lorenzo to an acute trust within two weeks.

E-Health Insider understands that a new deal with CSC for the North, Midlands and East of England hinges on the trust-wide go-live of Lorenzo at University Hospitals of Morecambe Bay NHS Trust by the end of March.

This vital deadline looks set to be missed. In an interview with CIO Magazine last week, Andrew Spence, CSC’s UK director of healthcare strategy, was bullish about progress at Morecambe. “We’re ruthlessly focussed on getting things right for Morecambe Bay,” he said.

But EHI has learned that a key test load of patient data into the new system – an essential step on the path to go-live – failed just weeks ago.

The Department of Health’s chief information officer, Christine Connelly, set go-live Morecambe Bay by the end of March as a cast iron deadline last April. If it is missed, the future of a new CSC contract becomes extremely fraught.

CSC’s current deal, covering 60% of the English NHS, is worth £3 billion, with cuts of up to £400m being required by the DH.  

As previously reported by EHI, a ‘descoped’ deal between the DH and CSC would see large chunks of clinical functionality ditched – including theatres, maternity, inpatient electronic prescribing and GP messaging.

NHS trusts would be given the ‘choice’ to buy and integrate the missing specialist and departmental functionality, but they will have to fund their own money to pay for it.

Many trusts are likely to have grave reservations about taking a cut-down version of Lorenzo, which may represent a step back from what they already have. NME trusts have been asked whether they still plan to participate in the programme. Up to a third have said no or maybe.

Meanwhile, in an EHI video diary last month, Christine Walters, associate director of IM&T at Pennine Acute Hospitals NHS Trust, said: “We’re being told that the strategic health authority is looking for a number of trusts to come off what they term the Lorenzo bus.”

EHI understands that the ‘descoping’ negotiations with CSC, which have seen key areas of functionality cut, reinstated and then cut again, were completed at the weekend. The new contracts are now being drawn up ahead of the looming end of March deadline.

Last week, shadow health minister Stephen O’Brien expressed concern that the DH wants to sew up new LSP deals ahead of the general election.

Health minister Mike O’Brien told the BBC: “We are certainly looking for a memorandum of understanding by the end of March if we can get it.”

As part of the new deal, CSC and BT, the two remaining local service providers, are expected to get easier payment terms and have their contractual liabilities for late and non-delivery significantly eased.

The ‘descoping’ exercise is ostensibly being driven by the need to find the savings demanded from the national programme by the Pre-Budget Report.

But the cuts announced by health secretary Andrew Burnham in December are the just the latest chapter in a continuous salami-slicing of features and functionality that has been underway since contracts were first awarded in 2003.

The latest round of contract re-negotiations with CSC long predates Burnham’s announcement. A parallel set of negotiations has yet to be concluded with BT the LSP for London and parts of the South.

In a related development, EHI has learned that a new ASCC procurement for acute systems in the South of England has begun, with suppliers invited to register their interest.