The Department for Health’s director general for informatics has emphasised that local service provider contracts are still in place; although negotiations with CSC have yet to be concluded.
In a briefing at Richmond House to expand on a ministerial statement about the future of NPfIT, Christine Connelly said: “The Coalition government looked at the [BT and CSC] contracts and the best way to provide value for money is to fully honour them."
However, she added: "We will be looking to reduce what we spend both with suppliers and internally.”
She also confirmed that trusts choosing to go outside the programme will have to pay for systems themselves.
Yesterday’s statement from health minister Simon Burns said that a review of the national programme had been concluded and that it had reached the view that "a centralised, national approach is no longer required."
It said that in future "a more locally-led plural system of procurement should operate", alongisde a more modular approach to deployment.
However, it also said that NPfIT’s central contracts would be honoured and its national infrastructure and applications retained as services.
Connelly confirmed that honouring the contracts would mean guaranteeing that a number of trusts would take the strategic electronic patient record systems Cerner Millennium and iSoft Lorenzo.
She said: “Where we are with our contracts with BT and CSC is that we have guaranteed them a number of NHS trusts and that is part of the contract arrangement.”
She added that the deals concluded with BT for London and some trusts in the South would be unaffected by the statement. And she said that the ASCC procurements in the South will be centrally funded and will “now work to move forward.”
Discussing the scope of the LSP contracts, Connelly said that £600m had been scaled back under the previous administration. This included £100m from the BT contract, £200m internally and £300m from CSC.
Further cut backs announced yesterday will take a further £700m from the programme, with £500m coming from local costs and £200m from the CSC contract.
Connelly said that while the discussions with BT were complete, the DH was still in negotiations with CSC.
She said the outcome would depend on the delivery of Lorenzo Regional Care Release 1.9; the latest version of the iSoft system which went live at NHS Bury last November and University Hospitals of Morecambe Bay NHS Trust in June.
Under contract remediation plans, which Connelly said CSC is yet to submit to the DH, the LSP will have to be successful in deploying R1.9 in the four early adopter sites of Bury, Morecambe Bay, Pennine Care NHS Trust and Birmingham Women’s NHS Foundation Trust.
“We are clear on what success looks like, and that is the trust signing off and saying that the deployment is successful… CSC have to be successful in those places for us to get past the early adopter release key milestone.”
She added that the deployments would not be rushed: “It’s not that we want to rush through and get those trusts done. It is very important that the environments get stable in Bury and Morecambe Bay before we move into future deployments.”
Referring to the £500m that will be shaved off local costs, Connelly said: “The local cost element of the original forecast was around £3.5 billion.
"That number was calculated as a top down number that essentially came out of the work done by the National Audit Office on forecasting the figures.
"There has been a lot of work done in the last few months with the strategic health authorities and then the trusts to say ‘based on our implementation plans, how much do you really expect to spend in this kind of climate’ and the number they came back with was £500m less."
She said the lower figure was the result of improved knowledge about the costs of implementation in comparison to four or five years ago and some components being cheaper now than they were then.
Speaking about NPfIT as a whole, Connelly said that the three parts of NPfIT – national infrastructure, national applications and local services – could be looked at very differently.
“Do not know yet how we will govern those three things, but we do know that we won’t manage them altogether. We don’t intend to carry on with them under a banner called the National Programme for IT.”