Christine Connelly has said that despite the recent changes to the National Programme for IT in the NHS, the “NHS as a whole” could face financial penalties if not enough trusts in the North, Midlands and East choose to take Lorenzo.

The warning comes as sources in the region suggest that ongoing negotiations are likely to result in a scaled back version of Lorenzo being offered.

The NHS now faces a delicate balancing act of ensuring that not too many trusts in North, Midlands and East choose not to take a de-scoped Lorenzo system, or series of Lorenzo modules.

The NHS’ director general of informatics yesterday told E-Health Insider: “Those who don’t [take Lorenzo] can do what they want and they won’t get penalised, however if we do not get enough trusts in totality to meet the contract then the NHS as a whole will be penalised.”

However, Connelly added that she “believes that there are enough trusts” that want to take the electronic patient record from iSoft, under local service provider, CSC.

Connelly’s clarification comes three weeks after the DH concluded its review of NPfIT, which put forward a “more locally-led plural system of procurement” and moduler deployment.

Connelly, who has recently been appointed national lead for patient empowerment, provided some clarity on how the local service provider contract, would be honoured whilst allowing for trusts to choose their own suppliers.

She said: “There is work for us to do about how we break these contracts into units of service and deliver on commitments.

“What we have to do is rescope the contracts; there we look at functionality, number of deployments and the length of time we run it.”

When asked if the contract length could be shortened, she said: “There is a possibility that that could happen but it’s unlikely, once the system is in and running we want it to run for along as possible.”

She added that the new contract, which is still being renegotiated, will provide greater flexibility, allow trusts to choose what modules they want and how quickly they want to implement them.

Earlier this month, Connelly announced that £200m will be taken off of CSC’s contract in addition to the £300m announced by the previous administration in Labour’s pre-budget report.

Despite being unable to shed much light on where the savings would come from she said that there was no longer a requirement for CSC to provide GP systems and that the scope is likely to be reduced to focus on the Clinical Five and some departmental systems.

She added that some savings had already been made from service and maintenance costs due to CSC’s failure to implement Lorenzo 1.9 on time.

“If we had Lorenzo 1.9 up and running live for twelve months then we would have been paying the service and maintenance costs of running that system. Because it hasn’t been we have not had to make those payments,” she said.