BT warned it may face chop in London

BT, one of the main contractors responsible for delivering the NHS IT modernisation programme, has been warned that it must start delivering in London or risk losing its £996 million contract for the capital.

Leading a consortium called Capital Care Alliance BT was awarded a ten year contract to update NHS IT systems across the capital in December 2003.

The threat to axe BT from the London contract was made by NHS IT director general Richard Granger. If acted on BT would be the second major supplier to be dropped from the programme. In June IDX was dropped as the clinical systems provider for the South of England.

Last week NHS IT boss Richard Granger warned that further supplier blood may soon be shed: "We will get very soon to a point where they will either come good with what they’ve got, or they will get a bullet in the head."

The latest warning came in an interview with Computing in which he made clear that BT is now in his sights: "BT has significant problems: its management has not been strong enough and IDX’s delivery has not been good enough."

Granger was also quoted as saying "BT had better get me some substantial IDX functionality by the end of summer or some predictable events will occur." Until IDX was dropped from the South of England BT had been responsible for delivering a Common Solution based on IDX’s Carecast software for both London and the South of England.

According to the report BT is not being fined for missing the targets for London, but will not be paid until it delivers working systems.

A spokesperson for BT told EHI: "We are working very closely with NHS connecting for Health in London and are confident of our ability to deliver there. We are in negotiations with the London programme board on deployment plans and are hopeful of speeding up deployment."

The spokesperson added that as well as University College London Hospitals NHS Foundation Trust recently going live with the IDX solution that is to be used across London there had been a number of successes. "We were the first LSP install Choose and Book and Picture Archiving and Communications and have installed the hosted Vision primary care system in 38 practices."

If BT were to be dropped for London Connecting for Health, the agency responsible for delivering the NHS National Programme for IT (NPfIT), is likely to be portrayed as vindication of the tough contracts which permit contestability and only pay when systems are delivered.

Yet replacing BT as LSP would represent a major failure for the programme, and raise questions over the whole IT-enabled NHS modernisation programme in London – at the very least it would almost certainly create further delays to the late running programme.

Such a move would also potentially raise serious questions about whether the adversarial management style of Connecting for Health is the most likely to deliver new systems that provide clinical benefits to patients in a timely and cost-effective fashion.

In a statement to E-Health Insider a spokesperson for NHS Connecting for Health said: "Richard Granger was saying no more than is already in the public domain. It has been widely reported that BT and IDX have had issues and there have been some delays to the work in London."

The spokesperson added that both NHS Connecting for Health and its suppliers are keen to urgently deploy much needed systems, "not only in London but across the country".