Inside story – ASCC

One of the big topics for debate among suppliers and visitors to last month’s Healthcare Computing conference was the imminent announcement of the Additional Supply Capability and Capacity (ASCC) framework.

The framework was announced by NHS Connecting for Health last March, and is intended to provide additional IT services and systems to the English NHS. A first round of ASCC contracts was announced in January, and the final lot – the eagerly anticipated contracts for clinical systems – were announced this week.

Whilst suppliers at HC 2008 were excited at the prospect of a form of NHS accreditation, health informatics workers were more concerned about how the new system will actually work and how much it will cost them.

Now the announcement has been made, NHS finance, procurement and IT directors have access to a list of suppliers; but there are still questions about how trusts can approach the suppliers, and how the new services will be paid for. And some EHI sources have raised an additional question; namely exactly how were the firms chosen?

Mik Horswell, a spokesperson for ASSIST and UKCHIP, told EHI: “It is great to have this catalogue announced by Connecting for Health, which could potentially speed up procurements or provide something different.

“But it is still unclear how exactly it works in practice and whether NPfIT funding is available. We must see more clarity on how exactly this will work, and, more importantly, how the funding streams will work for NHS informatics staff to really notice the benefits.”

CfH first unveiled the plans for an ASCC catalogue towards the end of 2006. They said it was intended to complement the offerings that were being promised as part of the National Programme for IT, however commentators wondered if it would become a full blown interoperability strategy.

CfH first published the tender for the catalogue at the end of March last year and split it into four lots – information and communications technology (ICT) services, clinical information technology (CIT) services, hardware and testing environments and related services (TERS) and solutions consultancy.

The OJEC tender notice stated: “The services are anticipated to deliver a broad range of service functionality…The services may also include some hardware, infrastructure and associated services where the majority of costs relate to service delivery.”

Lots 1, 3 and 4 were announced in August 2007, with contracts signed in January this year. Yesterday, the lot 2 shortlist was issued, detailing a list of over 50 system providers for a series of clinical categories ranging from patient administration systems, to dental systems.

Gordon Hextall, CfH director of informatics said: "The award of the framework contracts for ASCC Lot 2 sees the successful completion of a significant procurement. This will help to support the delivery of the National Programme for IT and ensure that the NHS has access to a range of suitable IT supply routes to respond flexibly to new and future business needs as they arise."

However, trade bodies say despite the long process, some of the basic questions that were raised when the announcement of the catalogue was first made remain unanswered.

Melissa Frewin, Intellect’s healthcare programme manager, said yesterday: “To ensure that ASCC delivers real benefits to the health service, Intellect would like to see additional clarity around how the framework will be promoted to potential customers, how they are likely to use it in practice and how it relates to Foundation Trust status.”

As Horswell indicated, another issue is funding. There has been no guarantee of funding from NPfIT if trusts pick these suppliers, and it is questionable if the suppliers are offering systems which aren’t being promised as part of the current NPfIT plans.

There might be more clarity if it was clear how the first round of shortlisted contracts is being used; or whether they are being used at all. One EHI contact suggested that it was, in fact, easier for trusts to procure in other ways, including through other government catalogues, and that few suppliers were seeing business from the ASCC.

He suggested it was a “holding operation” while bigger questions about the future of the National Programme and NHS IT procurement were decided.

Looking through the list of suppliers chosen for lot 2, it is also interesting to note who’s in and who’s out. In addition to familiar NPfIT names in the PAS SME category, there are some interesting new names and there are plenty of logical entries in others. However in some categories, there appear to be some big names missing.

These include large firms such as First Data Bank Europe, who appear to be missing from clinical decision support, INPS from GP surgery services, McKesson from mental health and Bridgeforward from systems integration.

Ascribe, who claim to be the market leader in medicines management IT, are not included in the ePrescribing list, but instead feature in the pharmacy stock control list. And Liquidlogic, who are working with social care trusts and PCTs across the country in children and adult care are also not listed in any categories.

Stephen Critchlow, executive chairman of Ascribe, said he was surprised that the firm was not on the e-prescribing list. The omission does not mean, however, that trusts will be unable to buy its e-prescribing software through the ASCC.

“The main thing to remember is that the national list did not mention sub-contractors. We are sub-contractors to some of the national framework providers,” he said.

He pointed out that that there were other channels for purchasing too. “We’re pretty relaxed because we can sell directly and, where we don’t, we work with other NPfIT suppliers.”

In4tek, who appeared to be missing from the list, contacted EHI to say that it did not wish to apply directly as an SME, but it had been listed as a subcontractor to a number of bigger companies. “We were listed exclusively for our Paris application with Logica, Siemens, Fujitsu and 3C,” said a spokesperson..

“The service areas selected cover mental health, community services, child health services, social care, screening and surveillance, health care professionals and elderly care services which is significant,” they added.

Although subcontractors not being listed on the ASCC may account for a number of companies being missing, another reason may be the way the selection was made.

A reader commented on EHI’s report of the ASCC launch: “The likely reason is that the selection was made not on product functionality or NHS experience, but on the supplier’s stated ability to deliver a ‘service’. The ASCC procurement was about finding large service companies, not NHS evidence based solutions.”

Suppliers were bound not to reveal details of the selection process but EHI understands only 25% of the marks awarded in the selection process were concerned with the functionality of the would-be contractor’s product. At least two suppliers claimed that no marks were awarded for products’ interoperability status.

CfH was asked to comment, but did not get back to EHI before this feature went to press. However, in March 2007, a CfH spokesperson said: “It is anticipated that this ASCC OJEU will be based on systems having to meet interoperability criteria and deliver broadly defined levels of functionality.”

Yesterday, saw the final announcement of suppliers on the ASCC list confirmed and Gordon Hextall, CfH’s director of informatics called it “a significant procurement”.

However, the specifics of the new catalogue, and guidance as to how the process will work, have still yet to be published, raising questions over what the purpose of the ASCC catalogue actually is and how it will work.