National Programme to sign first contract

Tomorrow morning Secretary of State for Health John Reid and NHS IT director-general Richard Granger will announce that SchlumbergerSema offering a Cerner solution have been awarded the electronic appointment booking contract for the NHS.

E-booking will be the first major supplier contract for the National Programme for IT (NPfIT) to be let. As previously reported in our E-Health Insider newsletter, SchlumbergerSema beat off competition from both Fujitsu and EDS, and signed up to exacting contractual conditions, to win the prestigious contract. Government policy calls for e-booking to be in place across the whole of England by the end of 2005.

E-booking will be critical to the success of the Patient Choice agenda, a policy with which Dr Reid has closely associated himself. It is hoped that providing the ability to book appointments electronically from general practice to the acute sector will help convince the public that the health service is improving in time for the next UK General Election – likely to be in 2005.

The announcement of the e-booking contract also provides a timely boost to the National Programme, coming as it does when the negotiations for the more complex Integrated Care Records Services (ICRS) and national ‘data spine’ contracts appear to face further delays.

As reported by E-Health Insider last week the award of the first two Local Service Provider (LSP) contracts has already been postponed from 31 October to 21 November. Sources now indicate that these dates will be actually be delayed further as contract negotiations continue between the National Programme and suppliers to try and resolve fundamental issues such as scope, pricing and risk for the core NPfIT contracts.

Of the two first wave LSP contract negotiations London is now understood to be lagging several weeks behind the North East, which appears to have emerged as the testing ground for hammering out contractual terms and conditions.

E-Health Insider understands that agreement on a viable pricing model for LSPs is proving elusive in the ongoing contract negotiations. This week the NPfIT is due to issue its latest ‘pricing documentation’, replacing previous guidance.

A source close to the negotiations, speaking under condition of anonymity, said of the National Programme. “They keep changing pricing models and can’t find one that makes any sense.” He added that much of the guidance issued to suppliers was proving contradictory.

The main problem behind the difficulties in contract negotiations, the source added, was a continued lack of clarity on the scope of contracts. “The real reason is the lack of definition of the scope of the contracts.”

The source also suggested that tensions between the centre, represented by the National Programme, and local NHS regions, represented by ‘clusters’, were becoming increasingly evident.

“What the cluster guys want is some money to spend, but they do not want the systems that the centre wants.” While the National Programme is fixated on the national ‘data spine’, the source said he just did not believe this was where the clinical and business benefits from NHS IT investment would come from, pointing instead to proven local clinical systems like e-prescribing, PACS and order communications.

He added that these problems were being compounded by the political imperative behind the programme. “They are just trying to push something through to meet a political imperative.”