NHS trust threatened by officials

Friday, January 16, 2009

An NHS foundation trust has been threatened by health officials to choose NHS software for electronic health records, or be forced to pay for it even if it chose an independent alternative.

The board of Rotherham NHS Foundation Trust has gone to open competitive tender for a hospital administration system. It is due to make a decision shortly on which system to buy. In an interview with Computer Weekly, the trust's chief executive, Brian James, revealed that health officials had threatened to charge his trust for the NHS software Lorenzo even if the trust purchased an alternative.

It has been rumoured that health officials have also made similar threats to other NHS trusts considering alternative options. If carried out, it would leave trusts paying millions of pounds for systems they do not install. NHS officials have for a long time recommended that trusts adopt the NHS options for software in the National Programme for IT (NPfIT). In particular, despite its problems in London NHS trusts, trusts in other areas of the country are still being encouraged to adopt the Lorenzo software, which is the cornerstone of the electronic patient records programme. The pressure from Connecting for Health – the body in charge of the NPfIT – is because the contracts with BT and CSC, which are worth approximately £4bn, guarantee a minimum level of business. If too many trusts choose alternative software, the companies can claim a non-deployment charge, with the cost of this paid for trusts having to pay for Lorenzo regardless of their choice.

Asked in the interview if health officials had put financial pressure on Rotherham to buy Lorenzo, James said: "They told us we would probably have to pay more. We would have to pay for the system they would have given us [in addition to any other system the trust bought]. It would still, from a financial perspective, pay us to do that."

James said that his board had been unable to obtain firm dates for the delivery of Lorenzo. Originally the trust had hoped to install Lorenzo in the 2006/07 financial year, but software delays made this impossible.

"We did as much investigation as we felt practical as to whether [Lorenzo] would be deliverable in a form that would be acceptable by 2010, and our assessment was that it would be possible but unlikely," he said.

Rotherham has claimed that its purchase will be an "interim" system – which is allowed under the NPfIT whilst a trust waits for the official software. James added that he believes he has convinced the local health authority, Yorkshire and Humber, not to charge for Lorenzo as they are opting for an interim system. The trust is expected to keep the interim system for up to eight years, implementing Lorenzo at the very end of its national roll out.