NHS IT to pay contractors only upon delivery

Richard Granger, Director of NHS IT, has declared that some of the key contractors supplying the £6.2bn national programme are to be replaced, because they are failing to live up to expectations.

Speaking at the Health Care Computing conference, Mr Granger said that the programme had achieved "substantial progress," but warned suppliers not doing their job could expect to lose their contract.

He warned that without taking action against ineffective suppliers, such progress would "continue to be difficult," and vowed to implement change within the next few months.

Subsequently speaking to the Financial Times, Granger elaborated saying those contractors considered "local service providers" – like BT, Accenture, CSC and Fujitsu, would be safe from the cull.

Despite a willingness to admit problems and delays, the IT Director believes critics of the IT programme only highlight the negative aspects, serving to dampen the spirits of existing project workers, while deterring others from joining.

He pointed out that it is not unheard of for big IT projects to experience "a dip" after an initial stage of optimism.

"Some things are taking longer than anticipated," admitted Granger. "But it would be surprising if that was not true given that we are doing something that has not been done before."

He added that the UK suffers from a "national sickness" when it comes to so-called large IT projects.

"We have this national sickness about what the French call 'grands projects'. When it goes into an entirely predictable dip, and when it has to deal with a lot of problems, we get this attack on the programme."

Granger added that some of the problems with the programme, such as the troubled Choose & Book system, were caused by the need to obtain code written offshore, in countries like the US and India.

He explained that these suppliers "mobilised late," but stressed that there were marked improvements in NHS IT, citing installation of new systems in GP surgeries and hospitals. He added that testing has proved such technologies are fully functional and reliable.

To avoid future disasters, however, tech contractors face the system of payment upon delivery.

This means not only is the supplier rewarded until they actually demonstrate their worth, but also that contracts are structured so that booting out the underperformer for the able provider is not a disruptive process.

Meanwhile, the IT chief welcomes the move by the Health Department to get more NHS managers practically engaged with NPfIT.

The news comes as the 10-year program is about to undergo a name change, which will effectively ditch the National Programme for IT and re-brand into 'Connecting for Health.'

Stephen Castell, who has examined public sector projects for over 15 years, said that one solution could be to give an independent watchdog, like the Public Accounts Committee, wider powers to appoint its own independent and forensically-experienced IT team.

He told CUK: "Only then can we get to the technical truth while giving the citizen taxpayer a skilled, truly independent opinion on the state of NPfIT that counts. The programme could then begin to face up to any proper remedial action necessary. Summarily blaming and chucking out a few suppliers will simply not do."

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