Andrew Spence, UK healthcare strategy director for CSC, told CIO sister title Computerworld UK that the NHS and its suppliers were “ruthlessly focused” on making sure the new electronic patient record systems worked well in trusts and improved patient safety by linking together different information.
CSC has a £3 billion contract for systems in approximately 60 per cent of NHS England, with most of its coverage in the North, East and Midlands. It also provides a number of other optional systems, including document management, to various healthcare organisations.
The government is negotiating hard with suppliers, aiming to remove £600 million from programme costs. CSC said it supported the government’s plans and that it was working closely with the NHS, its largest client, to deliver a workable, useful system that would transform the handling of information in hospitals. BT has similarly always said it supports the programme.
The government is striving to seal the renegotiated deals with suppliers, drawing fire from the Conservative party which said Labour was trying to tie its hands by agreeing to contracts that have expensive cancellation clauses. The Tories have also said they would abandon centralised patient records if they won this year’s election, favouring instead records hosted by companies such as Google.
Spence acknowledged there was “a lot of talk” about the renegotiations, but declined to reveal the specific details of ongoing talks. He insisted the future for CSC in NHS was promising.
“We’re ruthlessly focused on getting things right for Morecambe Bay,” he said. “If we don’t it would hurt confidence.”
Since a new programme director, Christine Connelly, joined the Department of Health in 2008, the government began to insist on new tough delivery deadlines for patient records. Both CSC and BT were forced to deliver a workable system in a trust each by November.
CSC delivered its key system to Bury and BT to Kingston. CSC's choice of national system, iSoft Lorenzo, also has to be delivered to an acute hospital, Morecambe Bay, by the end of March - including additional functionality for accident and emergency settings.
After Morecambe Bay is up and running, CSC and the Depatment of Health will “regroup” and spend several months reviewing the rollouts to make sure the future deployments are optimised.
Asked whether CSC’s relationship with the government was strained by the new deadlines, Spence said that the Department of Health was “fine from a commercial perspective”, and praised its attitude to electronic patient records as “forward looking”.
“It’s a long term relationship that we have with them, like a marriage,” he said. “Any marriage has its ups and downs, of course.”
The programme has met strong support from a number of trust managers and clinicians, who agree with the idea that linking patient records in a single view would mean hospital nurses and doctors have easy access to all the right information, at all hours.
But there have also been highly vocal critics, concerned about the security of patient data, the usefulness of the system, and whether patients understood what it meant not to decline a digital care record. Since the start, a number of voices spoke against the original idea of imposing a national system on all trusts. But this has now changed, with trusts able to opt out of the programme and choose their own systems.
“We’re very clear that we have to prove the usefulness of our systems to trusts,” said Spence. In order to best understand clinicians’ needs, it regularly meets healthcare staff and trust managers. It also took doctors from its next deployment trust, Morecambe Bay, to India in order to meet the software developers.
“Most trusts really like the idea of the system, and appreciate the benefits of moving away from multiple pieces of paper in different places,” Spence said.
“But it’s not about theory, we’re showing them the system in practice, including in use in hospitals, so they see what it can do to make things work really well. We’ve met some very sceptical doctors who’ve seen the system and changed their minds completely.”