Letters

Published: 28/02/2002, Volume II2, No. 5794 Page 23

Having acted as facilitator for the North West trusts which collaborated informally for electronic patient record procurement, I feel qualified to enter the debate on whether central procurement for EPRs is the best way forward ('Down to the wire', 7 February).

We considered central procurement but quickly rejected it to avoid participants re-inventing wheels. The consensus was that the hassle of a central procurement would outweigh any benefits (though two neighbouring trusts with virtually identical requirements did decide to procure jointly).

Participating trusts undertook market-testing activities together, jointly developed business cases, output specifications and a draft contract framework, sharing experiences.

With five contracts signed and more in the pipeline, the collaboration is a success - with national spin-offs: the output specification used in South and West regional EPR procurement is essentially that developed in the North West.

By judicious use of earlier work, it is possible for aspiring entrants to the EPR club to save time and cut both NHS and suppliers' cost of sales - a major issue for all. There is now enough experience of the minutiae of negotiating contracts - the single most resource-intensive task - to avoid trusts and suppliers having to start at square one every time.

But this whole issue is an irrelevance. If some regions or strategic health authorities want to run a central procurement and only do business with the large multinationals, that is fine. What really makes or breaks an EPR project is not mode of procurement nor even the technical solution but the amount of resource and NHS commitment in individual trusts put into helping clinicians and others to use the EPR effectively, the so-called 'soft' culture-change activities.

Alan Shackman The Consultancy Partnership Barnet