Trusts' freedom to manage their own IT procurement is increasing, but just how far does it extend? John Yates explains the finer points
The last few years have seen a steady erosion of the national IT programme - Fujitsu's recent contract termination in the South, Accenture's withdrawal from the North East and East of England, GP systems of choice, and the new framework for additional supply capability and capacity.
As the Department of Health loosens its grip on IT procurement, freedom of choice is flowing back to trusts. But have we not been here before? When the regional computer centres were privatised in the late 1980s, trusts spent more than a decade creating islands of legacy systems and data that the IT programme was designed to fix. Is the same thing happening now?
The IT programme is now moving into uncharted territory and trust executives are facing some difficult questions as a result:
- "I'm the chief executive of a foundation trust. Can we buy IT systems outside the IT programme?"
- "If we do, will we be penalised by being forced to pay non-deployment charges?"
- "Can we use the new additional supply capability and capacity framework to buy IT products and services? How do we use it?"
The IT programme and foundation trusts
Monitor's guidance is that foundation trusts must achieve technical and functional compliance with the IT programme but are not obliged to procure particular systems or hardware under it.
However, foundation trusts must exercise their functions "economically, efficiently and effectively" under section 39 of the Health and Social Care (Community Health and Standards) Act 2003.
Chief executives are also personally accountable for ensuring value for money. As with any other form of investment decision, the trust board will need to be satisfied that buying IT systems outside the national IT programme is supported by a robust business case, based on effective due diligence.
Outside the Southern cluster (where Fujitsu was the local service provider), FTs may struggle to justify a decision to buy outside the programme, given that they would otherwise get the benefit of central funding.
In the Southern cluster, the IT programme has broken down, and it is not obvious what the future holds. Will BT step into Fujitsu's shoes? Will the DH run a new procurement? Or will trusts be encouraged to use the new additional supply capability and capacity framework, but with central funding?
Faced with this uncertainty, but with the absolute certainty of further lengthy delays, foundation trusts in the Southern cluster should find it far easier to justify buying outside the IT programme.
Non-deployment charges are becoming a bone of contention between trusts and the DH. The department's legal right to penalise trusts buying outside the IT programme is unclear, but anecdotal evidence suggests that it is using its political and financial muscle to force trusts to follow the programme, and so perhaps Monitor needs to look into this urgently.
The new additional supply capability and capacity framework provides a streamlined vehicle for procuring IT systems and services from pre-approved panels of suppliers: Lot two (clinical information technology) has 61 suppliers covering many different systems and services. The framework is intended to supplement the existing supply capacity provided through the IT programme and to enable new requirements to be met. Although the framework is already being portrayed as a symbol of a return to local procurement of IT, it is not a "get out of jail card" for trusts that wish to ignore the IT programme.
But things are different in the Southern cluster. Foundation trusts in the South that are currently considering what to do next would be well advised to use the framework.
Trusts should not underestimate the effort involved in framing their requirements, tailoring the model contract and running a mini competition before selecting a supplier. And then they need to manage them.
Of one thing we can be certain - we have not heard the last of the national IT programme.