The Office of Fair Trading investigation into the public sector IT market could put fresh pressure on leading NHS providers to give trusts more flexibility on price and services, IT experts have told HSJ.

The investigation, announced last Wednesday, will cover the supply of information and communication technology goods and services to the entire public sector but the watchdog singled out hospitals as a key area for its work.

The timing of the investigation is pertinent for acute trusts, which have been given until 2014 to devise plans on how they will deliver fully functioning electronic patient record systems.

OFT investigators will look at whether public bodies’ ability to drive savings is being damaged by a “high level of dependence on suppliers’ expertise”, the regulator said.

It will also consider whether some suppliers “seek to limit the interoperability and use of competitor systems with their own” – an issue for acute trusts looking to bolt new functions onto their existing electronic record systems.

Ewan Davis, a health informatics expert and government adviser, told HSJ: “The plans that NHS England has already outlined involving a more mixed economy of suppliers is already a challenge for existing big specialist health IT firms.

“The OFT investigation, because of its questions around interoperability, could accelerate this. However, it offers a big opportunity for small and medium sized businesses and for the IT market in general.”

He added: “When you get disruptive innovation in a market such as this, not all the incumbents survive. Those which do will have to rise to the challenge.”

Large healthcare IT providers, such as Cerner, McKesson and Epic, have until recently been reluctant to provide the kind of “open interfaces” which allow their large electronic patient record systems to be interoperable with third party products.  

But IT experts said that with NHS England keen to allow more SMEs into the market and to promote “best of breed” solutions, which involves products from more than one supplier, the large providers are being challenged to reconsider this.

One market expert added: “The existing companies are going to have to rethink the business model and are going to find that their margins are squeezed.”

The investigation will also look at the structure of the sector and whether there are barriers to entry which make it difficult for smaller businesses to compete.

The OFT is consulting until 18 August and will announce its findings in October.  

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