NHS trusts in the North, Midlands and East of England may have to wait until 2016-17 for a new electronic care record system, a year later than planned.

The Department of Health’s chief information officer Christine Connelly said that changes were being considered to the £3bn deal with supplier CSC.

As the CSC contract currently stands, the contractor must install iSoft’s Lorenzo software at 97 acute trusts and 35 mental health trusts by July 2016.

However, Lorenzo has been fully installed in just three acute trusts and no mental health trusts despite the fact the contract was signed in 2003-04. The contract has already been extended beyond its original 2013-14 end date, and a DH review from 2009 found the system had 3,128 defects, against a contractual limit of 700.

A senior source in health IT has told HSJ that CSC has proposed a change to its contract allowing it to install other software packages and to extend the contract by a year to 2016-17.

Ms Connelly said there were “all kinds of possibilities” regarding the contract, adding: “If they were in a position where they felt they couldn’t continue with the sub-contractors they’ve got, and the products they’ve got, we would have to have a conversation with CSC on that.”

Although not ruling out any lengthening of the contract, Ms Connelly would not confirm what was under discussion.

A memorandum of understanding has been drawn up between CSC and the DH, but no sign-off has been allowed as the national IT programme is being reviewed by the Cabinet Office’s major projects authority.

Matthew Swindells, health chair of BCS, the chartered institute of IT, said: “Things have to happen faster, and people should get more choice. I can imagine this [the use of alternatives to Lorenzo] might be the only way to do it without terminating the CSC contract.”

Another NHS informatics figure welcomed the prospect of using other software in the CSC contract.

“Waiting for Lorenzo is a bit like waiting for Godot,” the source told HSJ.

Ms Connelly told the Commons public accounts committee on 23 May that she believed CSC was in breach of contract, but also said the contract as it stands could cost more to end than to stay with.

A CSC spokeswoman said: “As CSC are currently in contractual negotiations with the NHS we are not able to discuss any details surrounding these negotiations.”

Ms Connelly said she had some confidence in the contracts to install electronic care records throughout London and the South, which are held by BT.  She said that, after years of delays, there was now a “quite well proven” system”.

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