• New round of “digital exemplar” funding for trusts using the electronic patient record Lorenzo
  • About £10m to be spent on the programme, but money will go directly to IT supplier, DXC Technologies
  • NHS Digital says ‘initiative uses existing funds in the contract between DH and DXC’ 
  • Comes as figures show tens of millions still being spent on National Programme for IT “legacy contracts”

DXC Technologies - supplier of the Lorenzo IT system - is set to receive about £10m to take part in a new national “digital exemplar” programme, HSJ has learned.

The Lorenzo care records system was first introduced to the UK in the under the National Programme for IT in the 2000s, but had an extremely troubled early rollout. News of the new Lorenzo programme comes as figures obtained by HSJ also reveal that the Department of Health is continuing to spend tens of millions of pounds on legacy contracts from NPfIT.

An email, obtained by HSJ, shows 12 trusts running the Lorenzo electronic patient record were invited to apply to participate in a new “Lorenzo digital exemplar programme”.

The email said: “[The trusts] will be expected to accelerate the pace of technological change, inspire and educate others by demonstrating how successful adoption of technology can deliver both improved patient outcomes and increased operational effectiveness.”

As under the similarly named “global digital exemplar” programme led by NHS England, Lorenzo exemplars will be expected to buddy with less digitally developed trusts and develop digital blueprints for them to follow.

However, unlike the global digital exemplars, Lorenzo trusts will not receive any funding directly or have any discretion to pick their suppliers.

Instead, the email said it was likely that NHS Digital will pay Lorenzo supplier, DXC Technology, directly to support participating trusts to deploy IT systems.

The email said that DXC - which was formed in a merger involving CSC, the previous Lorenzo supplier - could be paid about £10m, the same amount as the 16 acute global digital exemplars.

HSJ was told that the sus would ultimately probably have to be paid to DXC, regardless of the “exemplar” scheme, as part of legacy contracts (see below).

Lorenzo is the only widely used electronic patient record in the NHS in England that does not currently have a global digital exemplar site.

The programme is being coordinated by NHS Digital, which has responsibility for remaining NPfIT work.

In response to questions from HSJ, NHS Digital’s director of provider digitisation and programmes, Nic Fox, said the programme would be funded from money already set aside as part of the Department of Health’s 2013 agreement with CSC.

“This programme is one of a number of ways we’re working to transform healthcare provision through maximising the potential benefits of using electronic patient records,” he said.

“The initiative uses existing funds in the contract between the Department of Health and DXC Technology to support health and care professionals to develop digital innovations that will improve patient care.”


Lorenzo trusts (starred trusts have been invited to be digital exemplars)

Barnsley Hospital FT

Derby Teaching Hospitals FT *

East and North Hertfordshire Trust *

George Eliot Trust

Hull and East Yorkshire Hospitals Trust *

Ipswich Hospital Trust *

Mid Essex Hospital Services Trust *

Norfolk and Suffolk FT *

North Staffordshire Combined Healthcare Trust *

Papworth Hospital FT *

Sheffield Teaching Hospitals FT *

South Warwickshire FT *

Tameside and Glossop Integrated Care FT

Walsall Healthcare Trust *

Warrington and Halton Hospitals FT *

Birmingham Women’s and Chidren’s FT

Humber FT

North Bristol Trust

Royal Brompton and Harefield FT

Salisbury FT

University Hospitals of Morecambe Bay FT

Under the National Programme for IT, CSC was granted exclusive rights to supply systems, including Lorenzo, to 160 trusts in the North, Midlands and East. The deal was worth £3.8bn in 2012 prices,

However, after development problems and disruptive deployments, Lorenzo was only every rolled out to a handful of trusts.

In 2013, the DH and CSC made an agreement that allowed trusts in those regions to pick other systems, but offered central funding to any that still chose Lorenzo.

At the time, the then public accounts committee chair, Labour MP Margaret Hodge, described the deal as a “bribe” for trusts to deploy a ”hopeless system” from a “rotten company”.

Fifteen trusts took up this offer, which ended in July 2016, and 21 are now using the Lorenzo electronic patient record (see box).

However, some trusts have continued to report performance problems with Lorenzo. In January this year, University Hospitals of Morecambe Bay Foundation Trust said there remained ”significant and fundamental issues” with its electronic patient record, nine years after it was deployed.

In April, Sheffield Teaching Hospitals Foundation Trust declared a serious incident after uncovering a glitch in Lorenzo that resulted in 14,000 patient letters not being sent. 

Legacy contracts

The 2013 agreement with CSC is one of several “legacy contracts” that have allowed parts of the NPfIT to continue for trusts that missed out at the time.

Figures provided to HSJ by the DH following a freedom of information request show that government is continuing to spend tens of millions of pounds on these contracts.

Since 2013, the Department has spent £38m, including paying £2m directly to CSC, on deploying Lorenzo in 15 trusts. It has committed to spend a further £8m on these deployments, excluding the new exemplar programme.

A similar legacy programme for trusts that missed out in the south, which is not tied to one IT supplier, has cost £69m so far, with a further £11m to come.

The email sent to Lorenzo trusts said any wishing to participate in the digital exemplar programme must “articulate your vision of a digital exemplar”, including how it will benefit patients, and the local health and care system.

HSJ understands at least one trusts approach to be part of the programme is not planning to participate.

DXC has been approached from comment.