Rushed IT framework 'favours incumbent suppliers'

A “draft scope and questions” document, published last Friday, asked suppliers seeking inclusion on a national framework for digitising hospitals and mental health to provide initial comment by Thursday this week. Final comments are required by 3 January.

In addition, the document said only bids that could provide a full-range product to digitalise a hospital or mental health trust would be included in the framework, meaning smaller niche suppliers would have to form consortia to participate.

Industry and senior NHS sources familiar with the framework told HSJ the tight turnaround and the need to cover a wide range of digital functions in one bid would advantage large incumbent suppliers over smaller start-ups.

One NHS source said: “Smaller suppliers will be challenged by this. They’ll have less capacity to respond quickly to a detailed set of questions…and also argue the case for the SME supplier community.

“Most will be dependent on the large supplier to give them work as it suits them.”

One supplier source planning to bid for inclusion said NHS England had already delayed the process by nearly a year.

“We have four days to input. That hardly allows for a considered opinion. It’s like someone forgot to get their homework in and is running out of time, but it is in our interests to comply. Unless certain suppliers have been consulted already. Then it is hardly a consultation, it’s lip service and its bad faith.”

Health and social care secretary Matt Hancock has repeatedly called for a more equal and competitive market for NHS IT, ending long IT contracts and “breaking the supplier-capture”.

The NHS England scoping document is seeking supplier input into a digital component of the health system support framework, the other parts of which were published in September. Specifically, it covers the global digital exemplar programme, which is being supported by hundreds of millions in central funding through to 2020-21. 

First announced in September 2016, the exemplar programme is based on funding a group of digitally advanced trusts to develop a set of “digital blueprints” for all other trusts to follow.

About 40 trusts are already involved in the programme and in September 2018 Mr Hancock announced a further £200m to fund an additional wave of exemplar trusts.

Many exemplar trusts are already using clinical IT systems supplied by one of the big US electronic patient records companies. Cerner alone has relationships with six of the 16 “exemplar” hospital trusts.

The scoping document said the framework was focused on helping “fast followers”, the first wave of trusts to pick up and use the digital blueprints, but could also provide a “rapid solution” for any trusts procuring a new electronic patient record.

It said: “The expectation is that systems on this framework may be supplemented by other specialist solutions tested through further waves of the framework, but at this stage, they must provide a core level of functionality for a trust. As the GDE programme continues to develop, we will extend the framework to support NHS organisations to continue to access innovative best-of-breed solutions from the market for specific capabilities and functionality that meets the needs of future GDEs.”

When approached for comment, an NHS England spokesman said: “Once finalised this framework will make it far simpler for hospitals to introduce groundbreaking new technology to help clinicians provide better care for their patients, and it will reduce the cost and time of procurements.”

All suppliers applying for inclusion on the framework will have to meet national standards for interoperability, cyber security and clinical coding.

The framework is scheduled to go live in April 2019 and will be refreshed annually.