Fujitsu pulls out of NHS IT programme

Fujitsu has ended its 10-year, £896m contract with the NHS, part of the £12.7bn health care IT upgrade, dealing another blow to the project following on the heels of previous delays, supplier departures and technical problems. The NHS is in the midst of a massive overhaul of its IT systems, known as the National Programme for IT (NPfIT), effectively the world's largest non-military IT project. But the project is over-budget and is currently projected to reach completion in 2014 or 2015, four or five years later than planned. Fujitsu has been installing an electronic patient records system known as the Care Records Service (CRS) in the South of England from Kent to Cornwall. The CRS is one of the NPfIT's key systems.

A National Audit Office (NAO) report earlier this month concluded that the "unrealistic expectations" raised by the CRS' original, "unachievable" time lines had put confidence in the programme at risk, leading to disillusionment amongst doctors. At the same time, the report acknowledged that, while over-budget, the project had stayed broadly within budgetary limits and that its vision remains feasible. What budget control has been maintained is largely due to the notoriously tight, results-based contracts negotiated by the NHS CFH's former head, Richard Granger, who left the NHS at the end of last year. Fujitsu was known to have been renegotiating its contract following Granger's departure, and was reported to have sought higher revenues from the project.

The NHS' Connecting For Health (CFH), the organisation responsible for implementing the NPfIT, said Fujitsu's departure was due to a failure to agree on new contract terms. "Regrettably and despite best efforts by all parties, it has not been possible to reach an agreement on the core Fujitsu contract that is acceptable to all parties. The NHS will therefore end the contract early by issuing a termination notice," said an NHS CFH spokeswoman. Fujitsu confirmed that contract talks had broken down, saying it decided to withdraw from negotiations "as we did not feel there was a prospect of an acceptable conclusion".

The departure of Fujitsu leaves the project with only two major suppliers, BT, which runs the project in London, and US-based Computer Sciences Corporation (CSC), which operates in the North and East of England and in the Midlands. According to reports, BT has said it would be willing to take on Fujitsu's workload, but the narrowing field of competition is likely to make it more difficult for the NHS to achieve tight contracts. Fujitsu has already installed some patient records systems in the South, and these will continue to be supported. The fate of hospitals without the system could be the subject of a legal dispute.

Another difficulty is the current lack of an NHS IT director, following Granger's departure, Matthew Swindells took over as interim head of the IT upgrade project in January, but left the NHS in April.

The North of England and the Midlands are using a different patient records system, called Lorenzo, developed by medical software firm iSoft, which was the focus of much turmoil in the project until it was acquired by Australia's IBA Health in October 2007. iSoft was originally a subcontractor to Accenture. Accenture ended its involvement with the NHS IT project in 2006 after a leaked email claimed that iSoft had "no believable plan" for the delivery of Lorenzo.

In June 2007, Granger assured a Parliamentary Health Select Committee that Lorenzo was nearly ready for production, but the software has yet to materialise. Earlier this month, the NHS said it would delay rolling out the Summary Care Record (SCR) system, a scaled-down version of the CRS, while it investigated a University College London report that the system was clunky, interfaces poorly with other systems and that patients were being pressed into using it without their full knowledge.

(Matthew Broersma)

(jbe)