Lorenzo plan unlikely before year end

Alternative delivery plans – codenamed Penfield – developed by Computer Sciences Corporation for delivery of the next generation Lorenzo clinical software for three-fifths of the English NHS are unlikely to be completed before the end of the year.

One of the NHS chief information officers taking a lead on the Lorenzo Penfield plan has told E-Health Insider that it remains a proposal, with no final decision expected before the end of the year.

CSC, the local service provider for three northern regions on the NHS IT programme is in ongoing discussions, with Connecting for Health the local NHS, on its proposed Penfield Lorenzo schedule and approach. These have been ongoing since at least April.

The LSP’s proposed Penfield Lorenzo plan is based on four software releases rather than the current two. The key change is that it is now proposed to make available some order communications tools ahead of patient administration system functionality. It also pushes out the final software release to at least 2010.

Sources suggest that there are currently a variety of variations of CSC’s latest delivery plans under discussion. The imperative to provide useful clinical functionality to hospitals, such as order communications, has grown as the delays have mounted in the NPfIT software development and delivery – now running three years late.

Phil Molyneux, chief information officer at Yorkshire and Humber SHA, told E-Health Insider that he remained extremely positive about Lorenzo, and said some encouraging demonstrations of parts of the software now being seen.

But he stressed that the Penfield plan remained a conversation and was not finalised or agreed yet: “This is still a CSC proposal. They are saying we think there are better ways we think we can deliver CRS software.”

Molyneux said a final decision was due by year end: “The existing Penfield proposal remains to be firmed up, which is due to by the end of the year.”

Although the original proposal came from CSC, Molyneux said that it came in response to the NHS telling the LSP what it needed. He said that a far more direct dialogue and communication between SHAs and their LSP has been one of the main areas of improvement since the introduction of the NPfIT Local Ownership Programme (NLOP).

Molyneux stressed that he and fellow CIOs from the other five SHAs in the contracts covered by CSC are heavily involved in shaping the CSC proposals. “A lot of us are taking a particular lead on Penfield stuff.”

The CIO for Yorkshire and Humber SHA, which last month adopted a contingency plan to implement shared records for primary and community care based on TPP’s SystmOne software, said that delays in Lorenzo have been felt hardest in the acute sector. “The delays in the delivery of Lorenzo have hit us particularly hard. The original plans just weren’t delivered. In part this was down to the difficulties that Accenture faced.”

He said that in the NHS locally five acute trusts have a system provided by the LSP, together with two mental health trusts. “Some of our trusts had decent systems already but others have had to take interims or maintain older systems, they really all need a decent system.”

Asked how confident he is in the latest proposed delivery timetables, given delays over the past few years, he said: “You can’t be certain of anything until you see it before your own eyes. But there remains a tremendous amount of commitment to the national programme across our organisation.”

Despite delays he said he remained convinced the fundamental NPfIT vision is correct, “leveraging information technology into clinical care, particularly through the introduction of shared electronic patient records”. To achieve this he said the SHA will use LSP systems “as much as possible”.

While working towards Lorenzo, Molyneux says his SHA and the NHS organisations served decided they had to have a workable plan B, based on developing shared electronic patient records using the TPP SystmOne primary and community system.

He stressed that the local IM&T strategy adopted last month by Yorkshire and Humber SHA was very much bottom-up, based on what local trusts and PCTs said they needed. “We’ve got a lot of hope around Lorenzo but as we said in our IM&T strategy we need a plan B”.

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Lorenzo delivery plans now stretch past 2010

Jon Hoeskma