Greenfield four becomes three

The Department of Health is struggling to find four sites in the South of England willing to take the Cerner Millennium hospital system, bought by NHS Connecting for Health as part of a £540m deal with BT.

Despite offering the system at no cost, the DH has been unable to find four NHS trusts willing to commit. The reluctance appears to centre on the realisation that trusts will have to pick up ongoing revenue costs, payable to Cerner from 2015, after CfH contracts expire.

One source told E-Health Insider: “Trusts have woken up to how high the running costs will be. If they implement a system in the next two years, they will face a massive increase in revenue costs two years later, just as NHS spending cuts are really beginning to bite.”

As previously reported by EHI, the NHS in the South will be liable to pay BT £44m if it fails to deliver four sites ready and willing to take Cerner, some 60% of the £73m the DH paid for the four Greenfield sites.

The three trusts lined up to take Cerner under the deal are understood to be North Bristol, Royal United Hospital Bath and Oxford Radcliffe Hospitals. Basingstoke and North Hampshire had been due to be the fourth, but pulled out last year. No replacement has yet been found to make up the numbers.

EHI has been told that the brick wall for many trusts is affordability. Although implementation and software licenses are centrally funded, the high ongoing support costs will fall on individual trusts once NPfIT deals expire.

Trusts were told at the end of 2009 they will have to take on the running costs from 2015. In the case of Cerner, this revenue commitment is said to be a sum “many times” most NHS trusts’ current annual support costs.

With the NHS as a whole required to deliver £15-20 billion of efficiency savings over the next few years, the question of ongoing support costs following the end of centrally negotiated NPfIT contracts is set to become a hot issue for all sites with a CfH-procured system.

Eight Cerner sites were implemented by Fujitsu before it had its local service provider contract axed in May 2008. The number using the sytem has since dropped to seven, after Worthing and Southlands switched off the system.

BT is currently working to migrate the existing sites into its data centre, putting them on the same release as London sites as a prelude to an upgrade later this year.

No new Cerner site has gone live in the South of England in two years, the last being Taunton and Somerset.

Royal United Hospital Bath had first planned on installing Fujitsu-provided Cerner in June 2006, and was to have been the final site installed by Fujitsu when its contract was pulled.