Decision day arrives for CfH and NPfIT

The National Programme for IT in the NHS is set to end in its current guise, with plans tabled for further deep cuts, and the name NHS Connecting for Health to be dropped.

E-Health Insider understands that a far-reaching review of the National Programme and Connecting for Health was completed by the coalition government last week, as part of a wider review of all public sector IT major projects.

The recommendations of the review was due to be evaluated today by a panel chaired by government chief information officer John Suffolk. Assuming it is approved, a ministerial announcement expected to follow within the next two weeks.

Sources indicate that the binding nature of the LSP deals with CSC and BT mean they will not be axed, but instead allowed to run down or expire. In the case of CSC – expected to be pushed hard to deliver further savings – its current contract runs until 2016.

Savings beyond the £600m required by the previous government – which included an agreed £100m from the BT London contract, and a yet to be agreed £300m cut from CSCs three LSP deals – are expected to be announced.

EHI has been told that further cuts will come from CSC and perhaps London, together with the unspent monies in the south. One source told EHI that the situation was still in flux, with it not being clear where final decisions would be taken.

The drive for savings, however, is being led by the Cabinet Office, with the DH said to be playing second fiddle. Cabinet Office minister Francis Maude is said to have begun negotiations with CSC by demanding 30% savings from CSC’s £3 billion NHS IT contracts, or up to £900m.

EHI has been told that CfH will disappear as a brand and the already much reduced agency will be dramatically scaled back. Over the past month an exercise described as “hold and let go” has been going on to identify what core responsibilities the DH Informatics Directorate should retain and relinquish.

Far more emphasis will instead be placed on local decision making, interoperability, shared records, clinical portals, and best of breed. “The national programme will become ‘a’ programme, rather than ‘the’ national programme,” said one source.

In effect trusts are being given greater choice, though with little central funding to help them exercise it.

An indication of the swingeing nature of cuts to come has already been provided in the last month’s termination of the Microsoft NHS enterprise licensing deal.

One EHI reader described the end of the Microsoft deal as: “Dumping cost out from the centre”, pointing out that trusts had already set budgets “and now is certainly not the time to get new local funding”.

Many of the responsibilities of CfH are expected to be taken on the Department of Health Informatics Directorate, particularly its Technology Office. This will focus on standards and interoperability, together with ongoing management of contracts.