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All change at NHS CFH

Tola Sargeant

All change at NHS CFH

NHS Connecting for Health (NHS CFH), the agency in charge of the £12 billion National Programme for IT in the NHS (NPfIT), is being reorganised in a significant shake-up of NHS IT. Under the plans, NHS CFH will become little more than a delivery arm, with the strategic power resting with the Department of Health (DoH). The move has considerable implications for suppliers but we do not expect major changes in existing NPfIT contracts unless there is another significant disruptive event.

New structure moves balance of power back to the DoH

According to press reports, responsibility for technology policy and strategy questions will move from NHS CFH to a new Informatics Directorate within the DoH on 6 April. It is understood that the DoH Informatics Directorate will report directly to Christine Connelly, the CIO for health, and consist of six directors plus Tim Straughan, CIO of the NHS Information Centre. The six directors are thought to include Martin Bellamy, director of programme and systems delivery; and Paul Jones, who will transfer from his CTO role at NHS CFH to the DoH, where he will be responsible for the technical architecture used by the NHS and DoH. The other director positions are yet to be filled. They are rumoured to be: a director of policy and planning; a chief business architect; a commercial director, informatics; and a clinical director, informatics.

NHS CFH is also understood to be undergoing a restructure at the same time. The new structure has eight directors, three of whom will report both to Martin Bellamy (who heads up NHS CFH) and relevant executives at the DoH. The move is designed to refocus CFH and align its systems of internal control with those used at the DoH.

Both reorganisations are the first visible changes made by Christine Connelly and Martin Bellamy, who were appointed last September in the wake of Richard Granger's departure from NHS CFH.

Closer integration of NHS policy and IT is sorely needed

Although NHS CFH itself will lose power under the changes, it is possible the reorganisation could actually benefit its cause. Closer integration of NHS policy with the IT infrastructure is much needed. Having some NHS CFH people in senior roles within the DoH will put IT experts in a stronger position to influence policy that affects the programme. Since 2003/4 when NPfIT began, the DoH has made a series of policy changes that had significant IT implications: the new General Medical Services contract for GPs, the choice agenda and the 18-week wait are but three examples. NHS CFH has then found itself struggling to implement these within contracts and budgets that did not foresee them.

IT suppliers need to be making new contacts at the DoH

The question that remains to be answered is whether these shake-ups herald real change or are merely, as the cynics would have us believe, a political move to silence critics at the House of Commons Public Accounts Committee, which published its second critical report into NPfIT in January. Regardless of the motivation, we believe the changes will have real implications for suppliers and NPfIT.

IT suppliers with established contacts at NHS CFH will now need to be forging closer links with members of the Informatics Directorate, who will make policy and strategy decisions going forwards. This may be particularly beneficial for suppliers that are not currently part of NPfIT but still have ambitions in the NHS IT sector.

No major changes to NPfIT expected

However, while the shake-up makes some change at NHS CFH more likely, we still do not expect major changes to existing NPfIT contracts unless there is another significant disruptive event - such as one of the two remaining Local Service Providers (LSPs) leaving the programme. At present, CSC is continuing with the rollout of Lorenzo to early adopters in the North East and Midlands, and BT has been allowed to restart deployments of Millennium having resolved most of the issues at the Royal Free Hospital in London. However, both LSPs have yet to complete contract resets with NHS CFH. There has also yet to be an announcement about the options for trusts in the south of England that are waiting for news of a replacement for former LSP Fujitsu Services, which walked away from its contract last year.

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