Concurrent with the LSPs' work, NHS needed vendors to take on three other mega-projects. The first was construction and management of the National Spine, which would evolve, Brennan claims, into "the biggest computer database in world history. It is the core service in the program; it will bring a number of benefits to the NHS including access to integrated patient data, prescription ordering, proactive decision support and best-practice reference data."
Second was Choose and Book, which the CfH describes on its Web site as "a national service that for the first time combines electronic booking and a choice of place, date and time for outpatient appointments."
Finally, there was the N3 national network, which Granger in public statements described as "one of the largest virtual private networks on the planet." N3 is a secure wide-area network that integrates enterprise-class broadband DSL, fiber-based Ethernet and other data network services as needed. It is designed to provide a seamless, efficient and cost-effective service linking NHS sites.
As described by the CfH on its Web site, N3 will enable electronic communication among different elements of the NHS and support Choose and Book, electronic prescriptions, transfer of patient information and many other initiatives that are part of the NPfIT. It will replace NHSnet, the NHS's current private communications network.
With so much money at stake over the 10-year life of the contracts, more than 30 major players vied for the business, but, Brennan says, "I think some of the vendors didn't realize how complex the program was going to be."
However, at least one group, a consortium that included Deloitte and Lockheed, opted at the last moment not to bid, fearing the project was "simply too risky," according to a member of the vendor team who asked that his name not be used.
Accenture proved the big winner. In December 2003, the Bermuda-based firm was named LSP for two regions, Eastern and Northeast; Computer Sciences Corp. (CSC) was awarded Northwest with West Midlands; BT beat out IBM to get London; and a Fujitsu-led alliance won the Southern region. BT was also given the contract to build both the N3 network and the National Spine, while yet another vendor, Paris-based IT services provider Atos Origin (formerly SchlumbergerSema), was commissioned to provide Choose and Book.
The LSPs, according to the June NAO report, were to act as prime contractors for their respective regions, "who have to decide how best to deliver the service specified by the NHS CfH, assembling and integrating software and other products from a range of services." Each LSP was informed that it was to pick its own software vendors and subcontractors.
"The CfH wanted only to deal with the LSPs," Brennan says.
Two of the fourBT and the Fujitsu groupselected Burlington, Vt.-based IDX (now part of GE Healthcare), an established health-care services and software provider, to develop health records software. Accenture and CSC went with iSoft, a U.K.-based supplier of health-care software and the largest company in Europe devoted to health care.
Significantly, the NHS's contracts with the LSPs had one thing in common: Vendors wouldn't get paid until they delivered the goodsworking systems. This meant that the subcontractors would also lose out if the project faltered.
Meanwhile, the NHS signed an Enterprise Subscription Agreement with Microsoft for 350,000 desktops for Office Professional, Windows desktop operating systems and various client access licenses. That agreement has since escalated to allow NHS to use up to 900,000 desktop licenses. In a separate agreement, Microsoft also is developing a common user interface for
the CfH. "This would provide common formats despite differences in the underlying software being used," says Gartner's Edwards.
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