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Accenture: NHS failure is 'track record for success'

While Granger juggles apples and pears

The company that gave up two failing NHS contracts today tried to paper over the cracks and claimed it had all been a roaring success.

After months of negotiations, Accenture handed contracts worth £2bn over to rival Computer Sciences Corporation after getting paid just £110m for spending a third of the allotted 10 years on the job. Its hand had been forced by losses of $450m it was set to make on the deal this year.

Lis Astall, UK MD of Accenture, said: "I don't believe we failed on the contract at all. There were 800 systems deployed - that is a track record for success."

Accenture delivered nearly 800 systems of varying styles and complexity to NHS trusts in the two English regions it was accountable to under the Local Service Provider (LSP) contracts it held with Connecting for Health (CfH), the NHS IT agency.

CSC, on the other hand, was said to have delivered just eight systems. Yet by another measure, the last official published implementation statistics for the NHS National Programme for IT, Accenture had installed 4,820 systems across two regions, while CSC had installed 3,208 systems across just one. Clearly, the figures gave good massage.

Richard Granger, director general of NHS IT, said comparing the performance of CSC and Accenture was like comparing "apples and pears".

Accenture had concentrated primarily on implementing GP systems, which bumped up its total implementations, but were in reality insignificant compared to the major hospitals tackled by CSC. The latter showed up as few implementations but scored brownie points.

Astall said Accenture had pulled out of the contract because it had been impractical for both CSC and Accenture to share the same primary software supplier, iSoft. So one of them should take on the whole shebang.

Like much of what the government says about procurement, all of these statements contain a little piece of the story, but they do not quite add up to form a complete plot unless you also consider the reports of the consultants who advise these firms.

It is necessary first to recount briefly the description given by Guy Haines, CSC's European MD, for being in the position to swallow £2bn of Accenture's NHS business without showing any concern for indigestion.

By installing systems first in the largest hospitals, he said, CSC got paid more money earlier under LSP contracts that only paid on delivery.

Accenture, on the other hand, had gone for GP systems first, which looked good on paper, but which presumably did not deliver much by way of payment from CfH.

The real reason why it was like comparing apples and pears, industry observers report far and wide, was indeed to do with their major contractor, iSoft, but the approach the two firms took to the business is more significant.

Consultants to the firms report that Accenture was trying to do it by the book, and was waiting for iSoft to finish developing the latest version of its picture archiving and communication system (PACS - a hospital administration system) before it implemented it at the major hospitals in its regions. This was what Granger ordered when he commissioned the LSPs in 2003. iSoft, however, was late with this, so Accenture suffered - the system wasn't getting delivered, so Accenture wasn't getting paid.

But if CSC used the same software supplier, how was it able to make such a success of delivering hospital systems that haven't even been developed yet? Consultants to the firms said CSC had been installing an old version of iSoft software to keep everyone happy and to reap its payments under the onerous LSP contracts while it waited for the version CfH ordered.

When iSoft delivered the goods, CSC would upgrade the systems it had installed. Neither CSC nor CfH were available to comment on this.

We would also have liked to ask them whether this would mean a further increase in costs, and lead to the programme increasing beyond its currently contracted 10 years in order to accommodate the replacement of the new old iSoft PAS systems put in by CSC now with new new iSoft PAS systems delivered whenever they are delivered and implemented whenever there's time.

Haines told journalists today he was "delighted" with the way the programme had gone. He thought the eastern and north eastern contracts it had inherited from Accenture would be run as successfully.

"We'll be using the same approach we utilised successfully in the north west," he said.

"We've been pleased with the progress of the programme. We have also been pleased with the commercial arrangements and our commercial progress of this 10 year programme," he added. ®

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