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When free and open source actually means £6k-£8k per package: Atos's £136m contract with NHS England

'All software must be safely and securely deployed within guidelines provided to us,' says outsourcer

French outsourcer Atos has been charging NHS England between £6,000 and £8,000 for packing up popular free and open-source software requested by workers in the non-departmental government body.

According to documents seen by The Register, data workers in NHS England have to request FOSS packages via their line management. These are fulfilled by outsourcer Atos, as part of its £136m agreement with the Department of Health and Social Care signed in June 2019.

Analysts within NHS England who work on strategic planning of one of the world's largest public health systems, as well as assisting with the COVID-19 response, have requested common, freely available open-source packages such as R, the statistical language, and Python, the general-purpose language.

Management teams said these would cost between £6,000 and £8,000 for Atos to "package" for the public-sector organisation. The exact figures have not been disclosed to protect the source of the information.

One worker at NHS England told The Register that there were also fees for updating FOSS software on NHS systems, which meant management turned down requests, creating security risks.

Dr Marcus Baw, chairman of the Royal College of GPs' Health Informatics Group, told The Register that the outsourcer's fees for free, open-source software were a prime example of why the health service gets such bad value for tech. There were not enough skills within the organisation to install the software, he said.

"If you're an IT manager who hasn't touched anything other than packages of Microsoft stuff in years, then one of the simplest ways to de-risk the process is to outsource it.

"It's a symptom of a wider cultural issue within all NHS tech organisations."

Baw said that NHSX, set up by former Health Secretary Matt Hancock to develop best practice in technology and data usage ("Allow Matt Hancock to access this device's location", anyone?), was a case in point.

"They've hired directors of everything, and yet they still haven't actually turned out any particularly useful products. The NHS COVID app, something they brandish as a success of NHSX... well, that was delivered by NHS Digital."

An Atos spokesperson told The Register: "In line with government and NHS policies, all software must be safely and securely deployed within guidelines provided to us. For a small number of users, the client does at times administer software deployment itself but we may be asked to package and deploy the software for a more significant proportion of the workforce.

"This involves a number of steps including requirements capture, testing, UAT and verification. Such activities and costs associated are always carefully considered and are proportionate and are not on a per user basis."

NHS England was contacted for comment last week but has yet to reply. ®

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