Q and A: NHS IT director general Richard Granger

The man in charge of the £2.3bn NHS National Programme talks exclusively to Computing about the agenda for modernising the health service

The £2.3bn NHS National Programme is central to government plans to modernise the health service. The man in charge, NHS IT director general Richard Granger, talked exclusively to Computing about the procurement process and the challenges he faces.

What are your main concerns regarding the delivery of the National Programme?

My main priority is to deliver IT that is part of modernising the NHS and does things of value to patients. I want to make sure that the IT we deliver enhances the work environment of the people who work in the NHS. It would be very easy to deliver things that look nice on the screen but aren't usable and we will not do that. Thirdly I want to make sure we optimise this unique opportunity to deliver a step change in the value for money enjoyed by the taxpayer. The final objective is to make sure we continue to build a strong team to deliver that.

Are you facing any particular issues, around cultural changes or technical interoperability, for example?

My over-riding objective is that we deliver solutions that are of value to patients, people who work in the NHS and the taxpayer. I'm not saying things won't be difficult on occasion, but if we have those things in mind we will stay travelling towards our objectives.

A lot of IT projects, not necessarily in the NHS, set grandiose day-one deliverables which they then decompose as they get closer to that delivery date. I want us to have more honesty about what functionality we will deliver and when, and have a gradualist approach.

A number of clinicians have written to me and pointed out the functional and data richness in some of their existing systems and we need to make sure we make the most of those assets and that experience. This isn't about sweeping the board clean and bringing in ruthlessly standardised solutions that may provide less functionality than existing solutions. This is about making best use of the existing asset base and having a coherent integration and upgrade programme.

The contracts for the National Programme are broken up into various delivery roles and a programme management responsibility to liaise between them. What stage are the different elements at?

The advertisement issued [to potential suppliers] on 31 January talks about local service providers (LSPs) and national application service providers (NASPs). We have had 99 responses from firms and consortia that want to do either one or both of those two things. LSPs will provide a holistic service for clinicians, which means if it goes wrong there is one phone number and it gets fixed. NASPs will have applications running in a limited number of locations that will be piped out over the wire to people working in the NHS, and onto a desktop environment which will be managed as part of the LSP contracts.

There are a number of existing desktop arrangements which may continue beyond the award of these national contracts. We will assess each deal on a case by case basis and the minimum requirement we will have of existing contracts is that they will work with new contractors, which they are all used to doing.

On the programme management side there is a shortlist of five organisations and we are close to making announcement. This is strong client-side support which you always see in successful programmes.

So what happens next?

The 99 expressions of interest will be evaluated on the basis of financial and technical viability.

We are looking to have a long-list completed by the end of March in line with the commitments I've made in the past around running the procurement process at a reasonable pace. There will be no six-month cogitation exercise while we expect the supplier community to keep their bid teams together. This is a process that is bringing together the NHS's desire to modernise quickly and the supplier community's desire to deliver things quickly.

The first LSP contracts will be signed in late October, and possibly one of the applications contracts as well.

When will work actually start?

We are still refining the detail of later stages of the procurement process, which you would expect given its scale and complexity. I would hope that in the latter stages of the process, where we have a limited number of bidders for each work package, we would move into a technical design phase which is funded - so they effectively start work prior to financial close. It is a good structure and it will serve the bidders and the NHS well.

Have decisions yet been made about how many LSPs there will be and what areas they will cover?

At the moment there are three blocks of information moving together:

The first is based around the wishes of the NHS, espoused by Strategic Health Authority chief executives and chief information officers. The second is a surveying exercise looking at current systems. The third is the number of viable consortia that emerge from the evaluation process in terms of their scale, delivery capacity and financial capacity. Towards the end of this month we will bring these three pieces of data together - what the NHS wants, what is there at the moment, and what works well in terms of the market capacity.

The real litmus test of the depth of planning - what date a particular workstation in a particular hospital will have equipment installed - will come as the programme matures. We are not at that point at the moment and it would be bizarre for anyone to imagine we would be.

The original targets for the Programme set a fairly aggressive timetable. How difficult will it be to deliver?

The requirement at the moment is to get agreement on what we're going to deliver. That is an exercise involving patients and patient groups, clinicians and clinician groups, and NHS managers.

We are beginning to get documentation together that articulates what will be delivered and when, from a functional and business logic perspective. We will then get bids from suppliers that have real commitment attached to them because one of the manifestations of that will be bonuses and penalties. The commercial process this summer will give us that and at the end of this year we will have decomposed the delivery targets into steps readily understandable by each of the individuals involved in delivering them.