NHS – will this pandemic re-emphasise funding for its systems? 8 steps to ensure fit for purpose procurement

By Allan Watton on

The effects of Covid-19 on the NHS and its staff are likely to be felt long into the future. The current crisis has seen an unprecedented demand for acute care, particularly intensive care units, which has led to significant efforts to increase the resources available to hospitals.

This has involved, among many other things, the reorganisation of hospital facilities, redeployment of staff and equipment, and a drive to draw in more human resources and skills from both recently retired and newly graduated individuals.

Although we have yet to see an end to the current wave of the pandemic, pressure is mounting to begin preparations for a ‘post-Covid’ world – or at least one where the coronavirus does not have top billing.

This article looks to investigate the systems and solutions that could be prioritised to help the NHS (and other organisations involved in digital transformation) to face the challenges of the future. It then takes the lessons learned from other strategic digital transformation initiatives and provides eight steps to assure fit for purpose procurement and contracting.

Drive for Digital Transformation

This pandemic has highlighted numerous services within the NHS that need to be better equipped to meet the future demands of the country. Long before Covid-19, and the subsequent lockdown, there were many ongoing discussions about the role of technology in the delivery of effective healthcare at scale. However, for the NHS, and many other organisations, hopefully this crisis has been the push required to turn discussions into action.

Evidence of some of the most fundamental changes that have occurred during the pandemic are within primary care. GP practices, for instance, have transformed their working procedures and changed to remote working, with video appointments in 93 out of 100 cases replacing face-to-face contact, according to a BBC analysis. This is a stark contrast to the 1% of appointments conducted via video just 12 months earlier.

Despite momentum for change, some of the emergency technology solutions utilised during the crisis are not necessarily suitable for long-term care delivery. The NHS requires a more robust way of delivering its ongoing solutions.

Nowhere is this more evident than in the NHS patient waiting list for routine surgery in England, which is predicted to surpass 10 million people by the end of the year. It is clear that acquisition and solutions development needs to be carefully considered in order to ease the mounting pressure on services and to replace ageing technologies which are also holding back the provision of care.

Transitioning to Modern Technology

Change brings challenges, as shown in numerous projects where the transition from legacy to digital has often produced little else but a costly hole in public and private sector finances. One such example was the (at the time) new patient record system project (NPfIT) launched many years ago.

The aim was to revolutionise the way technology was used in the health service by paving the way for electronic records, digital scanning and integrated IT systems across hospitals and community care. However, for various reasons – clarification of specifications, technical challenges and disputes with suppliers – the project was disbanded by the government 11 years after it was started. Unflatteringly, this was described as ‘the biggest IT failure ever seen’, with the cost to the taxpayer being reported as in excess of £12.4bn. Some estimates suggested it was as high as £20bn.

Moreover, technological issues can be expensive to rectify. Faults in the patients record management software, Lorenzo, reportedly led to an estimated 14,600 patient discharge summaries not being sent to GPs over an 11-month period, two years ago. This NHS IT system failure is reported to have cost somewhere in the region of £7m to fix.

These are just a couple of examples of significant public sector centralisation projects, where the risks of failure are traditionally high. While individually these particular projects had questionable value, investment has continued at a local level to maintain and optimise systems. It is at this level that the funding and innovation needs to continue and improve.

8 Steps to Successful IT Procurement and Implementation

Amid warnings that the UK is facing a steep recession, it is likely that the NHS and other public sector organisations will come up against even tougher financial constraints, despite government assurances to the contrary. While this can be seen as an opportunity to stimulate suppliers to improve original thinking in their service delivery, the scale of the challenge ahead of us is unprecedented.

With our experience of developing, optimising and managing over 500 strategic relationships across numerous NHS and other public sector digital transformation system procurements and upgrades, evidence has identified the following eight steps which will assure a smoother upgrade to newer technology, systems and solutions for the purposes of transforming operational effectiveness:

NOTE : The below 8 steps have been improved upon and are now 11 steps which you can find in our new article – 11 Steps to Procure an EPR System.

  1. Step 1 – Clear Requirements
  2. Step 2 – Clear Objectives
  3. Step 3 – Strategic Supplier Management
  4. Step 4 – Be Contract Enabling
  5. Step 5 – Align Culture
  6. Step 6 – Early Market Engagement
  7. Step 7 – Procurement Process
  8. Step 8 – Fit for purpose contract



Investment in digital transformation and solutions is necessary for the NHS to keep up with new challenges and greater demands on its time, its workforce and its resources. We have seen the issues faced on major strategic digital projects in the past, along with centralised systems that failed to deliver on their promises.

However, these failures have provided us all with valuable lessons, the evidence of which has been the inspiration for our eight steps above. Covid-19 has placed a significant strain on our NHS, but it will not be the last challenge we face, so it’s more important than ever that we have a health service that’s fit for the future.