A Serious Situation

Where's the money going?

Greater ManchesterNHS Capabilities

5Boroughs

Bolton FT

CMUHFT

East Cheshire

East Lancs

GMWestMHFT

MMHSCT

Pennine Acute

Pennine FT

Salford Royal

Stockport FT

Tameside FT

Christie FT

South Manchester FT

Wigan FT

0 5 10 15 20 25 30 35

Trust range of functional capability

sub-title

Onchology e-Prescribing Observation Vital Signs

In Patient E prescribing EPR

Substance Abuse Critical Care

Clinical workflow Clinical Noting

Clinical e Prescribing Clinical Datawarehouse

Bloods Bedsys

Analytics Onchology

Cardiology Finance

Digital Dictation Clinical

Child Health System Community SystemPatient Psych

Ecare Document Management

Integration BI & Data Warehousing

PACS Pharmacy

Pathology Maternity

Theatre RIS

A&E E Prescribing

Scheduling Discharge Letters

Diagnostic Reporting Order Comms

PAS

source: Digital Health Intelligence

Supplier Prevalencesource: Digital Health Intelligence

5Boroughs

Bolton FT

CMUHFT

East Cheshire

East Lancs

GMWestMHFT

MMHSCT

Pennine Acute

Pennine FT

Salford Royal

Stockport FT

Tameside FT

Christie FT

South Manchester FT

Wigan FT

0 5 10 15 20 25 30 35

sub-title

Xcelera Winscribe WinDIP Web Pharmacy Ward Watcher

Unisoft UG pro TTO meds TIMS Theatreman

TDHC TDBB Talking Point Synergy Symphony

Sunrise SQL SQL Somerset Cancer Register SLAM

Siemens Sharepoint Scanfile Rx Tracking Rhapsody

Review Prodacapo Prism PLICS Pharmacy

Patientrack Patient Flow Patient First Patient Centre Paris

Otter Ormis Oracle Olympus OCR

NOMAD NEP Mosaiq Modulus MIS

Miracle MetaVision Medway Medispeech Medisec

Medcon McKesson Masterlab Lorenzo LMX

LE LabCentre Keystone JCAPS iPharmacy

InView Integra Inpatient Flow Innovian In House

ICIS ICE ICBM ICAN IAPT

i.PM i.LAB i.CM Horizon Healthviews

Gecko Galaxy G2 Speech Evolution EuroKing

eTTO EPTS EPR ePMA Ensemble

EMIS eDischarge E3 E business Diamond

Dendrite DataGate DataCam Data Warehouse Data Academy

Dart CRIS Cost Master Corp Info Sys Concerto

Community Info DW CMiS Cloverleaf Clinicom Clinician

Clinical RTI Solutions CIRIS Chimera ChemoCare Centricity

CD View Ccube EDM CCH2000 Cassius Cascade

CareVue Care Plus Cardex Carddas Business Objects

Bloodtrack Bloodhound BigHand BEDS BedMan

Athena Ascribe Aria Amigos ALS

Agresso Advantis Advantage

The NHS IT landscape

PAS system

PACSsystem

FinanceSystem

PathologyLIMSsystem

Theatressystem

Observation Vital Signs

system

Child Health System

Cardiologysystem

GP systems

Privacy& InformationGovernance

Data SharingPlatforms

QUANTITY of Software and Service Value

Q2 – changes to Q1

UNITPRICE

Cost of ongoing competitiveOPEN SOURCE suppliermarket

TCO: no Vendor Lock-in

EXTRAPROFIT

PRE-CONTRACT CUSTOMERDEMAND

1

Cost from a CLOSED SOURCE Supplier with natural monopoly

2a

POST-CONTRACTCUSTOMERDEMAND

2b

PRE-CONTRACT

POST-CONTRACT

Its cheaper to own OSSthan rent closed source

£XmProjectSpend

CAPITAL EXPENSES

30%Implementation

Consulting

30%Training&Support

OPEN SOURCE

ExpenseAccount

Yrs

0 for OSS

Varies but assume a70/30 split

60% for OSS

10%Hardware

Cost

Same for OSS

CLOSED SOURCE

Yrs

Same for both

0.5%Strategy

Consulting

Not neededfor closedsource

30%Licence

Cost

Create new capital valuesource: NHS Manual

● For “in use” non-specialised property assets fair valueshould be interpreted as market value for existing use.For specialised property for which no effective marketexists, “fair value” is deemed to be the depreciatedreplacement cost for a modern equivalent (MEA) asset(i.e. one that is capable of delivering the samethroughput or volume of service). (Source: NHSFinance Manual)

● i.e. The network/datacentre on which OSS is live canattract the an MEA capital value equal to the value ofan equivalent closed source package license

● NHS Trusts will own the IP around their instance of OSS

● Can exploit and improve this capital in collaboration withsuppliers and partners

Help tackle the deficit!

● OSS allows you to innovate and create newsignificant capital value from nothing!

● transfer license spend to development spend

● Save money from an ongoing highlycompetitive supplier market

● avoid erosion of capital asset value fromsoftware license amortisation

● Capitalise full software value to reduce deficit