Over the past few weeks, there has been a lot of very familiar talk about the NHS IT market “opening up”. However, this time round and following renewed announcements by the Department of Health about the dismantling of the National Programme for IT, there appears to be a sense that companies, which have latterly been shut out of NHS IT, might finally get a chance to have the door re-opened to them.

But with all the optimism comes the question over whether there is really any place for SME’s in the market. Moreover, do the inroads exist to enable them to take advantage of opportunities that do come along?

A couple of weeks ago, one of our industry advisors, Jeremy Nettle, blogged about whether there is likely to be a procurement spate or blight. So far, it seems that trusts have used the DH announcement to move forward with procurements that had previously been put on ice. So, you would think that this is music to the ears of smaller NHS IT providers waiting to strike.

But instead, at several recent events I’ve noticed a common trend of frustration from the small and medium size companies. Companies appear exasperated that despite the big announcement from the DH, there are no mechanisms in place to allow them to even attempt to compete with enormous, multi-national corporations who have big balance sheets or big reputations behind them.

On a number of occasions I’ve heard how big players, whose primary focus is not healthcare, are winning trust procurements without even having the product that the trust initially tendered for.

Stories of how small companies, who have fantastic working and proven products that address all of the tender specifications and are being dismissed at the first hurdle, appear to be coming increasingly frequent. With the big players then subcontracting them to provide the service instead.

Whilst this method works in some ways, defining a company’s ability to provide for the NHS on their balance sheet as opposed to their product, could have some major implications.

Firstly, shutting smaller companies out has the potential to prevent the QIPP agenda from being pushed forward, stifling the innovation so often shown only by smaller more agile organisations.

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Perhaps more scarily is the possibility that NHS IT could turn into another National Programme for IT in all but the name, with only a handful of big and ‘trusted’ companies winning the contracts.

One thing is clear- the Department of Health needs to address this matter now. Whether it is the encouragement of collaboration within the industry, a commitment around interoperability that ensures that all systems can integrate, thus not shutting certain players out of the market, or an easier route to procurement that allows smaller companies to participate without requiring huge amounts of their resources away, it is now time to make those changes.

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