back to article NHS England spends £8M to extend Microsoft deals by a month

England's health service has stuck two deals to extend its Microsoft licensing terms for just one month at a cost of around £8 million ($9.9 million). Reseller deals with Insight Direct and Bytes were set to come to a close at the end of April, but both have been extended until the end of May to allow more time for replacement …

  1. Anonymous Coward
    Anonymous Coward

    Long Term Solution

    To fix the problem in the long term, we need to dump MS. A previous negotiating "tactic" was to pretend we were considering Linux. Perhaps we should do it for real?

    1. Yet Another Anonymous coward Silver badge

      Re: Long Term Solution

      How could the NHS offer cutting edge surgery without PowerPoint?

      1. David 132 Silver badge
        Happy

        Re: Long Term Solution

        “Hello! It looks like you’re writing a letter conducting open heart surgery! Would you like some help?”

      2. Doctor Syntax Silver badge

        Re: Long Term Solution

        The alternative is impressive.

    2. 3arn0wl

      Re: Long Term Solution

      Couldn't agree more.

    3. bo111

      Re: Long Term Solution

      I have both Linux and WIndows installed on same newer machine for many years now. Linux crashes every 2-3 sessions. Windows not a single time - it just works. I am telling this even though I prefer Linux myself. But it is a disaster having to restart in the middle of some important work. In Linux it depends on updates - some updates fix it, and some break again.

      1. Roger Greenwood

        Re: Long Term Solution

        @bo111 - some of us have exactly the opposite experience! Who would have thought it.....

        1. bo111

          Re: Long Term Solution

          How does the crash look like in Windows?

          1. Anonymous Coward
            Anonymous Coward

            Re: Long Term Solution

            And, in English?

      2. This post has been deleted by its author

      3. Anonymous Coward
        Anonymous Coward

        Re: Long Term Solution

        Try a different Linux distribution, e.g. Mint or MX Linux, then customise them to look the same as your current setup.

        I suspect you have some slightly unusual hardware that Linux is using a generic driver for rather than a proprietary one.

        For most people, Linux has been rock steady for decades. It doesn't crash for no reason.

      4. Anonymous Coward
        Anonymous Coward

        Re: Long Term Solution

        I'm sorry, but I find that very hard to believe. I have had a Linux server crash in the late '90s, and recently I had a crash, but it was a hardware failure - dodgy SSD. Apart from that, I don't really get Linux crashes at all.

      5. Anonymous Coward
        Anonymous Coward

        Re: Long Term Solution

        Run Ubuntu under WSL for Windows then Linux will just work too without even having to reboot when you need to do some legacy / *nix stuff.

  2. Pete 2 Silver badge

    Burn rate

    > a cost of around £8 million

    In perspective, with a total budget this year of £180 billion (or 493 million a day) that represents about 23 minutes of NHS time.

    1. John Brown (no body) Silver badge

      Re: Burn rate

      ...and divided across the entire workforce, might buy them all a cup of coffee each, so hardly related to pay negotiations.

    2. Anonymous Coward
      Anonymous Coward

      Re: Burn rate

      Irrelevant. That's called complacency.

      Unfortunately, yours is the attitude displayed by many responsible for public budgets, and when it's the culture, those "small" amount add up to billions - the pennies make the pounds.

      Regardless, it's £8M of tax payers money. And there are plenty of publicly funded organisations who would be very grateful recipients, rather than being fobbed off with "there is no money".

  3. Peter-Waterman1

    I mean Offices is really not great, they dont invest in it and its a money making machine. Everyone just defaults to it, and Microsoft laugh all the way to the bank.

    1. Anonymous Coward
      Anonymous Coward

      Actually Office has features added every month.

  4. SupportHell

    Nadella deserves it!

    Nadella is clearly doing 1000× the work of an NHS nurse, obviously he deserves 1000× the money! He clearly works 42,000 hour work weeks

  5. CorwinX

    Maybe not Linux but Office maybe ditchable

    Switching to Linux would be very tricky and massively expensive.

    It's not about Office - it's about all the specialist apps they use.

    For example: you get an X-Ray or CT scan and 30 secs later the doc is looking at it on a hi-res monitor using a custom-built Windows app.

    What they should threaten is to move to something like LibreOffice for everything back-office.

    That would maybe be achievable and would be a viable threat.

    1. CorwinX

      Re: Maybe not Linux but Office maybe ditchable

      Though on second thoughts... there is the recent article about some bits of the NHS still running on fax machines!

      Perhaps the thought of changing *anything* would put the higher-ups in their own coranary units.

      1. Peter2 Silver badge

        Re: Maybe not Linux but Office maybe ditchable

        Though on second thoughts... there is the recent article about some bits of the NHS still running on fax machines!

        That's because there is a procedural niche that they fill quite nicely. If a nurse is sending pictures of child abuse to someone, somewhere (eg, social services) then a fax machine that's locked in an office on both ends ensures that the contents is only seen by the sender and receiver in a foolproof manner.

        It hands a nice confirmation report which can show that the job of handing it over has been done, at which point after social services have confirmed that they've got it then the original at the hospital end can be destroyed and the only copy exists on paper at social services, making it impossible for a paedo type to get hold of it afterwards; the fax machine can't be used to produce another copy as it doesn't store anything.

        1. CorwinX

          Re: Maybe not Linux but Office maybe ditchable

          OK - fair point. Sometimes low-tech is the way to go for extremely sensitive stuff.

          If it's not stored it can't be hacked.

          1. Peter2 Silver badge

            Re: Maybe not Linux but Office maybe ditchable

            I wouldn't say it's the only way that can be done, but on the other hand it's a "good enough" solution to an issue using off the shelf equipment that is undeniably cheap to implement, cheap to operate, cheap and easy to train people on, and very effective in use.

            One assumes that replacing it requires such a large burden in getting social services and every hospital in the country to agree on new equipment, software, procedures and training that the old system has just soldiered on because the fax machine hardware is a sunk cost, and the operating cost is limited to a POTS line which is probably needed anyway for the ADSL for the public wifi.

          2. Anonymous Coward
            Anonymous Coward

            Re: Maybe not Linux but Office maybe ditchable

            You have got to be kidding!

            The NHS is NOT using fax machines because "someone is thinking of the children" or there's a requirement to only store data on paper. It's because they're operating in the dark ages. This is 2023!

        2. Mr. Flibble

          Re: Maybe not Linux but Office maybe ditchable

          Pictures by fax?? really??

      2. Doctor Syntax Silver badge

        Re: Maybe not Linux but Office maybe ditchable

        "Though on second thoughts... there is the recent article about some bits of the NHS still running on fax machines!"

        Fax doesn't depend on a server being up. Being synchronous it doesn't depend on some store and forward messaging system delivering the message in a timely manner.

        If your life depended on some image being transmitted reliably and you took a moment to think about the options you might be quite glad that fax was a choice, even if only as a backup.

    2. Peter2 Silver badge

      Re: Maybe not Linux but Office maybe ditchable

      For example: you get an X-Ray or CT scan and 30 secs later the doc is looking at it on a hi-res monitor using a custom-built Windows app.

      When I was in a management position at county level over a decade ago X-ray machines tended to create digital images which were stored on system with a web interface which was only accessible internally on N3; the NHS internet connection/VPN. A decade on, one hopes that things have advanced rather than regressed in terms of being platform agnostic.

      A threat to move to Libre Office ought to be perfectly viable to carry through with.

      1. John 110
        Coat

        Re: Maybe not Linux but Office maybe ditchable

        "A threat to move to Libre Office ought to be perfectly viable to carry through with."

        Many, many moons ago I provided it support for a diagnostic lab in a Scottish hospital. IT services decided (rightly IMHO) that not every single hospital PC needed Microsoft Office. It didn't go well.

        First they chose Open Office, then never updated it (at that time MS compatibility was still being worked on). File interchangeability with those Luddites that still used MS Office was awful!

        Second, they listened to those people who "can't do without MS office -- ooh, this new one LOOKS different..ew". (quick sidenote -- this was before ribbons, so there wasn't that much difference between interfaces)

        What should they have done? They should have insisted! If they had switched everyone over to Open Office and allowed no substitutes except for proven exceptional cases (we had an analyser that only exported it's results to a PC with Excel on it, and refused if it didn't find it; the supplies department relied heavily on Excel Macros)

        Instead, the Open Office installations were quietly dropped from the images used to upgrade desktops to Windows XP (I think...)

        I still think they were right to drop MS Office, it was costing a fortune and sitting on (in my lab) 30 PCs where all it was used for was reading the *.doc files that the upper floor aristocracy used to disseminate info via email. And it was the same in all areas of the hospital.

        It would be easier now with LibreOffice file compatibility being better than ever, but of course, now we have the "where's the ribbon" crowd...

        1. Doctor Syntax Silver badge

          Re: Maybe not Linux but Office maybe ditchable

          but of course, now we have the "where's the ribbon" crowd...

          Once MS had been forced to paint themselves into a corner by adopting open standards for documents they had no option but to make changes were they could. Hence all users forced to learn a new UA.

      2. Ian Johnston Silver badge

        Re: Maybe not Linux but Office maybe ditchable

        A threat to move to Libre Office ought to be perfectly viable to carry through with.

        Dear God, no. "A general input/output error has occurred" and that's it - everything you've done since you last saved is irretrievably gone. It's been a known issue with LO for a decade and (check the forums) the developers' invariable reply is "Fuck off. It's free."

    3. alain williams Silver badge

      Re: Maybe not Linux but Office maybe ditchable

      For example: you get an X-Ray or CT scan and 30 secs later the doc is looking at it on a hi-res monitor using a custom-built Windows app.

      Surely the NHS is a big enough customer that the vendor would write a custom-built Linux app to keep the NHS happy -- it can't be that difficult.

      1. CorwinX

        Re: Maybe not Linux but Office maybe ditchable

        I'm sure they would - my point is it would cost, probably a lot, and that's only a single example. There's probably hundreds of NHS-specific custom Windows apps that would eed to be rewritten.

        Office in comparison is to a certain extent "low hanging fruit".

        Like I said, it only needs to be a viable *threat*.

        1. JamesTGrant

          Re: Maybe not Linux but Office maybe ditchable

          For £8million, I’ll write you a SystemOne replacement, it might even take longer than one person month to complete.

          I could even add the ability to attach media files to a patient record… you wanna hear a chesty cough? You got it!!

          It’s not like going Microsoft removes the need for all the IT support folk, they are all still beavering away resetting passwords, fixing laptops etc (not changing usernames though, coz they are (apparently) immutable…

          1. J.G.Harston Silver badge

            Re: Maybe not Linux but Office maybe ditchable

            You do SystmOne, I'll do EMIS. It'll be a batch file with one line run C:\Programs\SystmTwo\SystmTwo.exe -skin EMIS ;)

          2. Sam Haine

            Re: Maybe not Linux but Office maybe ditchable

            You could build an Electronic Health Record on PostgresSQL.

            1. This post has been deleted by its author

      2. J.G.Harston Silver badge

        Re: Maybe not Linux but Office maybe ditchable

        In my installation archive I have (counts....) 44 seperate clinical applications installation archives. To switch to a different operating system you'd need all of them to run on that other operating system. And that's just for GP practices, it doesn't include hospital stuff.

        The clincial applications writers write for Windows because that's what's there.

        1. anonymous boring coward Silver badge

          Re: Maybe not Linux but Office maybe ditchable

          "In my installation archive I have (counts....) 44 seperate clinical applications installation archives."

          I would be very interested to learn what these applications do? How can there be a need for 44 separate ones?

          Thanks for any insight!

          1. J.G.Harston Silver badge

            Re: Maybe not Linux but Office maybe ditchable

            Gets CD backup out...

            accuRx - a prescription lookup system

            barcode scanner - scans barcodes

            cardiolink - connects to sensors that measure heart "stuff"

            cardioview - views the data collected by cardiolink

            crescendo - dunno

            digiscript - transmitting presciptions electronically

            dssplayer - dunno

            dymolabel - driver for dymo printer to print labels on sample tubes

            easylog - logs something

            EMIS - patient records system

            fujiscan - driver for fujitsu scanner for scanning barcodes

            ib4w - can't remember

            iMail driver - a printer driver that sends the "printout" as email

            inrstar - again, can't remember

            JayExDisplay - controls those big dot-matrix signs that say "Mrs Jones, see Dr. Smith"

            LogTag Analyser - analyses logtags?

            microlife - you tell me

            numed intelligent interface - errrr

            ecgviewer - views ecgs

            scriptswitch - alternative to accuRx, prescription lookup system

            SecaCario - alternative to cardiolink

            spacelab - errr...

            spriometry - errr....

            SSV Radar - errr....

            icg endpoint - ....

            lexacom - dicatation software

            sophos - virus control

            systmone - the other patient record system

            1. anonymous boring coward Silver badge

              Re: Maybe not Linux but Office maybe ditchable

              Ok, thanks for the insight!

              Mostly drivers and small utilities for specific hardware.

              They depend on the OS, but shouldn’t depend on Office.

              Pressure must be put on all HW manufacturers to supply and maintain Linux drivers.

              NHS contracts are huge, so this shouldn’t be a problem.

              Regardless, if Windows is kept, there’s no need for Office.

      3. Anonymous Coward
        Anonymous Coward

        Re: Maybe not Linux but Office maybe ditchable

        "Surely the NHS is a big enough customer that the vendor would write a custom-built Linux app to keep the NHS happy -- it can't be that difficult."

        This is exactly the issue - the NHS is vast with around 1.5m employees across ~1250 hospital campuses.

        A typical CT or XRay system is likely to be part of a larger digital radiology system with a 15+ year lifetime. You can get your new application written when you deploy your new system but that still leaves 800+ other sites using the older Windows versions for at least 10 years. The systems that I have seen provided "web browser access" via ActiveX/Java plugins that were updated significantly less frequently than the windows applications so they frequently forced the use of very old browsers/plugins and their related security issues.

        You've just increased your system support costs with no clear end goal and any savings you hope to achieve will be dependent on the wider NHS getting to the point where enough campuses have been able to switch across enough apps to provide cost savings.

        Or you can look at £50/user/year as a relatively small overhead for the functionality and existing system compatibility you get, let procurement specialists argue for discounts and concentrate on more pressing technology and operational issues.

    4. Kiss

      Re: Maybe not Linux but Office maybe ditchable

      Why is this a custom windows app? If it were a webapp it could probably also be accessed by any mobile device/Tablet etc. Another reason that confirms the costs of dealing with Microsoft as a locked in monopoly.

      If the NHS thinks it will pay less for it's Enterprise Level Agreement then it better think again

    5. Handlebars

      Re: Maybe not Linux but Office maybe ditchable

      Upvotes. But NHS could join the rest of the world in having some Linux servers. I don't think anyone was suggesting this is the year of Linux on the infusion pump.

  6. Anonymous Coward
    Anonymous Coward

    E3R licenses

    The first link in the article hides an important detail.

    These are for E3R licenses which are unique to N365.

    They are like E3 but don't include the the Office desktop and mobile apps. You do get Teams free though.

    Essentially many places use the email and Teams parts.

    NHS need to pay to ups to get full E3.

    NHS Digital (as was) had been encouraging Trusts to move to E3 but NHS Mail management portal is slow to reassign licenses, and they fail to grasp the concept of Locum and bank staff who don't have a permanent employer. This means it is difficult to assign licenses as you can only assign licenses to users in your organisation.

    This can also affect rotating medics as they are notoriously bad at getting marked as a leaver from previous organisation.

    The Shared tenancy causes other issues.

    An integration which is normally straightforward becomes impossible / extremely hard as the integration cannot be limited to a single organisation.

    .

  7. J.G.Harston Silver badge

    Exactly what are they extending licenses on? I completed the roll-out of Windows 10 in my bit of the NHS a couple of years ago, and was made redundant because, well, we'd completed the roll-out. So, what's left that's still outstanding?

    1. CorwinX

      I don't think it's Windows itself

      You refurb an office and buy new PCs the Windows licence comes with.

      It's the likes of Office 365 etc, that's subscribed yearly, where they're getting screwed.

  8. Big Softie

    " ..a full procurement process which will also save money in the long-term for taxpayers"

    Never seen this strategy working in my lifetime...so far

    1. Anonymous Coward
      Anonymous Coward

      At Government scale, their own procurement organisation should be able to buy direct from Microsoft at volume discount.and be the simplest things ever.

      These endless round of procurement contracts and bid processes are just illusions over jam for favoured companies and backhander rebates and are the worst of capitalism.

      1. anonymous boring coward Silver badge

        "These endless round of procurement contracts and bid processes are just illusions over jam for favoured companies and backhander rebates and are the worst of capitalism."

        Yes, and screwing the taxpayer over. But the £350m per week might help...

  9. anonymous boring coward Silver badge

    The NHS doesn't seem to be very good at negotiating?

    Why didn't they dangle a very large carrot further down the line to get free extension instead?

    Making it clear that if MS isn't interested, they will look for other solutions.

    All eggs in one basket, with no backup plan, is a surefire way to get fleeced.

    Obviously, they should have planned for this a decade ago, but I guess some managers/planners got "incentivised" by MS...

    1. CorwinX

      Thats exactly the problem

      They *aren't* good at negotiating - look at the whole Covid PPE mess. They panicked and got fleeced.

      They're dealing with people who, if you offer them a finger, they'll have your whole arm off.

      They need a team of professional contract negotiators (ie hard-nosed barstewards) to cut through the all the BS and pie-in-the-sky promises.

      And spot the small clause, slipped into page 100 of the contract, that'll end up costing them (us) shedloads.

  10. t245t Silver badge
    IT Angle

    £8 million worth of Microsoft licenses

    "England's health service has stuck two deals to extend its Microsoft licensing terms for just one month at a cost of around £8 million ($9.9 million)."

    For microsoft, not bad deal for a piece of paper /s

    Given the size of the NHS they would be better off creating their own in-house IT infrastructure.

    1. Boris the Cockroach Silver badge
      Unhappy

      Re: £8 million worth of Microsoft licenses

      Quote

      "Given the size of the NHS they would be better off creating their own in-house IT infrastructure."

      Ah but that would have to be funded from capex not opex.... which opens the NHS manglement upto headlines like "NHS spaffed 1 billion creating its own software instead of spending it on granny's hip op" from the daily wail(just after a m$ rep had lunch with the editor)

      Plus you have the constant wail from the MBA trained manglers of 'cheaper to outsource' as we dont have pay the going rate for devs , designers and testers(or their pensions and time off either)

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