After weeks of speculation, Accenture, one of four prime contractors for the £6bn National Programme for NHS IT (NPfIT), has walked away from its £2bn contracts for two of the scheme’s five regions.

The next few months – until the handover to CSC is completed in January – will be vital in ensuring that the programme is not allowed to be derailed.

The official line is that CSC, already responsible for NPfIT’s North West and West Midlands area, will apply its formula to get the lagging ex-Accenture regions back on track.

Though Accenture managed 827 deployments in its regions, they were almost exclusively smaller-scale GP and community care systems. CSC has done well delivering the large, complex patient administration systems (Pas) at the core of the programme, and, so the theory goes, can now do the same in the East and North East.

The main differentiator between the Accenture and CSC approaches was in their work with iSoft, the second-tier Pas provider that the two prime contractors shared. For the handover strategy to work, much will hinge on iSoft.

Since NPfIT’s first delays, NHS IT director general Richard Granger has emphasised the immaturity of the healthcare software market.

If the programme was buying accounting software it would have a range of options with well-resourced and experienced implementation and support teams, he says. But the programme is breaking new ground, and the systems contracted are still in development.

To some extent, NPfIT cannot win. NHS IT directors are baffled that Granger bought software that is still being built. But, equally, long-term government programmes are often criticised for being obsolete by the time they deliver.

Regardless of rights and wrongs, the relationship between the prime contracto r and the software supplier is of unusual importance. And where CSC took the iSoft situation in hand, Accenture walked away from it.

But even for CSC it is not all roses. Because development of iSoft’s next-generation software is slow, the systems it is installing now will have to be upgraded, and such a strategy will cause more upset along the way.

What happens next will depend on CSC’s continuing work with iSoft; how the latter’s financial issues play out; and the implications of Granger’s decision to create a catalogue of suppliers offering additional capacity.

Accenture’s departure has, so far, been managed as well as can be expected. But it is not over yet.

Recent suggestions that the national biometric identity card scheme is hanging in the balance may be misleading.

All the latest signals suggest that, despite the manifest absence of the technology procurement, the government’s commitment to the scheme is stronger than ever.

What is true is that the scheme is broadening almost beyond recognition. But these changes make its eventual implementation if anything more certain – although far, far later than planned.

The first signs of new thinking were suggestions last year that the cards might be used as secure door passes for offices or to streamline private sector hiring procedures. Now the mantra from all quarters is ID management in its broadest sense, rather than the cards themselves.

And Ian Watmore, head of the Prime Minister’s Delivery Unit, even goes so far as to say the scheme will ultimately have more uses in the private sector than the public.

Leaving aside the point that any wider ID management plan will, by necessity, rely on the register underpinning the cards, and the cynical view that there is no better time for refocusing than when money is tight and feet are cold, the reality is that a rethink of the scheme makes it more likely rather than less. As does the ministerial committee on ID management chaired by Jack Straw. As does the appointment of former Home Office ID head Katherine Courtney as director of business development at the new Identity and Passport Service. Not to mention the reaffirmation of the Home Secretary’s commitment in last week’s departmental reform plans.

But most telling is HBOS chief executive Sir James Crosby’s new role leading a public/private forum on ID management. The forum is not the first private sector group to consider the issue – the difference is that Sir James was appointed by the Chancellor.

There have been whispers since the beginning that the plan was resisted by the Treasury on the grounds of expense. That the Chancellor is looking for private sector gains suggests a certainty that the scheme will happen and an inclination to spread the costs as wide as possible.

There is little doubt that the ID scheme, whatever its final shape, will take far longer than originally thought. But that is as it should be. The longer spent thinking about what uses it might have, the better the chances of the taxpayer getting something back for the astronomic investment.