The first major shake-up of the £6bn Connecting for Health plan is underway with the replacement of a key supplier in the Southern region, Computing has learned.

Software provider IDX is being dropped in favour of rival Cerner to develop the electronic care records system for the area.

The new contract between Cerner and Fujitsu Services, local service provider (LSP) for the South, has yet to be finalised, but is expected to be signed in the next two weeks.

IDX's CareCast software was to have been used for the electronic patient records system covering London and the South, two of the national programme's five implementation regions.

But in April, CfH admitted that the shared implementation was running between six and nine months late, and the problems have proved irresolvable and the deal with Fujitsu has been scrapped.

The change in suppliers is likely to worsen existing hold-ups, with NHS sources predicting an extra one or two years of delays.

'This is bad news for hospitals with creaky old patient admin systems already on their last legs,' said one senior NHS technology professional. 'They have already waited this long for new systems, and now they won't get them until God knows when.'

IDX is the first supplier to suffer from NHS IT director general Richard Granger's public commitment to substitute any company failing to deliver.

At the annual Healthcare Computing conference in March, he said: 'If [suppliers] cannot do the job they will be replaced. We will not wait around for them to fix it.'

The LSP deal for the South was the last of the five regional implementation contracts to be signed. London LSP BT formed an agreement with the Fujitsu Alliance to share a common IDX implementation across the two areas. This was central to the low bid which won Fujitsu the £896m deal for the South in January 2004.

NHS insiders blame CfH for the problems with IDX. Granger's deals rely too much on penalty clauses rather than focusing on whether the technical solution will work, says one senior source.

IDX chief executive James Crook said in a statement: 'Fujitsu Services? decision to withdraw from the ?common solution? and to align itself with another provider for the Southern Cluster is disappointing.

'We believe that, together with our prime contractor BT, we have overcome numerous obstacles in delivering on the national program, which is unprecedented in scale, complexity and schedule, and will ultimately deliver real benefits to patients, care givers and NHS staff.'

The IDX implementation in London is to go ahead, the company says.