BT has completed the renegotiation of its £1bn contract to deliver new computer systems to the NHS in London, in another sign that the centrally managed model for the health service's £12.4bn National Programme for IT (NPfIT) has had its day.

NHS IT agency Connecting for Health had originally kept a tight central grip on contracts for the huge IT overhaul, under its combative director general Richard Granger. But in July, Granger announced he would quit his post by the end of the year - and the Department of Health has not advertised for a replacement.

Instead, the management arrangements of Connecting for Health and NPfIT are being reviewed by NHS chief executive David Nicholson, while the lead contractors for the program are involved in renegotiating their deals to enable a more locally tailored approach that meets the needs of strategic health authorities and trusts.

A BT spokesperson confirmed that the new contract for the London region would establish a "best of breed" approach to the software it supplies rather than a rigid one-size-fits-all model.

Negotiations had begun in summer 2006, when BT sought to switch the patient record system it supplied from one supplied by IDX to Cerner's Millennium product, he said. But the new deal had been completed this summer, after the advent of the NPfIT local ownership program (NLOP) - which transferred responsibility for the delivery of NPfIT from Connecting for Health to SHAs.

A Connecting for Health spokesperson insisted that the renegotiation of the BT contract should be described as a "reset," adding: "The contract reset is a normal repeatable commercial process to ensure the detail of the contract reflects the progress to date, current priorities and deployment plans for the future."

Another "reset," relating to "changes in development methodology and deployment" was under way with Fujitsu and CSC - lead contractors for the South, and North and Eastern regions - the spokesperson said.

But in September Lester Young, NHS account director for Fujitsu, confirmed that his company was expecting to sign a new contract with the NHS and would even be open to changing the original output based specifications for NPfIT set by Connecting for Health in 2003.

Changes to the contract - which is ultimately held by the health secretary on behalf of the government - would "deal with the differences" between what strategic health authorities in the southern region want and the requirements set out nationally by Connecting for Health, Young said.

It is unclear what the new contracts will mean for the overall cost of the NPfIT program. The Connecting for Health spokesperson said: "The original value of the contracts for the same services remain unchanged. However, when additional requirements are identified in conjunction with the NHS then any additional charges will either be funded separately or funded from within the original contract value, depending upon the particular need and the work required."