Dozens of patients at a north London hospital went
untreated for at least six monthsafter the hospital introduced IT systemsunder theNHS's £12.7 billion National Programme for
IT, Computer Weekly has learned.
Barnet and Chase Farm Hospitals NHS Trust did not see or treat
patients within government-imposed 26 week limits following
difficulties with its roll-out of the
Cerner Millennium Care Records Service.
The trust was
the first in the capital to go live with the system under the
National Programme for IT [NPFiT].
Staff at Barnet and Chase Farm Hospitals NHS Trust were unaware
of the problem for up to five months. This was because the trust
could not produce monthly information on patients who had been
waiting too long for treatment following the roll-out.
A trust board paper said:
"
The introduction of a new Patient Administration System meant
the [Barnet and Chase Farm Hospitals NHS]
Trust was unable to produce monthly waiting time data between July
2007 and January 2008."
"The production of the waiting time data in February revealed a
significant number of waiting time breaches which had occurred
there were 63 inpatient breaches."
Barnet and Chase Farm hospitals had 8,500 extra complaints from
patients, largely because of delays in making follow-on
appoinments after introducing the Cerner Millenium Care Records
Service.
The hospital did not re-admit patients whose operations were
cancelled at the last minute, within 28 days, as required by
government guidelines.
Computer Weekly has learned that a surveillance system - for
tracking patients whose operations were cancelled at the last
minute by the hospital for non-clinical reasons - was not working
in the Cerner Care Records Service.
As a result, at least 18 patients were not re-admitted within a
month of the hospital cancelling their operations. The government
has set a target that patients should be re-admitted within 28 days
of their operations being cancelled.
The trust has sent an explanation of the problems with the
patient administration system, and its effect on targets, to the
Healthcare Commission,
the NHS's regulator.
The trust has also contacted the patients who had been waiting
more than 26 weeks. The trust has reported that many of the
affected patients have now been treated. And it has given its local
primary care trust, at Enfield, an assurance that it now has a
system for tracking patients to ensure they are seen within the
target waiting times.
Despite the delays in treating patients, Barnet and Chase Farm
hospitals had under-used capacity - which is likely to mean
under-used operating theatres and wards - in April and May this
year, according to a paper to the trust's board last month.
It said: "The ongoing technical patient administration issues
have caused problems with scheduling and admission of patients. In
April and May the Trust had unutilised capacity arising from this
issue."
Implementations in London and the south of England of the US
Cerner system - which is only partially modified for use in the UK
- has caused disruption at several trusts including
the Royal Free at Hampstead,
Barts, where
some cancer
appointments were
delayed.
Geoff Martin of
London Health Emergency, a group which campaigns on NHS matters,
said: "You cannot have operations cancelled at the last minute in
these kinds of numbers."
Richard Harrison,
Consultant Gastro-intestinal Surgeon and Medical Director at
Barnet and Chase Farm Hopsitals NHS Trust said: "You can test the
system but you will only find out some of the complexities of
operating it when you put it into real life."
Barnet and Chase Farm executives say the Cerner system requires
staff to change the way they work. They said they have found it can
take much longer to do things that were straightforward before.
There have also been problems with the system. They said many of
the problems have been solved and extra staff have been brought in
which has helped to ensure that processes run quicker.
NHS Connecting for Health which runs part of the NPfIT said:
"Teething problems are to be expected. However, it is clear that
the patients and clinicians are beginning to see the potential
benefits of the system."
Some officials will regard the patients affected at Barnet and
Chase Farm Hospitals NHS Trust as the unfortunate few victims of an
IT-based strategy which will eventually help to improve safety,
care and health. But others will say that the Department of Health
should not embark on go-lives when they know there is a likelihood
the health of some patients could suffer as a result.