Barts and The London NHS Trust said today [1 September 2008] it
had underestimated the impact of going live with a new system under
the NHS's £12.7bn National Programme for IT [NPfIT].
Difficulties in scheduling patients for appointments have led to
operating theatres and clinics being unused at times, despite high
demand for them.
The trust is funding nearly £1m for extra temporary staff
relating to the NPfIT go-live from its reserves. And it faces a
further £1.5m shortfall in income because it may not be able to
bill its local primary care trust for the patients it sees and
treats.
A spokesman for Barts and The London NHS Trust told Computer
Weekly an "intensive programme of measures is in place" which "will
allow us to return to our previous performance levels as quickly as
possible".
The trust has "apologised publicly to patients, GPs and staff
for the difficulties they have experienced," he said.
The spokesman was responding to Computer Weekly's questions
after the trust published board papers on its website describing
"significant" ongoing problems after the implementation of the Care
Records Service,
The trust has had difficulty maintaining an overview of which
patients have been treated for what following roll-out of the
system. It is paid according to the information it provides to the
local primary care trust on the patients it sees and treats. But
the trust warns in its latest board papers that income may be much
less due to difficulties gathering accurate information on who has
been seen for what and when.
A financial paper to the board on the first quarter of the
trust's 2008/9 year says:
"There remain significant data quality issues with the Trust's
activity and patient activity and income information due to the
implementation of the Care Records Service.
"To reflect the high risk around income the trust has provided
£1.5m against the first quarter's income."
The paper adds: "There are also known system errors where data
which has been entered into CRS [the Cerner Care Records Service
system] has not been reflected in the data warehouse and therefore
is missing from SLAM [Service Level Agreement and Monitoring
system]. These issues have caused [a] significant understatement of
both inpatient and outpatient activity and income".
The trust says that BT and Cerner are "working on solutions to
stop further errors". With fewer than expected patients being
booked clinics and operating theatres have been under-used.
"There is some evidence that April activity was reduced due to
the implementation issues of CRS. Clinics were reduced in some
areas and issues with bookings meant that in some areas the clinics
and operating theatres were not operating their usual
capacity".
The trust has directed nearly £1m from central reserves nearly
£1m to ICT to "fund additional temporary staff costs relating to
the implementation and subsequent validation of CRS".
Bart's and the London Care Records System is based on a patient
administration system from US supplier Cerner and BT, London's
NPfIT local service provider.
Two other London trusts, Barnet and Chase Farm and the Royal
Free Hampstead have also had significant and protracted problems
after going live with the Cerner system. There have difficulties at
go-lives of trusts outside London too. But the government and the
Department of Health want trusts to accelerate plans for trusts to
deploy NPfIT systems.
A spokesman for Barts and The London said: "The
Trust anticipated that there would be a greater degree of
fluctuation in activity levels in the period before and after the
CRS [Care Records Service] go-live in April, but we underestimated
the level of impact that CRS would have on our operations."
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