Specialists preparing software for a roll-out to NHS hospitals this year under the £12.7bn NHS's National Programme for IT [NPfIT] have been trying to fix hundreds of issues in the initial release, according to a confidential report seen by Computer Weekly and The Guardian.
The specialists have also had to contend with hundreds of new issues as fixes arrived to close old problems. They are working on the delayed "Lorenzo" system for hospitals which cover 30 million people in the Midlands and the north of England.
The Lorenzo "Care Records Service" is already running four years behind schedule, according to a report published last month by the National Audit Office in May. Lorenzo was due originally to start rolling out in 2004. A key aim of the system is to provide to doctors and nurses electronic health records wherever they are needed.
The new problems could cause further delays in the roll out of the Care Records Service. Under the NPfIT, Lorenzo is one of two main software products for hospitals in England, the other being Cerner's "Millennium" software.
Ben Bradshaw, the minister in charge of the NPfIT, has told Parliament that Lorenzo will start rolling out to the NHS this year. Morecambe Bay Hospitals NHS Trust was due to be the first hospital to go live with the basic version, Lorenzo Release I, on 16 June 2008 but it has postponed the go-live, possibly until next month. A new date has yet to be set, its spokeswoman told Computer Weekly.
The confidential report says there were, at one point this year, more than 1,000 issues in Lorenzo release 1. The much more complex and functional Release 2 of the Lorenzo Patient Management System is due to start rolling out this Autumn but it's unclear whether this will happen now.
The report shows there have been internal delays with the project to finalise Lorenzo Release 2. Several areas of the project have been given a "red" status. The software is being built mainly in India for the local service provider CSC and its subcontractor IBA Health which acquired iSoft.
A spokesman for CSC denied that outstanding issues would delay the roll-out of Lorenzo to the NHS this year.
She said: "It is still planned that Early Adopters will go-live over the summer." Asked if the Lorenzo product was fit for purpose she said: "Absolutely, and it is endorsed by NHS Connecting for Health, the early adopters and the clinicians who have already viewed it."
On the outstanding issues and the scale of the challenge facing Lorenzo's developers, she said: "Identifying and resolving issues is to be expected within any major software design programme. We are working with the Trusts, NHS CFH and iSOFT to ensure Lorenzo meets the needs of the NHS."
The spokeswoman did not confirm that Release 2 would go live at NHS trusts in the Autumn but referred to testing beginning around that time.
"Release 1 includes clinical functionality and lays the foundation for subsequent release of Lorenzo ... We are currently working on the Release 2 schedule and expect that early adopters for release 2 will commence testing in the Autumn as planned."
A spokesman for NHS Connecting for Health said: "Lorenzo is being rigorously tested at early adopter sites with differing care settings and geographies to ensure it meets the necessary quality criteria and is relevant to the needs of diverse healthcare communities prior to going live within a working healthcare environment.
Designed to reflect patient journeys and support the modern NHS, the Lorenzo early adopter projects will deliver capability in acute and community services as a first step towards building a truly integrated care record across the entire healthcare delivery system."
On 21 February 2008 in a debate on the Electronic Patient Record in Westminster Hall, the Health Minister in charge of the NPfIT, Ben Bradshaw, said:
"The hon. Gentleman and another hon. Member asked about the progress of Lorenzo. The first implementation of release 1 is due in June this year in Morecambe Bay, South Birmingham and Bradford."
In March 2008 the Conservative's Shadow Health MInister Stephen O'Brien asked Ben Bradshaw about the progress of Lorenzo. Bradshaw said:
"The development of Lorenzo software by iSOFT under a sub-contract to Computer Sciences Corporation has been regularly assessed by NHS Connecting for Health. It is understood that the development plans will enable the deployment of Release 1 of Lorenzo into early adopter sites in the North, Midlands and East Programme for information technology, formerly North West and West Midlands, North East and the East Midlands, in the summer. Release 2 of Lorenzo is due to be ready for deployment in the autumn."