All eyes on the NPfIT go-live at Barts?

Some staff at the Barts and The London were without their new systems, delivered under the NHS’s National Programme for IT, for half an hour on Tuesday during the busy morning period when many patients come into hospital.

A spokeswoman for Barts and The London NHS Trust said on Tuesday (15 April 2008) that they “experienced some technical issues” with the Care Records Service but “these were resolved within 30 minutes of the issues being reported”. The spokeswoman added that the technical issues “did not affect all users of the system which continued to be used by Trust staff during this [30-minute] period”.

Installations of Cerner’s “Millennium” system at some NHS sites have not always gone as smoothly as staff had hoped and Barts has had its problems.

Some of the technical issues reported by trust staff at Barts and The London NHS Trust include intermittent problems logging onto the system, slow data entry screens, and inability to see some clinical information such as blood test results, data entry backlogs and difficulties tracing records.

Should it matter if one trust in London has some technical issues with a Cerner “Millennium” Care Records Service less than two weeks after going live? The trust has always accepted, and planned with contingencies, for a “period of adjustment”.

Barts is a particularly complex installation. It’s the oldest hospital in the UK, founded in 1123, and is spread over several sites.  But that’s not the reason its go-live has a potential importance which goes beyond London.

It’s because of a re-negotiation of parts of a £896m contract signed in 2004 under the National Programme for IT [NPfIT] between the Department of Health and Fujitsu.  The so-called “contract reset” leaves ministers with a decision on whether to pay Fujitsu a significant extra sum. It’s possible a deal will be done. Or it’s conceivable that Fujitsu will quit, gradually handing to a different main supplier for the NHS in the south of England.

A Memorandum of Understanding between Fujitsu and the NHS is understood to have been signed, which gives ministers another 90 days to decide what to do. The Department of Health is understood to be seeking to enlist the support of Downing Street and HM Treasury in securing the extra money. But the question is: what will happen after the 90 days?

This is why the go-live at Barts has some potential significance. With the help of BT, the local service provider for London, Barts has installed LC0, a version of Cerner’s Millennium system, which been tailored for use by the London Programme for IT.

There’s interest in the NHS in Barts because, if Fujitsu announce a gradual withdrawal from the NPfIT, who would replace it? Just as CSC took over Accenture’s contract as an NPfIT local service provider in the north of England, BT could take over Fujitsu’s contract as the local service provider to the south. In which case eyes are turned towards BT’s challenging installation at Barts.

If everything settles down quickly at Barts and Fujitsu quits the NPfIT, BT could slide into position as one of the two remaining NPfIT local service providers for the whole of England, CSC being the other. But serious problems at Barts or at two other London trusts that are planning to go live this side of summer, could affect BT’s chances of taking over from Fujitsu. 

Of course the Swindells and Darzi reviews could give NHS trusts a choice of suppliers. CSC, BT and Fujitsu – if it’s still there – may end up having to compete against a range of other accredited suppliers for work at NHS trusts.

Which would be a little like the way things were before the NPfIT existed. Before more than £4bn was spent on the scheme.


We asked Barts and The London NHS Trust whether it wished to respond to the comments of NHS staff that there were intermittent problems logging onto the system, slow data entry screens, inability to see some clinical information such as blood test results, data entry backlogs and difficulties tracing records. 

It re-issued a statement it had given to us in answer to other questions. This said:

“The new patient administration system – also known as the Care Record Service (CRS) – was installed across Barts and The London’s hospitals – Barts, The Royal London and The London Chest – last week.

“Any IT deployment of this size and complexity involves a massive amount of change for everyone involved. Contingencies have been in place to support staff as they adjust to the new system with any teething problems being quickly resolved.

“Phil Jones, Director of ICT at Barts and The London, said:

‘We are pleased that the CRS system has been successfully installed and is working correctly. However, this is an extensive and complex system and we recognise that we still have work to do in ensuring staff are using the system as intended.

‘While good staff training is essential before any go-live it is no substitute for actual hands-on use of the system. We will continue to provide significant support for our staff over the next few weeks as they familiarise themselves with the new system and refresher training will be provided on an ongoing basis.’”


NPfIT go-live at Barts ends up in The Sun

Minister defensive over Cerner NPfIT NHS sites

Fujitsu and the NHS – bound by obsolete contracts

Some NHS trusts put NPfIT plans on hold