More openness needed over the model IT system for the NHS in Southern England


Some NHS trust board executives have a policy of openness when it comes to the commercial, technical, financial and managerial aspects of the National Programme for IT [NPfIT].

And Homerton Foundation Trust in Hackney used to be open about its work on the Cerner Millennium patient record system.

But it has become more secretive after Whitehall officials took a decision to install NPfIT systems throughout Southern England, based on Homerton’s system.

A spokeswoman for Homerton said that references to Cerner in its board minutes are now part of “reserved business”. This means that the board now publishes nothing about its dealings with Cerner.

This secrecy is intriguing because one of the last significant public references to Cerner in Homerton’s public paper is this board minute recorded in May 2006:

“The Board discussed the Electronic Patient Record implementation and agreed that a section should be added to the Annual Accounts to note that the implementation of EPR had resulted in an inability to accurately record and code activity for a period of time and that this had resulted in a significant impact on income. It should also include reference to ongoing contract negotiations with Cerner. Ms Clarke confirmed that monthly service payments had been withheld from Cerner during December 05 and January 06 and that this had been accrued within the accounts.”

It may be worth pointing out that Homerton Foundation Trust and Newham University Hospital Trusts jointly deployed Cerner in September 2004. So monthly service payments were being withheld from Cerner more than a year after deployment.

Homerton was not the only trust to have problems with the system. A Care Records Service based on Homerton’s Cerner system has been installed at five NHS trusts in Southern England. At Milton Keynes and Nuffield Orthopaedic Centre there have been serious problems.

When this month (April 2007) we asked a Homerton spokeswoman about the hospital’s contract negotiations with Cerner, and whether Homerton has become less open since its system was chosen as the base product for the NPfIT Care Records Service in Southern England, she declined to comment. At least she was open about Homerton’s policy of secrecy; and she did not hide, as some politicians do, behind banalities.

Connecting for Health, the agency that runs the NPfIT, will doubtless have some strong evidence to support its decision to choose Homerton’s system. That evidence should be published.

Unnecessary secrecy builds a suspicion that in some important ways the NPfIT is going awry. On the other hand many trusts have set an example when it comes to the openness of their boards. Would that they were exemplars for Whitehall.