Royal Free considers compensation claim for Cerner problems

The Royal Free Hampstead NHS Trust is preparing for a possible compensation claim after a troubled go-live under the £12.7bn National Programme for IT.

The Royal Free Hampstead NHS Trust is preparing for a possible compensation claim after a troubled go-live under the £12.7bn National Programme for IT [NPfIT].

The trust's staff have been struggling to cope with bugs and downtime since the go-live of the "Millennium" system from US supplier Cerner in June.

The trust was the first in London to go live with Release "LC1" of the Millennium Care Records Service. One of the government's purposes in launching the scheme is to give 50 million patients in England an electronic health record.

But go-lives have led to operating theatres and clinics being unused, while backlogs of work have built up because bookings have not been scheduled correctly. Some hospitals have lost income because they are paid on how many patients they treat and for what. Appointments have been delayed or lost for months. Several trusts have referred to implementations raising "clinical risks".

The Royal Free's board of directors was told in August, "Some individual clinics have genuinely struggled to manage the implementation of Cerner. In the main these clinics tend to be those with the largest "volume of patients"

Officials at NHS Connecting for Health, which is part of the Department of Health, say that the difficulties at the Royal Free and at other trusts where NPfIT systems have gone live are "teething problems".

Although the system at the Royal Free is said to be improving gradually, staff have complained of weeks of chaos. Appointments are said to have been lost in the system and one clinician has said he spent more time booking appointments than in his clinic treating patients.

Now the trust's board has considered a possible claim for compensation. It was reported to the trust's board on 28 August 2008 that "the trust is continuing to log all the problems which had been encountered to be used in the event that a claim proves possible".

The board was also told that another trust was "known to be seeking compensation and it would be interesting to see what the outcome of the claim would be".

But NHS trusts cannot claim compensation directly from their local service providers because they have no contract with them. In London the contract is between the Secretary of State for Health and BT, the capital's local service provider. Trusts could make a claim for compensation to the Secretary of State.

A spokesman for NHS Connecting for Health was unaware of any claims as yet for compensation. He said, "There are no trusts seeking compensation in relation to the NPfIT."

He added, "NHS CFH and London hospital Trusts are enthusiastic and committed to the timely programme of go-lives of the Cerner Millenium system, given the beneficial effect to patients and healthcare staff." 

A spokesman for BT said that no London trust is seeking compensation. Asked if it was a good idea continuing with go-lives of the Cerner system given the effect on trusts and patients of the go-lives, the spokesman said, "The system is already bringing benefits to patients, so we have no plans to change our deployment strategy. That is not to say there have not been issues we have made no secret of that, but it would be unusual for this not to be the case with what is essentially a massive change management programme."

The Royal Free treats about 700,000 people a year, employs about 4,600 people and has a turnover of about £450m.

See also: "London Trust may claim after NPfIT problems" on Tony Collins' blog - includes Royal Free Hampstead NHS Trust board paper - August 2008

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