NHS Trusts defer patient records systems until next year at earliest

NHS trusts have deferred plans to go live this year with major electronic patient record systems under the £12.7bn National Programme for IT [NPfIT].

NHS trusts have deferred plans to go live this year with major electronic patient record systems under the £12.7bn National Programme for IT [NPfIT].

The cancellation of hospital-wide roll-outs of the Care Records Service - a scheme to give up to 50 million patients in England an electronic health record - comes after calamitous introductions of the system at some hospitals in London and the south of England.

Some observers will see the halting of e-record plans as a further sign of the slow demise of the NPfIT. But officials at NHS Connecting for Health, which runs part of the NPfIT, will see the delays as a chance to understand thoroughly what has gone wrong at trusts which have implemented the Care Records Service, before they try to persuade other trusts to resume the roll-out next year.

The cancellations of plans have added millions of pounds in extra costs for trusts which have recruited NPfIT specialists and trained thousands of NHS staff for go-lives which have not happened.

Documents obtained by Computer Weekly under the Freedom of Information Act give an insight into some of the extra costs, problems and risks which face NHS trusts whose boards have taken decisions to become an "early adopter" of the Care Records Service.

St Mary's Hospital in London, which is part of Imperial College Healthcare NHS Trust, has released the documents. It was due to become an early adopter of the problematic Cerner "Millennium" system which has been installed at Barts, The London and the Royal Free hospital in Hampstead.

But St Mary's has cancelled several go-live dates this year, the latest in August 2008. Its spokeswoman told Computer Weekly it now has no firm plans to go-live with the system. It is among several NHS trusts that have delayed plans to implement the Care Records Service and have not set any new dates to go live.

Documents show that senior executives at St Mary's in Paddington regarded an implementation under the NPfIT as carrying "huge risks".

Minutes of a St Mary's executive meeting said, "There were huge risks to implementation as experienced in other trusts such as Barts and The London and The Royal Free the situation [when to go-live] was being dealt with on a day to day basis. The delay would mean that the project costs were likely to exceed the budget by £1m with the actual amount depending on the new date."

A spokesman for NHS Connecting for Health said the e-records rollout has not halted. He said the Lorenzo system from CSC has been installed at a podiatry unit within South Birmingham Primary Care Trust.

"Many elements of the National Programme for IT are advancing and some are complete. The Programme is one of the largest IT change programmes in the world and it is inevitable that such transformation will present challenges. We are working with the NHS and our suppliers to ensure that systems are implemented as smoothly as possible. It is clear that patients and clinicians are now beginning to see the potential benefits these systems bring to improve patient care."

But a spokesman for NHS London said a decision has been taken to focus on solving problems at trusts which have gone live. The delays will allow trusts which had planned to go live this year more time to prepare and learn lessons from others.

AN NHS London spokesman said that trusts have not postponed implementations indefinitely. He said, “Meetings will be taking place over the next couple of weeks with the London trusts to discuss the implementation dates. NHS London and those trusts hope to have revised dates as soon as possible.”

He added, [and then go into the original quote] “The  NHS in London is working hard to deliver an electronic care records service, called Cerner Millennium, which will help provide better care for patients.

"Versions of this are now up and running in four hospitals trusts. However, as is common in programmes of this size and given the complex and sometimes unique operational demands of London's hospitals, these implementations have given rise to a number of challenges.

"Following the latest stock-take of progress, the decision was taken with BT to concentrate on quickly resolving the remaining issues facing the live trusts whilst continuing with plans for future deployments for which revised dates will be agreed.

"This prioritisation will mean more focus can be given to the need for greater localisation of the system based on many factors including different local workflows and clinical practices. It will also mean a more effective use of BT, Cerner and NHS resource.

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