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IT problems at Central and North West London NHS Trust affect medical staff

London Hospitals are reverting to manual processes due to IT systems failure

Central and North West London (CNWL) NHS Foundation Trust is experiencing serious problems with its IT systems as a major IT upgrade nears completion.

Patients are taking up much-needed bed space for longer than needed due to delays caused by staff waiting for information to come through to IT systems. Without the manual efforts of staff, services would be in chaos.

A CNWL spokesperson told Computer Weekly the problems are with the current, inherited infrastructure, and “that's why we contracted with CGI to make improvements”.

The trust admitted that staff and patient frustrations were inevitable, given the size and complexity of the IT transformation.

The spokesperson said CNWL “completely understands staff frustration over IT systems and how it affects the care they provide in numerous ways”, adding that, due to time constraints, the hospital has to implement systems before every issue is settled. 

“In times of change – and we're replacing clinical information systems too – that frustration is compounded as delivery begins without settling all issues, which unfortunately takes time,” said the spokesperson.

The trust – one of the UK’s biggest, with 150 sites – is currently integrating multiple operations to use a single IT infrastructure as part of a major IT transformation. This is taking place alongside the switch to IT services firm CGI.

Medical staff revert to manual processes

But problems are being experienced. Medical staff at Hillingdon Hospital, for example, are being forced to revert to manual processes because of problems with IT systems, according to one patient who was rushed into the hospital with an acute condition.

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He said, during his time in the hospital, nurses and doctors were using manual processes because systems were down. For example, doctors were forced to look at scans in the locations they were done because the information could not be sent elsewhere.

He said medical staff were complaining about the problems.

The patient, who wished to remain anonymous, praised staff for their efforts. “First, let me say the Hillingdon medical were exemplary,” he said.

“Over the three days I was in the hospital, the lack of IT systems clearly showed how critical these services are, with nurses and doctors having to ask for the information multiple times, x-rays (usually digitally stored) getting lost, blood test results being repeated due to poor hand-writing on reference numbers.”

He added that people were staying in the hospital longer than necessary due to the problems. “Half the ward was capable of being released but were forced to stay another day due to an inability to pull the paperwork together, getting the take-home drugs from the dispensary, etc. How many people in need suffered unnecessarily on accident and emergency trolleys while fit people were occupying acute ward beds?”

Teething problems as IT infrastructure is updated

The IT problems go beyond Hillingdon Hospital. The hospital is part of the large CNWL Foundation Trust, and is one that serves Heathrow Airport. In 2013, the trust signed a deal with CGI, to deliver new IT infrastructure services over next five years. The agreement came into operation in April 2014.

The CNWL spokesperson said: “As we won bids to run services we had to bring legacy IT infrastructure up to what it should be; it's a very practical part of building a single organisation out of many services. We understand and accept the challenge, but it is a challenge.”

The spokesperson added that much has been achieved, but not in every area and not always as originally envisaged. “The programme has been, and will continue to be, subject to revision in terms of where services and buildings will be placed in the upgrade plan, though staff will not necessarily be aware of these changes as they are still in the process of being agreed.”

Robert Morgan, director at sourcing consultancy Burnt-Oak Partners, has worked on public sector IT projects. He said hospitals cannot afford IT systems to be unavailable like this. 

“Recurrent and non-supply of IT over multiple days is totally unacceptable. People's lives are literally at risk without the trust's critical systems being fully operational 24 hours,” he said.

“The hospital is the first stop for Heathrow emergencies and major incidents. Major infrastructure upgrades are everyday activities for professional service providers – there is no excuse for these continuing service outages. The Trust deserves better, as do its patients.”

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