Rescue plan for Royal Free

A 90-day rescue plan is underway at The Royal Free Hampstead NHS Trust to try and fix a catalogue of 22 major problems with the Cerner Millennium Care Records System installed by BT.

Problems caused by the system have so far cost the trust £7.2m, disrupted the delivery of care and led to delays in patients getting treatment, affecting its ability to meet national access targets.

Barts and the London NHS Trust has experienced similar problems, and E-Health Insider has been told that a similar recovery plan is underway at the trust. BT, the local service provider for London, announced in October that it would suspend all future CRS deployment plans.

In a November board paper, Andrew Way, the Royal Free’s chief executive, says: “By early September it became apparent that the trust could not continue with the system as supplied.”

Having alerted BT Health, the Department of Health, the London Programme for IT, NHS London and the National Programme for IT in the NHS, a series of high-level visits to the trust took place.

This led to the development of a turn-around programme, titled “business as usual”, that was launched on 6 October. The rescue plan is based on a 90 day work programme to address each of the outstanding issues, many of which were supposedly fixed before the Royal Free took the Cerner system.

Work is being carried out by “a full system and support team on site, working on the Royal Free build of the software directly and thus changing the London Programme model of one build appropriate for all trusts.”

By moving to directly re-writing and reconfiguring the Royal Free’s version of Millennium, BT, LPfIT and NPfIT appear to given up on the concept of a single version of the software to be used across London, providing the basis for interoperability across the capital. The standardised solution approach is central to the way local service provider contracts were specified.

With all further deployments of Cerner Millennium on hold in the capital, all of BT Health’s and LPfIT’s attention now appears to be on trying to sort out the problems at the Royal Free and Barts and the London.

Convincing future trusts that they can take the system without lurching into crisis will be a challenge for the future. Hammersmith Hospital, St Mary’s Hospital and St George’s Healthcare NHS Trust were all meant to have taken the system by now.

Royal Free was the third trust in London to have taken the Cerner Millennium CRS from BT. But it was the first to receive the London Configuration 1 (LC1) version.

In the November board paper, Wray also says: “In line with other Cerner implementation sites issues have resulted, including problems associated with data entry, system processing, data management and reporting despite assurances pre-go-live to the contrary.”

“This resulted in a significant impact in relation to waiting list management and patient booking processes with activity for both outpatients and inpatients reducing during the months of July and August 2008.”

As well as the list of fixes required work would also be carried out on “enhancements” to the Millennium CRS system, “to address operational and performance issues raised by managers and clinicians”.

The report ends on an upbeat note: To date, progress appears to be good. The trusts implementation team are working with increasing confidence that the problems the RFH has encountered with the system can be overcome.”