Barts still stuck on 18-week waits

Barts and the London NHS Trust is still unable to report on the national 18-week referral to treatment time target and other key activity targets, four months after its reporting system was suspended.

The trust suspended reporting on 18-week RTT waits in March and doesn’t expect to be able to resume until September. It has also been experiencing problems in other areas, including maternity.

In March, the trust reported 834 breaches of the related 13-week elective outpatient access target, following the implementation of the Cerner Millennium hospital care records system by BT.

Problems with the operation and use of the new CRS also left the trust unable to reliably capture or report on how many patients had exceeded the 18-week RTT target, and 13-week wait target.

Not all of the recorded 13-week breaches related to real patients; some were the result of duplicate entries, incorrect data entry and coding.

The problems led the trust to negotiate a unique deal with the Department of Health, NHS London and Tower Hamlets Primary Care Trust that allowed it to temporarily suspend 18-week reporting.

By June, it was still working on “a detailed data validation exercise to ensure that an accurate picture of performance on 18 weeks referral to treatment time is captured."

Board papers from April stated: “While some progress had been made, the trust was still not in a position to report against the 18 week referral to treatment targets." This was a matter of extreme concern for the trust, which hoped the work would be completed this summer.

A team of experts has been working on site to address the problems. However, E-Health Insider has learned that the trust has not yet been able to resume reporting of 18-week waits, and has been working to a September deadline.

A statement to EHI said: “The trust has undertaken a rigorous assessment of each clinical speciality and is expecting to begin reporting 18-weeks performance from September."

Other problems reported include difficulties with cancelled operations. A June board paper reported: “There have been challenges in the use of the CRS in the creation of the deferred list and add/set encounter components of the waiting list management functions in the system. The trust is working with Cerner/BT to resolve these issues."

Problems have also been encountered in consistently capturing and recording statutory maternity data. The June board papers also state: “The trust is currently unable to meet a key national target for maternity HES [Hospital Episode Statistics] data quality. While data has been submitted, some elements have previously been missing or invalid.”

The board paper says that it is hoped the next Cerner update – Maintenance Release 3 (MR3) – would resolve these issues. “However the position is not yet clear as data still does not appear to be consistently complete."

The problems have also not stopped the trust being rated by Dr Foster as having some of the best clinical care in the UK, in terms of survival rates.