Epic contract under review

Cambridge University Hospitals and Papworth Hospital NHS foundation trusts’ joint electronic patient record contract with Epic is under review, while Monitor takes a close look at Cambridge’s finances and performance.

The EPR is a part of Cambridge and Papworth Hospitals’ eHospital programme.

In what was seen by many as one of the most important NHS IT procurements in recent years, the trusts announced in April that they were awarding the software component of the tender to US supplier Epic and the hardware and infrastructure contract to Hewlett Packard.

However, Cambridge has recently come under close scrutiny by NHS foundation trust regulator, Monitor, regarding its performance and finances and has been warned it may be in ‘significant breach’ of its terms of authorisation.

The costs associated with the eHospital programme mean it is the only project that has been flagged for review and eHealth Insider understands that no contracts will be signed until that process is complete.

The review itself appears to have been delayed by changes at the top of the trust. Long-serving chair Dame Mary Archer has recently been replaced by Jane Ramsey, previously vice-chair at University College London Hospitals NHS Foundation Trust; while a new chief executive is to be announced imminently.

Former chief executive Dr Gareth Goodier had said the contract with Epic would be signed in late June, but then left the trust that month to take up a role in Australia.

A spokesperson from Monitor told EHI: “Monitor is currently reviewing its regulatory approach to Cambridge University Hospitals NHS Foundation Trust.

“While this process is taking place, and given recent significant changes to the trust’s leadership, we have advised the trust that we will review the eHospital project when the trust’s new leadership is fully up to speed with the proposals; and if it triggers the appropriate thresholds as set out in our Compliance Framework.

“The trust is currently completing its review of whether it meets these triggers.”

The financial triggers are based on the size of the contract in relation to the trust’s turnover. According to EHI Intelligence, Cambridge had an income of £617m and Papworth £129m for 2011-12.

Sources suggest that the cost of the EPR project is in the region of £30m – £40m.

A spokesperson for Cambridge University Hospitals confirmed that the Epic contract has not yet been signed and that the trust is in talks with Monitor about the borrowing facilities required to finance the IT project.

The trust is reviewing whether the eHospital programme constitutes a “significant transaction” and therefore needs Monitor’s approval to go ahead.

"We are progressing well with eHospital and contract clarifications with our preferred bidders are being finalised now,” she said.

“We are following due process with all our arrangements and discussions continue with Monitor."

A document from the trust’s July board meeting suggests it was aware the EPR programme could prove financially difficult: “The trust’s ability to achieve its cost improvement plans could influence Monitor’s view of its ability to invest in eHospital,” it says.

Cerner and Allscripts were shortlisted with Epic for the Cambridge and Papworth contract.

In July, eHealth Insider reported that Cerner had accused the trust of failing to conduct a fair and transparent tender process for the procurement and of picking a winner in advance.