Royal Berks writes £18m off EPR

Royal Berkshire NHS Foundation Trust has axed £18m from the value of its Cerner Millennium electronic patient record system.

Papers from the trust’s Council of Governors meeting yesterday say it will take an impairment charge of £27.3m in its 2012-2013 accounts. This reflects a reduction in the book value of assets on the trust’s balance sheet.

The charge is made up of an £18m reduction in the value of its EPR, a £3m reduction in the value of other IT assets which have become obsolete and a £6.3m reduction in the value of some land and buildings.

The trust has been facing significant operational and financial pressures after implementing Millennium last June.

Documents obtained by EHI under the Freedom of Information Act showed it had spent £30m on the system up to October 2012 and a report to the Council of Governors earlier this year revealed that it expected to spend another £6.2m implementing the system in 2013.

In February, the trust confirmed it was “in dispute” with Cerner over the costs of the system.

A statement from Royal Berkshire following yesterday’s meeting explains that a financial review by the trust’s management concluded the valuation of the system needed to be reduced.

A report to the council from the trust’s head of informatics Elizabeth White also describes the progress the trust has made on stabilising the EPR.

This included a major review of letter production, a “deep dive” carried out in ophthalmology on the Reading site, a review of costs and close monitoring of the system functionality on the wards.

Royal Berkshire staff have visited other Cerner sites, Homerton University Hospital NHS Foundation Trust and Newcastle upon Tyne Hospitals NHS Foundation Trust, where experiences were similar, the report says.

It adds that there will be an ongoing dialogue with these trusts.

The meeting papers say that despite progress being made on “addressing the operational inefficiencies of the system”, extensive resources continue to be consumed on the EPR.

A trust statement to EHI says that the EPR impairment charge relates to historic costs incurred and there will be no adverse impact on Royal Berkshire’s budget for this year.

In 2012/13 the trust reported a surplus of £0.5m and it is forecasting a surplus for the current financial year.

Chief executive Ed Donald said that once implemented, an EPR will bring “considerable benefits for all our patients and our staff”.

“Our decision to implement a new records system was made for sound reasons with the interests and benefits for patients as the priority,” he added.

“However, development and deployment is a massive task and such systems are complex and challenging.

“Undertaking any large programme can lead to issues particularly in the initial stages and we acknowledge that we did not fully appreciate the challenges and resources required in a number of areas.

“We have learned important lessons and actively addressed the issues, leading to improvements in the performance of the patient record system. The trust remains committed to reducing the EPR operating costs and to ensuring the system continues to improve and better serve our patients.”

A Cerner spokesperson said the company continued to support the trust.

“When successfully implemented, Millennium gives doctors and nurses real-time access to high-quality clinical information which is critical in the delivery of world-class care for patients,” he said.