Walsall to solve EPR issues by September

Walsall Healthcare NHS Trust aims to get to ‘business as usual’ with its Lorenzo electronic patient record system by the end of September.

The trust deployed the EPR from CSC in March this year, and became the first combined acute and community trust to do so.

However, EHI reported in May that the trust had hired 25 temporary staff to tackle data quality, reporting and backlog issues that had arisen with the deployment. 

The trust has now entered a “stabilisation period” and Ian Baines, Walsall’s director of finance and performance, told EHI that once this is complete, the trust will return to business as usual.

“Current expectation is that this stage of the project will be reviewed for business as usual at the end of September,” he said.

Some of the main problems related to staff struggling to complete ‘a day’s work in a day’ and the trust has had to change some of its processes to address this.

“Lorenzo has identified some efficiencies that can be made here in the trust, due to the way the system collects data through a patient’s pathway,” said Baines.

“In order to do this, the various areas – which include the access team, call centre, health records and the outpatient clinics – are being reviewed and supported to ensure the patient flow through the trust is optimised.”

The trust went live with the EPR as part of the revised deal between the Department of Health and the company that was drawn up following the development and deployment difficulties experienced with Lorenzo as part of the National Programme for IT.

The Walsall deployment involved moving to Lorenzo from two patient administration systems; the legacy McKesson Star PAS used by the trust’s acute services and the CSC iPM PAS used by its community services. In itself, this was a “significant challenge”.

One of the main reporting problems at the trust is in relation to the referral to treatment time target. As a result, the trust was one of five unable to report waiting times data to NHS England for the latest figures, which showed that the number of people waiting for NHS treatment went over 3m for the first time since 2008.

An update on the project, presented to the trust board this month, says that the trust has now submitted validated data for admitted and non-admitted pathways, but that some issues are still outstanding.

“Incomplete pathway reporting has remained problematic and it has been acknowledged that the only option now available to the trust is to undertake manual validation and correction of pathways,” says the paper.

“Ten Lorenzo staff have been identified to undertake the exercise and have received intensive two day training on the systems and 18 week process by the deputy divisional director. They are now starting to validate and correct the incomplete pathway records, overseen with management support.”

The trust hopes to be able to submit validated data by September. It has identified that the problems encountered are “not just about Lorenzo”, but about patient flow through the hospital. 

One of the issues discussed in the paper is that information was not being recorded in a “timely manner” and Lorenzo was not being used correctly. The trust identified 12 projects, which are being reviewed on a week by week basis to solve this, which includes redesigning the structure to “reflect patient flow.”

It has now launched an outpatient improvement programme, which will “review and look to change where necessary the whole process from referral to booking, to clinic utilisation to outcomes.”

“In addition to Lorenzo the trust is now starting a wider transformation project, led by the director of transformation, which is concentrating on scoping and developing an outpatient improvement programme,” said Baines. “It is expected that this will help the trust secure the longer benefits of Lorenzo once stabilised.”

Walsall has also initiated several projects to strengthen management support and improving staff involvement. “This has developed into a “You said” – “We did” campaign including direct feedback, a fortnightly newsletter and hints and tips as appropriate,” said Baines.

A spokesperson for CSC said in a statement: "We have been working closely with Walsall Healthcare NHS Trust since the go-live of Lorenzo, helping it through a number of outstanding issues, which are now largely successfully resolved.

"We continue to make good progress and our joint work has identified a number of opportunities where Lorenzo can help improve the efficiency and effectiveness of the trust’s operations. We also anticipate contributing to Walsall’s wider transformation project with the aim of maximising the benefits delivered by the Lorenzo system."