Sherwood reports RTT problems with PAS

Sherwood Forest Hospitals NHS Foundation trust plans to go live with its Medway patient administration system in October, but has discovered issues relating to its use of the system’s RTT functionality.

The trust decided to take the PAS from System C in September last year, but during the implementation work it has encountered problems using the system’s referral to treatment functionality with existing trust processes.

A paper presented to the trust board earlier this month, says that these problems could impact the trust’s ability to correctly report RTT waiting times, once it has gone live with the system.

It says the supplier will not be able to implement revised RTT functionality until October 2015.

David Linacre, head of IT at Sherwood Forest Hospitals told EHI that acceptable RTT functionality is “key to accurate reporting as part of our Medway PAS implementation and go-live.”

“We have been working closely with System C to ensure that the RTT issues exposed by the project during the testing processes are managed and mitigated correctly.”

The board paper says that there are three main issues. The first is that the PAS is unable to record an “admin event” such as referral to another organisation, in a dedicated field.

“This is necessary to ensure ‘clock stops’ are not missed and that reporting is not incorrect as result. Misreporting of incomplete pathways and clock stops can adversely impact various critical performance measures,” says the paper.

The second is relating to the trust’s central alerting system, as the Medway PAS is “unable to record the RTT start data commencing at the CAS [Central Alerting System]”, which the trust needs to calculate accurate waiting times.

The third is elective waiting lists as the PAS “does not comply fully with national guidance, which would result in misreporting.”

The trust has contacted System C regarding these issues, however the paper reports that the company has said it is not technically possible to deliver the changes in time for the October go-live.

“The earliest date by which the revised functionality can feasibly be implemented is October 2015 – a year from the planned “go-live” date,” says the paper.

Markus Bolton, joint chief executive at System C, told EHI that although every trust using Medway has a standard RTT functionality, the trusts use them in different ways.

“Workflow discussions with trusts, like those ongoing at Sherwood Forest, are a standard part of every deployment.  We are working closely with the trust to determine the best way forward and we are confident that this project will continue on schedule,” said Bolton.

“The RTT workflow at Sherwood is different to that in use by our other users so we have not come across this issue before. In most cases, variations like this are dealt with by process changes, but it is too early to say whether that will be the approach in this instance.”

The paper presented the board with two options. One is to go live with the current functionality and wait until the next release of the Medway software to implement the fixes, and the other is to delay the go-live “until a suitable fix in next release.

“This is estimated to become available to early adopters end July 2015. Earliest go-live date would therefore be October 2015,” says the paper, and therefore recommends option one.

“We accept that there are many trusts using the Medway RTT functionality. However, we are very keen to ensure we support our staff and patients by implementing the Medway PAS system with minimal workarounds,” said Linacre.

“Further dialogue is in progress with System C and we will work in partnership to resolve this issue in a way which is both efficient and cost effective.”

EHI reported in May this year, that Barking, Havering and Redbridge University Hospitals NHS Trust paused all further go-lives of its Medway modules, due to going live before it was fully ready.

Barking 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.

System C, which, along with the rest of McKesson UK, was recently bought by American company Symphony Technology Group, has deployed the Medway PAS to 11 trusts in the last 11 months.

Bolton said that whilst “some problems are inevitable with a system change of this scale, I think that this achievement compares well with the NHS’s overall record for PAS deployment over the last decade or more.”

“There is of course plenty of room for improvement and we are driving hard with our users to improve our systems on all fronts.”

The board paper, previously available on the trust’s website, has now been removed, though not before EHI downloaded a copy.