Cambridge chief exec resigns

Cambridge University Hospitals NHS Foundation Trust’s chief executive has resigned amidst a growing financial deficit and "significant performance and quality concerns" relating to the trust's e-hospital programme.

Dr Keith McNeil, who has been at the trust since November 2012 and overseen the implementation of the £200 million eHospital programme, which included a major infrastructure upgrade by HP, and the first implementation of the Epic electronic patient record system in the UK, resigned yesterday with immediate effect.

Paul James, chief finance officer since August 2014, also left the trust, which is facing a serious economic shortfall and is currently under investigation by Monitor for the way it has handled its finances, including the impact of the eHospital project.

A report on the trust’s performance from the Care Quality Commission is also due out next week.

At the end of July the trust had a deficit of £20.6 million, of which the eHospital programme accounted for £8.6 million. 

This total deficit was £8.4 million worse than planned, while eHospital costs were over budget by £200,000.

In a statement McNeil said: “This has been a very difficult decision, but I have decided to step down as chief executive. It is a matter of public record that we face a number of very serious challenges here in Cambridge, including a growing financial deficit, and I feel the time is right to have new leadership in place.”

David Wherrett, the trust’s director of workforce, will serve as acting chief executive at the trust while it works with Monitor to secure an interim chief executive ahead of a permanent appointment.

Cambridge University Hospitals has previously reported that the roll-out of its major IT project is going relatively well, leading to a reduction in use of paper notes for inpatients by 80% and a 40% reduction in the use of paper in outpatient services. 

However, the trust’s Quality account 2015 paints a different picture, mentioning that Cambridge has “put in place a detailed action plan to recover from the eHospital implementation problems and increase support for staff.” 

The report lists several “significant performance and quality concerns” related to IT, including missed targets in areas including venous thromboembolism assessment, outpatient bookings, emergency department waiting times, and referral to treatment times.

GPs have also reported an “increase in inaccurate and incomplete discharge summaries, and problems with pathology services.”

As part of the recovery plan, NHS Cambridgeshire and Peterborough Clinical Commissioning Group has carried out a series of visits to the trust, which according to the report “gave assurance that quality of care has not been compromised by the eHospital problems.”

In her report in September board papers, the trust’s chair Jane Ramsey acknowledged the problems with the eHospital programme, but said she expects the situation to improve. 

“The significant investment this year in our new electronic patient record system is having an impact on our finances, with efficiency benefits expected later as the system becomes fully embedded. The board is concentrating a large amount of time and energy in addressing the financial position, whilst ensuring our patients continue to receive safe, kind and excellent care.”

Nearby Papworth Hospital NHS Foundation Trust had also intended to take on Epic as part of Cambridge University Hospitals’ procurement process, but last month said it had decided not to take the system, concluding that it did not provide the best value for money.

Cambridge University Hospitals remains the only trust in the UK to have installed Epic, although the board of Royal Devon and Exeter NHS Foundation Trust recently approved a business case for the system.