CQC: concern at Croydon’s two IT systems

The Care Quality Commission has raised concerns about Croydon Health Services NHS Trust using two different IT systems for patient care.

In the latest of a number of reports that touch on record keeping and IT issues, the CQC says: “Staff working in inpatient and community services were using different systems to record patient care.”

In its main report, it goes on to explain that this is because the trust has started to introduce an electronic patient record, but “this has still to be fully implemented and integrated across all services.”

Some staff also complained about not having sufficient training, while “staff in children and young people’s services felt the system had been designed primarily with adults in mind.”

The CQC report concludes that: “Staff in some services were continuing to use paper records until the problems had been resolved or the systems could be integrated.”

Croydon Health Services confirmed to Digital Health News that its primary system for storing patient information in an acute setting is Cerner Millennium.

This is also used by some teams in its community services, although the main system used in community services is Ascribe ePEX.

Lisa Chesser, director of planning and informatics at Croydon Health Services told Digital Health News: “We are working with our health and care partners in Croydon to determine a solution that will not only upgrade our system integration and functionality in line with the CQC’s recommendations, but which will also work effectively to support more joined-up care and working between our various organisations, including a shared electronic patient record.”

She added that Ascribe ePEX will no longer be supported after 2017 and replacing the system is one of the “key parts of our integration programme”.

In a general statement, Croydon Health Services said that it is investing in new IT systems, including a £969,000 award win from NHS England’s Nurse Technology Fund to give community nurses, therapists and midwives better remote access to secure patient records. 

Overall the CQC rated Croydon Health Services NHS Trust as ‘requires improvement’, having concluded that while services were generally effective and caring, change was needed to make sure they were safe, responsive, and well led.

It found there were particular issues with operations being cancelled, and with discharges being delayed from the critical care department.

The CQC has also issued reports on Hull and East Yorkshire Hospitals NHS Trust, King’s College Hospital NHS Foundation Trust, Manchester Mental Health and Social Care Trust, Southern Health NHS Foundation Trust and York Teaching Hospital NHS Foundation Trust in the past month, and concluded that all ‘require improvement.’

The report for Hull and East Yorkshire Hospitals was a follow up to an earlier inspection in February 2014.

The CQC notes some improvements at the trust in that time, but that systems and processes for the management of medicines and the checking of resuscitation equipment on some wards “did not always comply with trust policy and guidance”.

For King’s College Hospital, the CQC’s report notes “congestion” at the trust’s emergency departments, as well as a need to reduce waiting times, the number of cancelled operations s and delayed discharges.

At York Teaching Hospital the CQC highlighted that patients were often waiting too long for treatment, while national targets for A&E, referral-to-treatment, and cancer waiting times were not being met.

The CQC report for Manchester Mental Health and Social Care Trust states that patients’ medication for treatment was not always properly authorised and that the trust wasn’t managing patients effectively through the mental health system.

Safety concerns were also raised at mental health trust Southern Health, with the CQC noting blind spots and ligature points that could endanger people at risk of suicide and a lack of training for staff to identify and reduce risks.

The reports follow the CQC’s recommendation to put both Cambridge University Hospitals NHS Foundation Trust and East Sussex Healthcare NHS Trust into special measures, with IT raised as one of the issues behind the decision at both.