Harlow trust challenges EHR-related fine

The Princess Alexandra Hospital NHS Trust is facing a fine of around £1.8 million for multiple breaches of the 52-week target for treating patients due to problems with its implementation of the Cosmic electronic patient record from Cambio.

In papers for its July board meeting, the trust says it faces a £5,000 fine from NHS England per patient for every month or part month they waited over 52 weeks to get an appointment. 

However, the trust says these breaches are not due to a failure to treat patients in time, but due to “ongoing issues relating to technical faults in Cambio.”

Princess Alexandra Hospital explains in the papers: “Some patient records are ‘locked’ and we cannot open them to check dates and hence treat.”

Phil Morley, chief executive officer at Princess Alexandra Hospital, has objected to the application of the fines on these grounds.

The trust’s board papers also say the NHS Trust Development Authority, which provides support for NHS trusts, has expressed its support for resisting the fines.

In a statement to Digital Health News, Cambio said there was an issue with the data migration, but this was only “one component that contributed to delays in patients being seen and treated in a timely way.”

The company said: “Working in partnership, Princess Alexandra Hospital and Cambio quickly addressed the identified data migration issues.

“[This has] resulted in Princess Alexandra Hospital now being able to track patients’ journeys far more effectively than previously using the Cambio Cosmic EPR.” 

It added that national reporting has now gone live for Cosmic at the trust and the first full submission is to be made in October 2015.

Princess Alexandra Hospital was the first trust in the UK to deploy the Cosmic EPR from Swedish supplier Cambio when it went live in July 2014.

The system was a replacement for the trust's McKesson Totalcare patient administration system, which had come to the end of its national support contract.

In an email to Digital Health News, a spokesperson for the trust said: “Whilst there were some initial technical issues with our Cambio Cosmic implementation project, particularly relating to data migration, there were also some operating errors following launch that, in some cases, contributed to delays in patients being seen and treated in a timely way. 

“Both factors are being addressed and the Cambio Cosmic system is now enabling us to track patients’ journeys far more effectively than previously.” 

Regarding the fines, the spokesperson added: “We are currently in negotiations with our CCGs over the potential level of fine for any breaches.

“However, our overriding priority is to complete work that is already well underway to ensure that all patients who have breached have not come to any clinical harm and that all are seen at the earliest opportunity. This work is progressing well.”

The September board papers also mention that the trust’s chief medical officer Andy Morris has “highlighted concerns with Cosmic” and is overseeing improvements to the system.

Both the company and the trust said they are working together and that the use of Cosmic at the hospital is improving.

Steph Lawton, chief operating officer at Princess Alexandra Hospital said: “With new executive teams in place at both organisations, our partnership with Cambio is a collaborative and productive one, and one that will enable us over the coming weeks and months to continue to utilise the Cambio system to further support improvements in waiting times as well as in delivery of performance.”