Epic improvements pull Cambridge out of special measures

The Care Quality Commission has recommended that one of the UK’s largest trusts is removed from special measures.

The CQC report, published Wednesday, rates Cambridge University Hospitals NHS Foundation Trust as “good” and gave its recommendation following a inspection in September.

The report also said that concerns with the Epic electronic patient record, that were partly responsible for the trust being placed in special measures, have been addressed since its last visit. 

It said, for Epic, “many of the concerns we had identified at previous inspections had been addressed” following a “significant number of modifications”.

The CQC said staff were more familiar with the system, “though care planning was not always individualised and personalised”.

Trust chief executive Roland Sinker said that Cambridge has “achieved a lot in a short time”.

“We will continue to focus our attention on the areas rightly identified for action, such as ongoing issues with capacity and waiting times, where we are still not as responsive as we should be.”

Cambridge was the first, and so far only, NHS trust to deploy the Epic EPR, in October 2014, as part of its £200 million eHospital programme.

However, a week after go-live the trust was forced to declare a “major incident” and divert ambulances for five hours after the EPR became unstable.

In September 2015, the trust’s chief executive Keith McNeil resigned amid growing concern about the trust’s finances and performance, linked to the Epic deployment.

That same month, the CQC rated the trust as “inadequate” and, just a few week later, Monitor placed the trust into special measures, blaming the eHospital programme caused “significant cost increases”.

Clare Marx, president of the Royal College of Surgeons, later described the Epic deployment as leading to a “catastrophic loss of confidence in the system”, that took months to rebuild.

However, the 2017 CQC report said care and staff engagement at the trust were now outstanding.

In a separate CQC report on the trust’s Addenbrooke’s Hospital and the Rosie Hospital, it noted that four out of six staff confirmed improvements with Epic have been a “priority”.

The same inspection said: “nursing staff told us that since the introduction of Epic in 2014 they had never had to request paper records”.

Mike More, interim Cambridge chair, said the latest CQC result as a “significant improvement” for the trust.

“We acknowledge that this improvement is the first step in a much longer journey for the trust and look forward to continuing our progress.”

Epic has still yet to make significant inroads in the UK, although that may change.

In November last year, University College London Hospitals NHS Foundation Trust picked the US company as the preferred supplier for its new EPR.

Royal Devon and Exeter NHS Foundation Trust also Epic in May 2014 although it has yet to move towards deployment, a decision Digital Health News understands is partly linked to funding.

Cambridge is on the largest trusts in the UK with around 1,486 beds and compromises of Addenbrooke’s Hospital and The Rosie Hospital.

Digital Health Intelligence: holds information on the clinical systems installed at trusts across the UK and uses this to calculate a Clinical Digital Maturity Index score. Cambridge University Hospitals NHS Foundation Trust ranks shared top of the table, with a score of 95 (requires log-in).