NHS Improvement rejects Leicester’s multi-million pound EPR bid

A Midlands trust has reined in its paperless ambitions after NHS Improvement declined to fund its multi-million pound electronic patient record bid.

University Hospitals of Leicester NHS Trust wanted to deploy a £26.3 million integrated EPR plan, a Digital Health News review of recent trust board papers reveal.

However, the board papers also show that NHS Improvement (NHSI) refused to fund the plan.

“NHSI have confirmed that they are not in a position to support the proposal and their proposed cost envelope would mean that an integrated solution, UHLs preferred option, is no longer achievable”.

Tellingly, the board papers suggest that NHSI did not rejected the bid because of any concerns about the proposal itself but because there was no money available.

“The Trust’s EPR Scheme as it currently stands would have an unaffordable impact on the national capital resource limit and, therefore, would not be recommended for approval.”

The trust will now propose “an alternative proposal for the delivery of a ‘best of breed’ paper lite solution”.

As part of this work, the trust is upgrading their current Clinicom and ORMIS to “ensure they can be supported for a longer period”.

The papers show that the trust was working with EPR supplier Cerner on its original bid. That work would be now revisited to find a cheaper solution.

The trust declined to comment further on their EPR plans when approached by Digital Health News but said it “will be announcing further details later in the year”.

All NHS trusts are nationally required to become fully digital and “paperless at the point of care” by 2020 with national funds available, in theory, to help them met this goal.

However, that target had come under come increasing pressure as funds set aside for digital transformation are instead diverted to keep the financially struggling acute sector running.

In September last year, Bob Wachter’s review of NHS IT called the 2020 target “unrealistic” and suggested it be pushed out to 2023. Officially paperless 2020 remains in place, although some NHS digital leaders have downplayed the importance of meeting the target.

For trusts like Leicester , another of Wachter’s recommendations, to fund digitally advanced trust first, has also had an impact.

The Government has adopted this recommendation through its global digital exemplar programme, 15 of which had been named so far, effectively putting about half of all NHS trusts to back of queue for digital funding.

Leicester’s board papers show that its bid was rejected despite NHSI recoginising “the importance of upgrading the Trust’s systems and their contribution to the wider Leicester, Leicestershire and Rutland Sustainability and Transformation Plan [STP]”.

The 44 STPs across England are intended to outline how regions intend to transform the delivery of health and social care and close a projected £22 billion funding gap by 2020/21. There are also critical to accessing central funding.

The draft STP for Leicestershire and Rutland says that deploying a “comprehensive electronic patient record” at Leicester is a “key enabler” to delivering the plan.

Many STPs has asked for big injections of central funding, with North Central London claiming it needs £180 million for digital projects alone.

Few, however, are likely to receive the funding they’ve requested. In November last year, NHS chief information officer, Will Smart, said trusts should lower their expectations for digital STP funding.

“I can’t afford many £153 million [sic] chunks of cash, so I would dial back your aspirations about what will come from the centre,” he said.

In February, Smart also announced that NHS England plans to spend £100 million on 20 “fast followers” to unleash a second wave of digitally advanced NHS organisations, following on from the digital exemplars.

NHSI was contacted for this story.