Bolton delivers one of the largest PAS mergers

Bolton NHS Foundation Trust have merged its hospital and community patient administration systems (PAS), in one of the largest merges of its kind in the UK.

The merge, which took place in May, combined 300 million rows of data and 60 million appointments.

The trust was operating two PASs after it became a combined acute and community trust in 2011.

Ken Bradshaw, deputy chief informatics officer at Bolton, said the process of merging was a major undertaking, and will provide significant benefits for both patients and staff, including improved quality of the patient data captured.

“Having records spread over two systems frustrated our attempts of becoming an integrated organisation, so the biggest benefit is actually having a single patient record that covers our entire community and that’s what we’ve done”, Bradshaw said.

Late last year the trust experienced an integration issue that hadn’t been anticipated in the scoping of the merge project. It resulted in a delayed process of about three months.

The PAS merger had required the trust to import the demographics of every patient who has only been seen in the community, and all the community care details.

“We had some rather specific integration with some of our clinical applications and we realised quite late that, although we have done full testing of merge of data, it wasn’t generating update messages to our clinical applications where we were updating demographic data”, Bradshaw said.

“We did identify 80,000 updates to improve quality of our data which was needed to be replicated in all our downstream systems.”

“NHS Digital funded for the development of the messaging that would allow those updates to go to our downstream systems – that delayed us by about three months while we were testing that.”

Despite this, the merger was successfully delivered and implemented, bringing together 17 million case-note activities and 26 million waiting list entries.

“Having a single patient administration system has been a huge piece of work for the trust, but one that will act as a platform for future digital development work.” Bradshaw said.

The trust worked with NHS Digital and supplier DXC (formerly CSC) which has the contract for the trust’s acute hospital PAS. In December 2015, NHS Digital (then HSCIC) agreed to support the merger as part of the trust’s exit from National Programme for IT.

“Here in Bolton we’ve made significant developments to our systems and infrastructure recently in order to become more digitally mature, including desktop deployment so that our busy staff can log onto any machine in the trust in seconds,” Bradshaw said.

“We’ve also upgraded our ‘Hospital at Night’ system and recently gone live with an electronic patient record in our busy ophthalmology department.”