NE trust faces clinical systems conundrum

A mental health trust board formed from three merged organisations has been advised to stop using a clinical information system supplied under the National Programme for IT on part of its new territory and use another single system across the whole trust.

Northumberland Tyne and Wear NHS Trust board members received a paper on options for clinical information systems (CIS) which has been leaked to E-Health Insider. Board members were recommended to continue negotiation with CSE-Servelec for its RiO mental health system and to support the development of detailed plans to implement RiO, which is already used in part of the trust.

The paper emphasises its full commitment to Connecting for Health’s strategy, however, it says: “The project team which has worked on developing the interim strategy for CIS has concluded as previously reported to the board in confidence, that the option of remaining on the three system until delivery of the Future Main Release product (Lorenzo) for the national programme is unacceptable clinically and also from the position of generating substantial risk to the management and improvement of trust performance.”

EHI asked the trust to confirm whether the recommendations regarding the CIS had been accepted and was told: “The trust has reviewed current options for systems across the new trust and the least preferred option is to continue with three systems. Therefore a single system is to be rolled out across the organisation but no decision yet taken on which system.”

A statement from the trust also said: “Detailed plans currently being drawn up but no final decision has been taken and project board is being set up in the organisation for implementation of trust wide information system. A paper for the August board has been deferred while negotiations continue.”

Like many merged trusts, Northumberland Tyne and Wear (NTW) finds itself with multiple systems. The new organisation was created from South of Tyne and Wearside NHS Trust; Newcastle, North Tyneside and Northumberland Mental Health NHS Trust and Northgate and Prudhoe NHS Trust on 1 April this year.

The board paper, understood to be considered in private session, shows that it has a P1r1d solution provided through iSoft as part of NPfIT for services south of the Tyne, a PIMS solution from iSoft for disabilities work and the RiO system for north of the Tyne.

The 18-page paper, presented by trust finance director, James Duncan, says: “As previously discussed P1r1d does not have the clinical functionality to support rollout across the trust and as yet there is no clear developmental route for this product. However ongoing support is guaranteed, PIMS is no longer actively maintained by iSoft and contractual agreements could be rolled forward.”

Looking at other options, the paper says: “RiO is the system in use in mental health services north of the Tyne. RiO is perceived to be a ‘best of breed’ system suitable for use directly by clinical staff.

“The contract for this system is due to expire in January 2007. Negotiations with the system supplier have indicated that RiO could be licenced (sic) for use across the trust for the same annual fee paid in the existing contract. RiO offers opportunity for immediate deployment on top of an existing user base. However, implementing RiO would mean the trust operating outside of NPfIT for the next three years. This may have cost and political implications.”

The paper explains that a possible alternative offering may be available from the national programme for a period of up to three years, but says commercial negotiations are still ongoing to organise this.

It says: “CfH [Connecting for Health] have estimated that any alternate system would not be available for deployment until the first half of 2007.The [NTW] contract for RiO will expire in January 2007 and therefore the trust must have a solution in place by this date. It is now clear that no acceptable solution will be available through the national programme at this date.”

NTW is not alone in its deliberations over strategy to fill the gap between the arrival of national programme solutions and the expiry of existing IT contracts. In December 2005 Norfolk and Norwich NHS Trust, located in the Eastern cluster of the national programme, decided to shelve implementation of an interim PAS system.

In the same month Tees and North East Yorkshire NHS Trust, a mental health trust, also postponed an Accenture implementation of iSoft iPM. South West Yorkshire Mental Health Trust has also gone outside the NPfIT programme to procure a new integrated clinical system, as an ‘interim solution’.

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