Royal Devon still in discussions with Epic

A Devon trust is still in negotiations with Epic about buying its electronic patient record system – nearly two years after choosing the company as its preferred provider.

Digital Health News reported in May 2014 that Royal Devon and Exeter NHS Foundation Trust had selected Epic to supply its EPR. The trust approved an EPR business case in April 2015, but remains locked in discussions a year later.

A Freedom of Information request confirms that the business case was approved, in principle, “with agreement to explore routes to secure the necessary funding for the investment. This work is underway and funding options are being assessed with a view to a final decision being made during 2016."

The affordability of the Epic EPR has previously been highlighted as an issue for the organisation, which is projecting a deficit of £19.7 million this financial year. 

The trust made a bid for £19 million from the second of NHS England's technology funds to support its EPR programme, but was not successful. The 'Integrated Digital Care Record' fund was cut from £240 million to £44 million in January 2015, to support winter pressures and only a fifth of the applications made to it were approved.

A trust spokesman told Digital Health News this month that it is “still in commercially sensitive discussions” regarding its EPR provider and is unable to comment further.

If Royal Devon goes ahead with Epic, it will become the company’s second UK trust. Cambridge University Hospitals NHS Foundation Trust went live with the software in October 2014 as part of a £200 million eHospital programme for which HP provided the infrastructure and hardware.

Papworth Hospital NHS Foundation Trust, which was part of a joint procurement with Cambridge, decided against deploying Epic last summer; saying it did not represent the best value for money for the organisation.

Cambridge was put into special measures by Monitor a year after its EPR go-live, following a Care Quality Commission report that highlighted serious safety and quality issues at the trust, including several related to its eHospital programme. The IT overhaul was also said to be contributing to problems with the trust’s finances, with an average weekly overspend of £1.2 million.

The situation has raised questions at Royal Devon, with one staff governor asking a recent board meeting if it should be concerned about the problems that Cambridge has experienced.

Minutes of the trust’s October 2015 board meeting say Paul Bedford “referred to Cambridge Addenbrooke’s Hospital, who had recently been placed in special measures, and its issues with its Epic EPR system."

Chief executive Angela Pedder responded that greater understanding was needed of what happened at Cambridge. She said she was in contact with Addenbrooke’s previous chief executive, Dr Keith McNeil, who resigned a week before the CQC report was published. A report from Monitor on the EPR system is also due to be published, the minutes say.

“Pedder said it appeared that implementation of the system was the issue, not the system itself which was delivering as planned at Addenbrookes," the minutes add. "She said it was important that the trust learnt as much as it could from others’ experience and minimised the disruption caused by the implementation of a new system."