By Tony Collins
North Bristol NHS Trust reports in its latest board papers that “overall the level of spending on Cerner continues to be a major concern and the IM&T Director is working to develop a plan to identify what will be needed in the current year”.
The trust went live with Cerner Millennium in December 2011 and had various problems which the Trust said had been “overcome” by 1 May 2012.
But the Trust’s board papers last month hint that some difficulties are continuing.
“There are also clearly still data issues from Cerner which are affecting these numbers which the team are working on,” says a North Bristol finance paper in June.
The overspend on Cerner is about £900,000 for a two-month period. The paper says the “costs of Cerner remain a risk as some of the forecast spend may need to be re-classified as revenue.
“The detail on this is currently being reviewed by the Director of IM&T and isn’t included in the month 2 position… There has been relatively little spend in capital with the exception of Cerner which has incurred £0.9m of cost for 2 months.”
The anticipated spending on the Cerner implementation for the Trust will be more than £5m.
It’s not unusual for hospitals to run into trouble with a Cerner Millennium implementation. When confronted with serious IT-related difficulties private sector organisations sometimes confront what has gone wrong with urgency, pragmatism and trying not to pretend things are better than they are.
Public sector organisations, when facing IT-related difficulties, can fall into the trap of concentrating on what has gone right, and talk as little as possible about the problems. Indeed North Bristol’s latest board papers hardly mention the Millennium difficulties. There is not a mention in the Audit Committee report. Not a mention in the board agenda. Only a finance report says that spending on Cerner is a major concern. Elsewhere in the board papers there are short, oblique references to data difficulties.
“With reference to the figures in Table 3, it was confirmed that all patients had been contacted but accuracy of the data could still not be guaranteed and reporting continued to be 2 months behind… There were also a lot of duplicate referrals on the system. This was being rectified but may affect billing,” says one board paper.
It would be wrong to suggest that a culture of accentuating the positive and hunching the shoulders at the negative has anything to do with IM&T. It’s one of the differences between the private and public sectors.
North Bristol’s board needs to be more open. If it cannot admit its difficulties how will it tackle them? And what is the point of taxpayers paying for internal auditors that simply assure the board they are doing a great job?