By Tony Collins
Reading-based Royal Berkshire NHS Foundation Trust says in an FOI response that its spending on “computer consultants since the inception of the EPR system is £16.6m”.
The Trust’s total spend on the Cerner Millennium system was said to have been £30m by October 2012.
NHS IT suppliers have told me that the typical cost of a Trust-wide EPR [electronic patient record] system, including support for five years, is about £6m-£8m, which suggests that the Royal Berkshire has spent £22m more than necessary on new patient record IT.
Jonathan Isaby, Taxpayers’ Alliance political director, said: “This is an astonishing amount of taxpayers’ money to have squandered on a system which is evidently failing to deliver results.
“Every pound lost to this project is a pound less available for frontline medical care. Those who were responsible for the failure must be held to account for their actions as this kind of waste cannot go unchecked.”
The £16.6m consultancy figure was uncovered this week through a Freedom of Information request made by The Reading Chronicle. It had asked for the spend on consultants working on the Cerner Millennium EPR [which went live later than expected in June 2012].
The Trust replied: “Further to your request for information the costs spent on computer consultants since the inception of the EPR system is £16.6m.”
The Chronicle says that the system is “meant to retrieve patient details in seconds, linking them to the availability of surgeons, beds or therapies, but has forced staff to spend up to 15 minutes navigating through multiple screens to book one routine appointment, leading to backlogs on wards and outpatient clinics”.
Royal Berkshire’s chief executive Edward Donald had said the Cerner Millennium go live was successful. A trust board paper said:
“The Chief Executive emphasised that, despite these challenges, the ‘go-live’ at the Trust had been more successful than in other Cerner Millennium sites.”
A similar, stronger message had appeared was in a separate board paper which was released under FOI. Royal Berkshire’s EPR [electronic patient record] Executive Governance Committee minutes said:
“… the Committee noted that the Trust’s launch had been considered to be the best implementation of Cerner Millennium yet and that despite staff misgivings, the project was progressing well. This positive message should also be disseminated…”
Royal Berkshire went outside the NPfIT. But its costs are even higher than the breathtakingly high costs to the taxpayer of NPfIT Cerner and Lorenzo implementations.
As senior officials at the Department of Health have been so careless with public funds over NHS IT – and have spent millions on the same sets of consultants – they are in no position to admonish Royal Berkshire.
So who can criticise Royal Berkshire and should its chief executive be held accountable?
When it’s official policy to spend tens of millions on EPRs that may or may not make things better for hospitals and patients – and could make things much worse – how can accountability play any part in the purchase of the systems and consultants?
The enormously costly Cerner and Lorenzo EPR implementations go on – in an NHS IT world that is largely without credible supervision, control, accountability or regulation.
Laughing hysterically and not because it’s funny
I am continually stunned by such news. I don’t know why as it seems to be par for the course but none the less here I sit agog.
Let’s try and put this into perspective i.e. the spending of £16,600,000 on consultants.
We charge £500 per day plus expenses for consultancy, £750 per day for development (unless a fixed price for the work is agreed) and at our top end £1,500 per day for disaster recovery when no DR contract is in place. Taking the most expensive rate £1,500 which took account working at weekends and for any period within a 24-hour day, the Trust would have bought 16600000 /1500=11,066 man days of consultancy, or put it another way 11,066/365=30.3 man years!!
Now I know a man day and a man year is a questionable metric but it does put things in perspective. My maths also assumes that all 365 days are actually being worked, which they wont be, so the actual numbers increase significantly. If we assume that the number of days we actually work is 5 in every 7 and account for leave and bank holidays it comes out at around 260ish so 11066/260=42.5 man years!!
I would like to know, and here is an FOI if someone wants to request it, how many consultant days were bought, and how many actual consultants were involved. That would give us some indication of the rate at which the Trust was being fleeced.
At the end of the day commercial organisations can charge what they like as they are free to do so. It is clear that, from the Trust’s perspective, they had never considered or even heard of caveat emptor, and, to an extent I can understand this.
The ballyhoo surrounding the illusion that was and is NPfIT was very compelling, especially if you were a Trust board member who bought into the ‘don’t worry this will all be done for you and all your IT woes will be soothed away’ nonsense. The weight behind NPfIT was such that only very few Trusts were in a position to resist (in their case resistance was clearly not futile). Having made a decision to go with the now known to be lemmings, they are then pressured into making it all work so the powers that be can laud their achievements and therefore reinforce the NPfIt myth and ipso facto justify their position.
However, one would assume that a board who was keeping an eye on such an important project might have noticed the inverse relationship between amount spent and benefit delivered. One would be wrong. The psychological processes which govern such decision making are well documented and it can only be such processes which gave rise to the position that in the age of a cash strapped NHS the Trust could just write of £18,000,000 (http://www.taxpayersalliance.com/waste/2013/06/nhs-trust-loses-18-million-system.html) without any heads rolling alt all.
Utterly appalling and possibly negligent behaviour. NAO, PAC, Secretary of state for Health do something and do it now.
On Twitter Tim Manning @design4services says:
That is truly amazing. I would love to know actually what they were doing. A few SMEs would do it for a fraction.
And they would probably model the process & find the s/w not fit for purpose.
Incredible: Royal Berks #NHS FT spends £16.6m on #Cerner #EPR consultants