By Tony Collins
Richard Bacon, a long-standing member of the House of Commons’ Public Accounts Committee, has called on Croydon Health Services NHS Trust to be more open about problems it faces after deploying a Cerner Millennium patient records system at the end of September.
The installation was carried out by BT under the London Programme for IT – a branch of the NPfIT. The Health and Social Care Information Centre, which has taken on BT and CSC contracts under the NPfIT, was the trust’s partner for the Cerner deployment.
Bacon has closely followed the NPfIT and written a chapter on it in his book, “Conundrum: Why every government gets things wrong and what we can do about it” which he co-wrote with Christopher Hope, the Telegraph’s senior political correspondent.
According to fragments of information in Croydon Health Services’ latest board papers, dated 25 November 2013, the trust has faced a series of problems after the NPfIT Cerner go-live.
– N3 Network downtime and waiting time breaches.
– Excessive waits for patients in A&E.
– Going over budget.
– Significant loss of income.
– A bid to recover Cerner costs.
– A need for HSCIC support for delays.
-A need for extra investment in Cerner to “stabilise the operational position”
The trust has not published any specific report on the implementation’s problems. Now Bacon says it is “unacceptable for any trust not to disclose the problems it faces – and possibly patients face – after a major IT implementation such as Cerner”.
“If these implementations go wrong they can affect the safety of patients. We know this from some NPfIT deployments at other trusts. For Croydon to say that board members have been kept informed of the potential risks of the Cerner implementation through the “Corporate Risk and Board Assurance Framework” is not reassuring.
“This is putting a matter of importance in the small print. Indeed, for officials to brief board members on the potential risks, rather than actual events, is also of concern.
“Patients need to know that Croydon takes a duty of candour seriously. If the Trust cannot be open about its IT-related problems, how can we be sure it will be open about anything else to do with patient safety?”
I am a little stumped on reading this.
I do not understand how a Trust can get into such a position with what ought to be a fit for purpose system. It has, after all, been implemented elsewhere without such problems. BT are responsible for N3. I assume that prior to the implementation the N3 service was working as described? I also assume that the cost of the implementation is a fixed one. How then can it go over budget?
Significant loss of income – what does this actually mean? It can only mean that the Trust can no longer evidence the services it provides to its commissioners and therefore loses the income for that service. The alternative is that services cannot be provided at all, therefore impacting on patients well being and possibly safety.
“A need for extra investment in Cerner to “stabilise the operational position” WHY
I suspect that other such implementations may have gone the same way but the Trusts involved may not have been as open as Croydon.