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Barts cancer patients have urgent appointments delayed after problems with new NHS computer systems

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11 patients at Barts and the London NHS Trust have had urgent cancer appointments postponed for up to a month because of problems with the new Care Records Service installed under the £12.7 billion National Programme for IT (NPfIT). The problems are disclosed in minutes of the Trust Board reported in Computer Weekly.

The delay is a breach of the Government’s guarantee that every patient with suspected cancer will get an appointment with a specialist within two weeks.

It is only one of a series of problems with the Care Records Service at Barts. The Millennium software system was provided by Cerner for British Telecom, the Local Service Provider for Trusts in the London region.  Barts went live in April with the biggest new system so far installed under the NPfIT.

The NPfIT – of which the Care Records Service is a central part – was launched by the Labour government in 2002. It is the world’s largest non-military IT programme, but has been hit by a series of crises, including major delays in introducing the two key Care Records software systems, iSOFT’s Lorenzo and Cerner’s Millennium.

Commenting, Richard Bacon MP, a member of the Public Accounts Committee which last week held hearings on the latest National Audit Office report on the NPfIT commented:

“This alarming news confirms a key truth about the National Programme for IT. The Government’s original mistake in over-centralising the Programme and trying to force Trusts to choose from over-ambitious and untested systems offered by a small handful of national suppliers has led to delays, failures and a deepening sense of crisis.

“The latest revelations from Barts show that this is not just a story of about IT. These failures directly threaten the standard of care offered to patients – in this case, patients with suspected cancer. It is hard to imagine a more serious failure.”

The Trust Board of Barts was told this week that the implementation of the Care Records Service across the trust is the most significant new risk since the start of the 2008/9 financial year. They were also told that:

• Breaches of the two-week urgent access guarantee to patients with suspected cancer were “directly attributable to the erroneous migration of outpatient clinics [data] at the change-over to [the] Care Records Service.
• The trust is not receiving income for treating patients and does not have reliable reports of patient activity “due to ongoing recording issues arising from the implementation of the Care Records Service”.
• The Trust is “behind trajectory” on meeting the Government’s target for seeing emergency patients within four hours. Reasons include “staff familiarity with, and functionality of, the Care Records Service.
• There was a sharp increase in formal complaints from patients in the month the Care Records Service went live. In April there were 95 formal complaints, more than double the number in the same month in 2007.
• Complaints included patients being booked into closed clinics and appointments being cancelled repeatedly. “These issues and related Care Records Service problems are being addressed and extra resources and staff being deployed,” the Trust board was told.
• Data errors mean that some patient activity might have been overstated.
• Reporting errors are continuing – and there could be delays in reporting how the trust is performing.
• Problems with the Care Records Service have led to duplicate outpatient attendances and the creation of spurious events for some specialities, which have “falsely inflated patient activity”
• There are “significant risks” to the trust being able to report its first-quarter activity by the end of August. 

Other NHS Trusts have also had problems with the Cerner Millenium system, including Barnet and Chase Farm, Milton Keynes, Nuffield Orthopaedic and Worthing.  Weston Area Health NHS Trust have spent more than 18 months trying to resolve problems with the Cerner system, in part because the US software needs adapting to the UK market.

27 June 2008

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The Barts and The London Trust comprises St Bartholomew’s Hospital in the City, The Royal London in Whitechapel and The London Chest Hospital in Bethnal Green.

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