Millennium remains a 'challenge' at Worthing

04 Mar 2008

The chief executive of Worthing and Southlands NHS Trust has said in a letter to staff that the Cerner Millennium system installed six months ago by Fujitsu continues “to be a challenge across the trust”.

In a letter posted on the trust’s intranet, Stephen Cass, told staff: “All staff – whether you use the system or not – will be aware that the new care records system – or Cerner – is continuing to be a challenge across the trust.”

Cass added he was aware of the difficulties staff faced in using the system: “I know the ongoing issues are causing difficulties and adding to your workload.”

The trust’s Millennium R0 was installed by Fujitsu in September 2007. At the time in the months since the go-live has consistently been described as the best implementation yet of Cerner Millennium under the NHS IT programme.

In his letter, Cass says that the trust has invested in extra functionality and training resources, to help staff get used to the system.

“As an organisation, we have put in additional resources to improve the system’s functionality. The trust is also making additional resources available for training and support,” he wrote.

He stressed that as Millennium is the chosen software for the whole of the Southern NHS the trust had no alternative but make it work: “There is no going back for us – and we are committed to making it [Millennium] work.”

In February the trust came under scrutiny from Channel 4 News when Dr Patrick Carr said it had been abandoned in the hospital’s A&E department: “Every process we used to do by hand seemed to take longer using the Cerner solution.”

Problems with Millennium are also acknowledged in a letter written by Candy Morris, chief executive of the South East Coast SHA, sent to local MP, Peter Bottomley who had raised questions about problems with Millennium.

Morris told the MP that the functionality ‘deficiencies’ have resulted in Connecting for Health (CfH) asking Fujitsu to explain why implementation dates continue to slip for trusts in the South.

“Following the deployment project, whatever the ultimate gains, further deficiencies in functionality have emerged. We are very mindful of these.

“You may be aware that NHS Connecting for Health with the support of the three SHA chief executives in the South of England has escalated the issue with Fujitsu in relation to their failure to deliver key implementation milestones in their work for the Southern Programme for IT. Negotiations continue, and there are no rose-tinted glasses. We await Fujitsu’s remediation plan,” she told the MP.

EHI contacted staff working at trusts live in the South live with the Millennium R0 solution and found a number were still experiencing difficulties with the software.

One anonymous member of the Somerset Health Informatics Service, responsible for Taunton NHS Trust, told EHI: “It’s not been as easy an implementation as we hoped it would be. Staff have found the Cerner system difficult and tedious, and there have been a series of complaints arising from the deployment. We have had to bring in outsourced floor walkers to deal with the disruption, and help clinicians get used to the Cerner solution.

They added: “We have had a team of people working on this for over two years, testing and retesting the system to make sure that it does what we need it to, and to some extent it is making a difference, but it doesn’t surprise me that Worthing are still experiencing functionality deficiencies.”

A senior nursing staff member at Surrey and Sussex meanwhile told EHI: “Worthing followed our lead in deploying Millennium after the solution was signed off three months after deployment and given a great review in E-Health Insider when they did so. In reality, we have had difficulties and the system isn’t the great clinical management asset we needed. It still has some real problems in generating information which nurses need – especially when it comes to printing. The SHA are well aware of our problems and hopefully Mr Bottomley will look to take action on this.”

In her letter, dated 26 February, Morris told Bottomley the Southern Programme for IT’s contract reset with local service provider Fujitsu was still under negotiation.

According to health minister, Ben Bradshaw, the next Southern Programme of IT site to get the system will be Bath Royal United Hospital NHS Trust in May, though the trust were unable to confirm this to EHI.

In a statement to EHI Fujitsu said: “Worthing and Southlands NHS Trusts was agreed as a R0 implementation site for the new NHS Care Records System following criteria from NHS CFH and in full consultation with the Trust.

“Worthing’s A&E department is utilising the First Net functionality of Cerner Millennium, however they are limiting the usage of the clinical functionality available to them within the software. This was a decision made by the trust prior to the site going live.”

The spokesperson added: “Fujitsu Services has worked closely together with the trust at Worthing to deploy a successful NHS Care Records System.”

Cerner and CfH had not responded to questions by the time of publication.

Links

Worthing says PAS teething problems over

Worthing to switch on Millennium PAS

Surrey and Sussex becomes sixth Millennium site in the South

Doctors go public with Millennium concerns

DH seeks tougher sanctions for security breaches

Cerner

Reader's Comments

Royal Free next?

06 Mar 08 07:58

The worrying part of the recent Ch4 News item on CERNER was that the Royal Free is planning to "go live" soon. The risks to an organisation that size of decreasing efficiency, demoralising staff, and increasing costs to achieve the same administrative, financial and clinical processes must be very significant.

The software may eventually do what it is meant to, but it is very slow to use, complex, hard to remember, easy to get wrong - a bit like old DOS word processors compared with a modern one. It looks as if CfH, CERNER and Fujitsu have measured parameters that can be proven to be satisfactory (keystroke response time) but not the crucial matters of whether it makes overall working faster, more effective, safer, and cost neutral or better to the organisation.

The Oliver Twist Implementation model

07 Mar 08 08:45

Stoke Mandeville are going next at the end of March. This is a multi-site trust, Wycome and Amersham have already gone live a year ago and the difficulties encountered dissuaded Mandeville for the promised early implementation.

However as Milton Keynes, Worthing et all have discovered, making a fuss does NOT create any improvement reaction whatsoever.

Its the same functional R0 release which does not have the functionality of the 20 year old Unix programs it is replacing and IMO is about a 20 fold time and work increase to perform simple tasks, such as making a follow-up appointment. Instead of patient data being returned on the pressing of the 'Enter' key - there's enough time to make a cup of tea before the client software responds.

Productivity? [Insert expletive here....]

(post edited by EHI)

Give me a break

07 Mar 08 18:32

The comments on this article and else where on this site gives a impression that the people currently working in NHS-IT are exceptional and the ones working with LSP's are idiots. Well these guys needs to realize that the same pool of people who comes out of UK colleges go to both; dont tell me that exceptional people go to NHS and idiots go to software companies. Right!

If we compare how long the existing PAS'S took to stabalize and how the SLA's used to be met-if there are any and the compliance level of various universal standards of these systems then the skeltons of these holy cows will tumble.

These very holy cows in the days of IDX and ISoft used to moan how brilliant Cerner Millennium is and how by not selecting it their dreams have been dashed.

Time for PAS to bed in - a week tops

09 Mar 08 14:24

It took about a week for user's to get used to our last PAS, when it went live. I hear from several Trusts that users are still struggling months after go live to remember how to do even simple procedures, and that it is easy to go wrong in CERNER.

Any "user friendly" software package should be intuitive, easy to learn, hard to forget, and hard to get wrong. Sounds like CERNER R0 is not user friendly

RE:Give me a break

10 Mar 08 09:01

Dear 'Give me a break'

Nobody who works in the NHS would suggest that all their colleagues are geniouses or that the LSP staff are idiots. However, there IS a huge yawning chasm of understanding in both CFH and in LSPs (and i have worked with 3 of them) in their understanding of the way the NHS works.

I am emphatically NOT one of those who beleives that you need 30 years wiht the NHS man-and-boy in order to have credibility, but you DO need to have an interest in the better treatment of patients and you DO need to work at understading NHS processes. Neither LSPs nor CFH appear to have any interest in either of these things, they are entirely driven by getting their product out and meeting their own targets, regardless of its fitness-for-purpose or the chaos that these actions can cause.

NHS Process, if only

12 Mar 08 14:57

If only there was a single "NHS" process. Having worked with Suppliers and LSP's for over 4 years the hurdle is not finding people who understand the NHS but rather amalgamating all these "NHS processes" into a single cluster level system which meets the approval of all the individual Trusts.

NHS Processes

14 Mar 08 08:17

You are quite correct, forcing Trusts to change established back-end processes to 'align' them with the way other Trusts happen to do things, is indeed a very difficult task.

The point, however, is that it is also a completely pointless task that brings no actual benefit to patients or staff, causes massive disruption to operations at Trusts and stifles innovation both within the NHS and in the software supplier's offerning.

There really is an obvious solution: don't do it

An example

19 Mar 08 22:39

I am not allowed to criticize Cerner. However, an observation. In the old days I could get a single print of clinic availability (slots for patients) for 6 months in advance. We have now improved to a situation where we have to scroll down a screen and count the numbers booked in to see how many are in each clinic. No-one knows how to get a print out. Non-one knows who to ask.

US Processes

26 Mar 08 21:10

Fundamentally, Cerner is still mainly a Billing system designed for the US Heathcare setup. The Rigid Standardisation from CfH, the apparent lack of interest and knowledge from Fujitsu, the censorship and control freakery, and apparent inability of the various parties to actually listen to those who have been through traumatic implementations before has led us here.

It seems to me that the LSP process is the most broken, and least functional within all of this. And also the huge leaps of faith between what people do day to day with existing systems, and what an idealised process 'supposedly NHS but the new system is designed this way, so the US version will do'.