Cerner gets green light in London

Tags: A Barts and the London BT Cerner CRS David Nicholson emergency Green iS Kingston London London Programme for IT LPfIT Millennium Monitor Nicholson Royal Free St

11 Feb 2009

Cerner gets green
light in London

NHS London and the NHS London Programme for IT have given the green light to further Cerner deployments in the capital.

The decision comes despite the fact that a programme of work to fix 22 known problems is running late and has yet to be completed.

The Royal Free Hampstead NHS Trust, where a Cerner implementation has run into well-publicised problems, reports that although good progress has been made it will not be possible to judge until March whether the fixes require work.

Implementations of Cerner's software were shelved in October and an emergency ‘recovery plan’ instituted by LPfIT, BT and Cerner after serious problems with the Millennium software came to light at Barts and the London and Royal Free.

In January board papers the Royal Free's chief executive, Andrew Way, reported good progress had been made, though the 90 day rescue project had been extended by agreement. The trust’s project board will monitor progress and “test the views of clinical and administrative staff in early March to assess the degree of improvement.”

EHI understands that a decision to restart Cerner implementations in London was taken at the beginning of February.

In December, NHS chief executive David Nicholson told the Commons Health Select Committee that no more Cerner implementations would occur until known problems were resolved.

He said: “We’ve got some serious issues around the Cerner system, particularly in London at the Royal Free, and what we’ve said to Cerner and BT is that they’ve got to solve that problem at the Royal Free before we think about rolling it out across the rest of the NHS.”

At least one London trust reports having been told in the last few days that it should now “re-engage with Cerner.”

In a statement to E-Health Insider, LPfIT said on Tuesday: “NHS London has renewed its commitment to continue to implement Cerner Millennium within acute trusts as part of the rollout across the capital of electronic care records to deliver improved patient care.”

The statement added: “Due to the good progress made with the improvement programme and greater confidence in the functionality and stability of the system, the London Acute Programme Board has recommended that the implementation of Cerner Millennium should continue in London.”

LPfIT said that several upgrades have been made to the Cerner Millennium London Configuration 1 (LC1) software currently being used by the Royal Free to streamline and enhance the system for users.

It added that improvements are also being made at the trusts using the LC0 version of Cerner Millennium – Barnet and Chase Farm, Queen Mary’s Sidcup and Barts and The London.

BT said in a statement: "We are pleased with the decision reached by the London Acute Programme Board to recommend that we move forward with the rollout of Cerner Millennium. This follows the good progress we have made in implementing an improvement plans at the four live trusts."

LPfIT stated: “Throughout this period trusts have continued with their deployment plans and NHS London Programme for IT will now work on agreeing appropriate go-live dates with these trusts.”

The next NHS sites that had been due to take Cerner Millennium from BT are Kingston Hospital NHS Trust and St George’s.

There is understood to be intense pressure in NHS London to get the NHS IT programme back on the rails, fix known problems in the CRS software and not repeat past mistakes.

BT, the local service provider in London, has yet to complete a long-running contract renegotiation (CCN3), which is thought to centre on a new delivery model for installing Cerner.

Jon Hoeksma

Readers Comments

Can be done but at what cost?

11 Feb 09 10:46

Every large acute hospital that BT has deployed Cerner has appeared to run into serious trouble. These problems are not trivial - the deployments have caused chaos, and in the case of the cancer breaches must have had a negative effect on patient care.

LPfIT has shown that it may be possible to make progress fixing problems at a trust, if you thrown enough resource and attention at it for long enough.

However, IMHO, this says nothing about whether BT or the NHS has learned any lessons that stops future deployments from being as disruptive as the Royal Free, Barts and Chase Farm were.

If I was a CEO of a London Trust planning a BT/Cerner deployment, I would be extremely concerned and would be making every attempt to delay any planned go live by at least a year or two.

(Post edited by EHI)

Green, Amber or Red

13 Feb 09 10:18

According to the News on the BBC and the BBC Website the Chief Executive isn't advocating this seems to imply you should move very carefully from red to green

Fascinating Times

roy.dainty@ntlworld.com

13 Feb 09 13:00

This news opens some extremely interesting dynamics over the next few months wherein the interests of BT and LPfIT do not necessarily coincide with those of the Trusts. For BT & LPFIT there is a major need to proceed with deployments, not least because the PAC review recommendation hovers mightily over the next few months. No more deployments by July and the PAC will seek to terminate the Programme. This suggests a small window to achieve at least two Go Lives immediately before the PAC meets. Apart from the impracticalities of achieving any too soon beforehand, any significant issues would play to terminating the London Programme. None beforehand and, well, PAC has stated what it intends. At Trust level, the dilemma is local to each and comes down to risk acceptance versus risk aversion. The RF and B&L both suffered significantly following their Millennium deployments; system and process issues. We are advised that the main system issues have been resolved. Do the next Trusts accept this at face value and proceed to Go Live during late Q2 or do they leave their deployments on hold until the fixes and process changes have been in operational use for, say, 3 months and their outcomes can be objectively reviewed? This would be the risk aversion route, deployment costs being maintained at no more than tick over during the meantime. Alternatively, risk acceptance would warrant proceeding now with the caveat of making that final Go Live decision at the very last moment. However, that would bring about a momentum that could prove extremely difficult to rein back; users would have already received their training. Also, it would leave the change management teams insufficient opportunity to apply the lessons learnt from the RL etc. Whatever the decision, this is going to be a hot potato topic for Trust Boards. Something they cannot shy away from, nor would they want to. Against this timeline, we will have the unfolding story of the Lorenzo early adopter full PAS deployments. And, of course, the potential service transfer of the live Southern Trusts. However the runes fall, this is going to be a fascinating few months.

Is the problem with Cerner or NPfIT?

maryhawking@tigers.demon.co.uk

13 Feb 09 20:31

Are the problems many Trusts have encountered due to the system or the arms length mode of implementation? The only live acute trust system being implemented under NPfIT is Cerner Millenium (we, in NME, are still waiting for Lorenzo..). In non-NPfIT implementations - especially Homerton - the implementation appears to have been successful. I'm a GP: but it does appear that the Trusts have very little direct contact with the system suppliers: some of the PCT Helpdesks imposed between the general practice and the system suppliers under the NPfIT contracts have proved unsatisfactory (I restrain my comments) and delayed resolution of the problems: is this an example of the same problem of introducing third parties between supplier and end-user?

Shortest lifespan of a PAS / EPR

15 Feb 09 19:13

One Trust in the Southern Cluster has announced that it is finishing with CERNER Millennium. Is this the shortest survival time ever of a PAS / EPR?