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Implementation dates for hospitals continue to slip

Tags: A   Accenture   Acute   Bacon   Cerner   CfH   CSC   Information   iPM   iPM   Ipswich   iS   iSoft   LSP   Medway   Millennium   PAS   PAS   PCT   South  

31 Aug 2006

An investigation by E-Health Insider has found that two-thirds of the 22 NHS acute trusts that were meant to be receiving a replacement patient administration system by the end of October say they will not hit the target.

In late June NHS Connecting for Health and its local service providers told Richard Bacon MP, a member of the Public Accounts Committee, that 22 trusts would get replacement PAS systems by the end of October. Two months later, just seven of the trusts named have told EHI they believe the target will be hit.

Of the four acute trusts that Accenture – the LPS in the North-east and Eastern clusters – said it would provide new PAS systems to by the end of October, only Ipswich said it was still working towards its date.

The CSC Alliance, LSP for the North-west and West Midlands Cluster, said in June they planned to deliver six iSoft iPM systems by October. Two have gone since live.

BT, the LSP for London, said in June that they would implement new systems in three trusts in London, but did not specify which. EHI has been unable to include these in its investigation.

Fujitsu, LSP for the Southern cluster, planned to deliver 12 new Cerner Millennium systems by the end of October. EHI has spoken with all but one of these trusts. Only three said they were confident of hitting the target, with most expecting delays of at least a month or more.

Nuffield Orthopaedic Centre were the first NHS trust in the Southern cluster to go live with the Millennium software, in December 2005. In July Weston Area Health NHS Trust became the first trust in the South to implement Millennium since.

A spokesman for the trust said that there had been “initial teething issues with the clinic templates, which resulted in some patients being booked into slots that are not available, or had already been booked into”, but this had since been fixed.

Rob Baird, director of finance for the Milton Keynes General NHS Trust told EHI that following implementation problems at Weston, most trusts awaiting further tests on the software to be completed.

“The date for our implementation has been moved from 14 August to mid September to allow more time for end to end testing of the Cerner software and to integrate the lessons learnt from the Nuffield Orthopaedic Centre last year and Weston’s implementation at the end of July,” said Baird.

A representative of Buckinghamshire Hospitals NHS Trust, said it too would be delayed in going live for the same reasons. Bath Royal Hospital and the Mid Hants PCT also told EHI that they will go live in September.

Elsewhere in the South, Surrey and Sussex Healthcare trust said they now expected to go live between September and October and Kent & Medway have delayed implementation by two months to the end of October.

Worthing and South West Hospitals have delayed their implementation by a fortnight to 2 November, while North Devon will go live three weeks late on 18 November. A spokesperson for South Devon told EHI: “We presently anticipate a go-live date early in the New Year.”

Despite the implementation delays, the trusts were generally positive about eventually going live with the Cerner software, provided by Fujitsu.

The CSC Alliance, LSP for the North-west and West Midlands Cluster, said in June they planned to deliver six iSoft iPM systems by October.

Two of these have happended: The Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust has gone live throughout the hospital, while North Cheshire Hospitals’ Physiotherapy and Occupational Therapy Outpatient Departments went live this week, with the whole site due to follow go-live next February, if the system is successful.

However, East Lancashire, South Manchester University Hospital and Southport and Ormskirk, all expressed concerns at the current state of iSoft when EHI contacted them to see if systems were still due to go live, and have all reported board meetings to discuss implementation plans.

South Manchester University Hospital told EHI that it was having problems with the software: “We have experienced a number of technical problems with the proposed new PAS which has led to the trust believing that it will not be ready for the 9 October, as previously stated. A number of completion errors have hindered the plans for this hospital, and the board has now decide that the new PAS will not be installed or go live until December at the earliest now.”

A later statement issued by the trust to E-Health Insider added that while 90% of the criteria had been achieved, the three issues were the delay in the Fleming version of the system, the need for resources to install hardware and the need to specify additional work with interface suppliers.

Similar concerns were expressed by Rob Bellingham, director of planning and IT at East Lancashire, who said: “We are currently conducting a review of our options for the implementation of the new PAS and a decision will be made by the Trust Board in due course.”

Jason Newman, information manager at Southport and Ormskirk told EHI: “We have had strategy and development meetings ahead of the proposed implementation of a new PAS on 10 September, but due to a number of concerns with regards to the software and the technology itself, we will not meet the go-live date and I cannot give you a new go-live date.”

In the two Accenture clusters, four trusts were named as going live by the end of October.

First reported by EHI on 16 August, Sheffield Teaching Hospitals NHS Trust has abandoned plans to implement the CFH version of iSoft’s iPM PAS system.

EHI has this week learned that Northampton General Hospital NHS Trust, which was due to go live on 31 July, has not received a new system. The trust told EHI the date had not been met and a spokesperson told EHI there was “no new go-live date planned at the moment”.

Airedale NHS Trust which was due to go live at the end of August also says the date has not been met. Mark Hutchinson, director of IT and projects said: “We continue to work with Accenture to implement a replacement PAS system through the National Project for IT. There are a small number of outstanding issues but we are working hard with Accenture to resolve them.”

The only acute trust in the Accenture clusters that confirmed it was still working towards the October target was Ipswich Hospital NHS Trust.

Reporting by Jon Hoeksma and Joe Fernandez

© 2006 E-HEALTH-MEDIA LTD. ALL RIGHTS RESERVED.

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1

Justifiable Reasons Please

31 Aug 06 21:51

It would help if you gave reasons in each case why the Trusts had decided not to go live or could not go live with the project. Often (but not always) it is due to accounting reasons, or staff shortages, or bad time of year i.e a non-LSP concern. Without this context the site risks sounding very "Computer Weekly" in its biase to the overall project.


2

Programme management??

01 Sep 06 09:30

Just flicking through my PRINCE2 manuals this morning .... and wondering why all sorts of mechanisms aren't kicking in (as specified in the PRINCE methodology) to bring some order to this ongoing delivery fiasco?


3

Programme/ Project Management?

02 Sep 06 16:20

Sorry, CfH and LSPs do not understand such governance and processes! Just think of it as a frontal lobotomy at national expense!


4

Justifiable Reasons Please ?!?

04 Sep 06 00:47

"concerns at the current state of iSoft " "a number of technical problems with the proposed new PAS " "due to a number of concerns with regards to the software and the technology itself" - these all look like justifiable reasons to me!


5

Justifiable Reason

04 Sep 06 09:46

I belive the reason is made very clear. Quote - 'We have experienced a number of technical problems'; 'initial teething issues'; 'due to a number of concerns with regards to the software and the technology itself' etc etc etc. That would seem to be a justifiable reason to delay installation of the system to me. I didnt see any comments about staff shortages or accounting problems.

Without Computer Weekly and E Health Insider most of us wouldnt have a clue what was going on in CfH. I cetainly dont go to the CfH website for reliable up to date information.


6

Justifiable Reason

04 Sep 06 13:33

I only see two sites (South Manchester University Hospital and East Lancashire) stating their technical difficulties. This could be printers, data conversion, legacy systems integration, spine or LSP realted. That leaves at least another dozen sites delayed but no reason given in the article. Even blaming 'testing' is too generic; is this user acceptance testing, clinical testing, PDS tests, volumetric or perofrmance related? Delays in implementing medium to large software system is not news, the new information is in the cause of the delays.


7

Justifiable reasons number 4

04 Sep 06 14:50

In June CfH told Richard Bacon MP that 22 Trusts would have new PASs by October. Two months later only 7 are expected to go live on time. CfH and its LSPs are either lamentably ignorant about the ability of their clients to take the systems, or else they have no idea of the state of the software they are delivering. Or both. Doesn't seem very justifiable whichever way you look at it.


8

Lack of understanding

04 Sep 06 16:41

The reason for the delays is usually due to the software being "Not up to scratch" when it comes to delivering what is really required within the health service. This is due to the system being designed by a group of techies with little or no understanding of the way the NHS works and the scale of data we work with.


9

Off point

04 Sep 06 17:06

The last two comments are completely missing the original point, which was questioning why, given 14 or so delayed sites out of 22, only two were specifically quoted and neither of those were entirely clear where the delay was. It was asking for clarity but, obviously, there are those that just want to lay blame elsewhere rather than find out why, and one wonders why the NHS will not drag itself out of the 1990's. Scale of NHS data is nothing new or even impressive to private sector companies such as CSC, BT or Accenture, if it was they wouldn't be LSPs. Now, I don't want this thread to go off course and into fruitless flaming. I have worked for both the NHS as an IT Manager of an acute and for these LSPs and have no axe to grind. I would just like to know, apart from the two sites mentioned, the reason for the other dozen delays, then maybe, we can move on. Surely CfH know and this publication can find out.


10

Off Point

05 Sep 06 09:04

In reply to the "Off Point" comment. There seems to be a misunderstanding to the point I was trying to make about the scale of the NHS data. I have found that working alongside the likes of CSC et al that they understand the fundamentals of setting up a large database but have had to be told on many occasions that we need X, Y and Z and they have just been shocked as to the size of what we are asking for. We are still waiting on a number of areas within our Lorenzo system to be improved for the next version roll-out (Called Fleming I believe) and the sheer scale of the alterations needed has delayed this time and time again.


11

Off point - not

05 Sep 06 11:16

The point about this is that in June CfH grossly overestimated its projected implementation of PAS systems. This was so recent that it should have known about any reasons for non-delivery at that time and announced the correct figure, which was seven, not 22. There are no justifiable reasons for giving such an inaccurate estimate.


12

Truths and lies

05 Sep 06 14:15

I think that the prime reason that everyone is so circumspect about delays is the over-secrecy of the contractural framework, and brinkmanship about who caused a delay.

From what I gather in the Southern Cluster, the Cerner system has very different outpatients templates to those previously designed around NHS practice. This was not clearly known by early implementers, and various configuration choices were probably, on hindsight, poorly made.

There have also been significant concerns about the information reporting facilities, Casenote Tracking, A&E letters, Maternity, and probably other aspects that I have not heard about... ... but the shortcomings are very real when trying to do data conversion, train users, and persuade the Board of organisations which are moving towards Foundation status that NCRS is a good idea. The Clinical aspects of NCRS still appear a distant dream.

It is not helpful to keep defending CfH on the basis that people feel deterred from entering honest debate. I am very grateful that EHI and Computer Weekly continue to challenge hard. I am also heartened that the PAC have reconsidered their much mangled report. Doubtless this will take so long to re-issue, that much of the damage will have been done.


13

Way Off Point

05 Sep 06 14:48

The point is this (and let's get back to the article please): of the 14 or so delayed implementations only 2 were quoted with reasons, I, for one, want to know what delayed the vast majority not a few. We have Trusts, CfH, LSPs and 3rd parties in the mix and I doubt it's down to just one of these but I'd be happy to be proven wrong with the facts, not conjecture or biased opinion. Another NAO report is not due until next year so, either we wait for that or ask more questions now.


14

Clarification on Kent and Medway go-live target date

jon@e-health-media.com

06 Sep 06 10:56

Since publication E-health Insider has been contacted by Kent and Medway NHS Trust to request a clarification in the above article regarding their planned go-live date.

The trust say that the correct implementation date Kent and Medway is working towards for R0 implementation of the LSP CRS solution is not 27 September as we originally reported. "The go live has moved one month to end October, as our previous date was end September," a trust spokspesperson said.


15

PRINCE2

drgordon.caldwell@ntlworld.com

06 Oct 06 22:13

I mentioned PRINCE2 to supplier and heard 30 seconds of agonised silence at the end of the phone, before a further 4 weeks delay

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