London hospital trust loses millions in upgrade debacle

The Royal Free Hospital in London has lost £7.2 million (US$11.4 million) over six months as a result of its implementation of new Cerner-based IT systems.

Details of the loss, around six percent of the budget, were outlined in a half yearly review presented to Royal Free board last month.

Hospital chiefs were given details of the additional costs and lost opportunities to treat patients -- and hence get paid -- incurred during deployment of the system by BT.

The report stated that the new system did not properly support the trust's "patient pathway." This meant "many clinical and admissions slots were not used."

It highlighted incorrect and missing data on the new system. This was "in part due to the clunky workflows and, in part to the lack of experience of our staff in using the actual Royal Free build," the board was told.

Trust leaders heard that: "The system supplied was different to the system supplied for training, and there were no operating procedure manuals for the system."

Additional staff were required to rectify data issues and to "maintain normal activity levels", at a cost of £1.2 million. Finally, problems with the stability of the system were reflected in declining levels of clinical efficiency, which the Royal Free estimates cost it £900,000.

The LC1 system, which went live at the Royal Free in August, is London's first version of Cerner Millennium, is one of two key records systems being rolled out across the UK under the National Programme for IT in the NHS (NPfIT). It links directly into the NHS spine, which is the central database for digital records of patients.

Responding to staff complaint about "chaos" after the new system went live, the Royal Free said, reports of major problems were exaggerated and that it was "certainly not correct" to call the situation chaotic.

"A new system of this size and complexity inevitably meant a few teething problems and that staff had to get used to new ways of working and new processes," the trust said in a statement. "The implementation of the system involved training 4,000 staff and months of preparation."

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