Agreement reached on CHIA replacement
- 6 March 2007
Ten London primary care trusts using BT’s troubled interim child health system have agreed to move to CSE-Servelec’s RiO solution for child health, on condition BT meets a series of risk mitigation requirements by August.
The decision means that some of the PCTs may have to continue using the Child Health Interim Application (CHIA) for another year while they await the implementation of RiO, even though concern continues about its impact on the immunisation status of children in London.
The ten PCTs have accepted the recommendation of the Child Health Interim Application (CHIA) Board to migrate to RiO but the board has also recommended that the PCTs switch to an alternative interim system if BT cannot meet its milestones for risk mitigation by August.
Dr David Elliman, consultant in community child health at Great Ormond Street Hospital and a CHIA Board member, said CHIA was still unable to generate appointments and reminders.
He told EHI Primary Care: “In somewhere like inner London where child systems are using for appointing and we don’t have that function it’s reasonable to assume that children are not being immunised who should be although we can’t say that definitively because there will always be children who are not immunised for a variety of reasons.”
The CHIA Board was established last summer after Connecting for Health, BT and the NHS in London accepted that CHIA was failing to meet the needs of a child health system for London. The original brief was to look at alternative interim solutions with an option appraisal of CHIA, RiO, HSW and Care Plus. EMIS and TPP expressed initial interest in taking part but then pulled out. .
According to the business case document some members of the board originally wanted to move to HSW or McKesson’s Care Plus on the basis that RiO did not meet requirements and that CHIA was a “failing product.”
However the board decided to back a move to RiO after BT announced that RiO would be its strategic solution for London.
Dr Elliman said the feeling was that it would be better to move to RiO now even if its functionality would not yet meet requirements rather than switch to another child health system and then have to move again in two or three years’ time.
The three areas BT is expected to deliver on by August are:
* data cleansing work on CHIA to remove incomplete and duplicate data;
* electronic interface with Great Ormond Street Hospital to allow electronic results for blood-spot screening; and
* workshops for PCT child health staff to identify pan-London requirements for child health to inform RiO configuration needs.
Dr Elliman said that, even though the recommendation was for PCTs to switch to another interim system if BT does not deliver on the risk mitigation requirements by August, the 10 PCTs were likely to take that decision on a trust by trust basis.
He added: “They would like to make that decision for themselves.”
Last summer the Health Protection Agency (HPA) strongly criticised CHIA after it found that immunisations had fallen by up to 19% in trusts using the system and that eight out of ten PCTs were unable to submit data because of problems with the system.
The report from the HPA said that the children may not necessarily be unvaccinated but, because no information has been collected on their vaccination status, those who have missed out are unlikely to have been identified and followed up.
The latest HPA Cover of Vaccination Evaluated Rapidly (COVER) programme report, for July to September 2006, shows that five of the ten PCTs were still unable to submit data because of ongoing implementation problems with data. The other five submitted data with caveats about data quality.
However a spokesperson for Connecting for Health (CfH) told EHI Primary Care that since September 2006 PCTs have had the ability to provide the statutory immunisation reports required. She added: “Despite these previous difficulties, dedicated PCT staff have ensured that routine immunisation and vaccinations programmes have continued to run.”
She added: "The ten London PCTs have now accepted the recommendations of the CHIA Board to move to the RIO system, which has always been the strategic solution. CfH and BT are working hard with the PCTs to support them in achieving this and in meeting their responsibilities to ensure children in each area are offered immunisations as they fall due."
Heather O’Meara, Redbridge PCT chief executive and CfH chair of the CHIA Board said: "Whilst it is recognised that there have been some difficulties with the child health information system, known as the child health interim application (CHIA), the 10 affected London PCTs have worked hard to minimise the impact of these problems and to ensure that data was captured and appointments sent out."
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