Barts still struggling with Cerner CRS

Barts and the London NHS Trust is still struggling to fix problems resulting from the installation of a BT delivered Cerner electronic patient record system.

Six months after go-live, the system is said to be hindering the trust in hitting national waiting time targets, including the 18 week total wait. The trust is having to validate activity data every week to correct errors created by the system.

The inability to accurately record and report activity data — partly the result of staff recording outpatient activity as inpatient care — has also created a financial shortfall. In September, E-Health Insider reported the trust was projecting a £3m shortfall in income this year due to the data problems.

The Cerner Millennium electronic patient record, also known as a Care Records Service, was installed at the trust in April as part of the £12.7 billion National Programme for IT in the NHS.

Since go-live, the trust has reported a series of problems. The software, which initially focuses on patient administration tasks, has also made basic activites such as managing outpatient bookings more difficult and complex.

In June, the trust reported that problems with migrating outpatient clinic data had led to delays in care for 11 cancer patients, breaching national wait targets.

September board papers report that continuing problems with the CRS software meant the trust missed more key targets in July; 54 patients breached the 26 week inpatient appointment target and 44 the 13 week outpatient waiting time target.

Although it has made progress, the trust reports incomplete data continues to create problems with meeting the 18-week target. “A significant level of validation is required on a weekly basis to correct data errors post CRS implementation.”

In his September report to the board, trust chief executive Julian Nettel says CRS was the main reason for the missed target. “The causes of the breaches were multi-factorial but were predominantly due to operational and reporting difficulties following implementation of CRS.”

He also says remedial work continues: “An intensive work programme is continuing to address the outstanding issues arising from the implementation of the Care Records Service (CRS) which have impacted on trust operations.”

Andrew Holden, the trust’s financial director says in his board report that the trust faces financial pressures resulting from the difficulties with the CRS. “There are on-going recording issues arising from the implementation of CRS which may impact on activity and associated income.”