Morecambe Bay creates stabilisation plan

University Hospitals of Morecambe Bay NHS Trust has launched a stabilisation plan to bring major and persistent problems with its electronic patient record system, Lorenzo, under control.

Weekly updates sent to Morecambe Bay staff, and seen by E-Health Insider, show that one of the aims of the plan is to allow them to “transact a day’s work in one working day – reducing the need for spending extra hours putting-in information.”

The updates also lay bare some of the problems that the trust is still experiencing with the system, fourteen weeks after go live. These include some live patients being identified as deceased when contacts are being created.

The ‘Lorenzo – thirteen weeks’ in log says that ‘when creating contacts for certain non-deceased patients, a message box appears asking the use if they want to continue as the patient is deceased.’

However, the trust stressed that the problem is a "cosmetic issue" affecting the message box, rather than the patient record.

Over the past fourteen weeks, the trust appears to have persistent problems with the link between Lorenzo and Choose and Book. At one point, Choose and Book appointments were ‘being cancelled by Lorenzo’ although a fix has been put in place.

It has also experienced persistent problems with outpatient clinics appearing to be full when there are slots available, with transfering and discharging patients, particularly from ICU, with generating letters of all kinds and with generating accurate reports for payment. In all cases, fixes have been delivered or requested.

When asked about the problems that the trust is experiencing, Patrick McGahon, director of service and commercial development at the trust, issued a statement to EHI that said: “The number of issues reported is not currently increasing and no new major issues have been identified.

“Our local project team, staff from the key areas and [staff from local service provider CSC] have developed a Stabilisation Plan, which aims to deliver a series of upgrades, fixes and changes to the core Lorenzo application.

“An upgrade is planned for this month and this will deliver around 140 fixes – approximately 90 of these are configuration changes, not software fixes."

EHI understands that senior executives from CSC and the trust’s informatics team are attending meetings at Morecambe Bay this week to discuss the future of Lorenzo.

Lorenzo is the iSoft electronic patient record system that was due to be delivered to the North, Midlands and East of England under the National Programme for IT in the NHS.

It has been subject to repeated delays. Last April, Department of Health director general of informatics Christine Connelly set CSC a deadline of March this year to get the latest version working smoothly across an acute trust; Morecambe Bay.

CSC missed the deadline. Morecambe Bay went live with Lorenzo Regional Care Release 1.9 in June.

Last week, it delayed a decision to roll-out a further release to provide A&E functionality in order to give the initial release time to “bed into business as usual operations.”

Following a ministerial statement on the future of the national programme, Connelly made it clear that CSC would receive milestone payments for deploying Lorenzo only when it was successfully live at Morecambe Bay and three other earlier adopter sites.

The next site due to take the system, Birmingham Women’s NHS Foundation Trust, also delayed its go-live of Lorenzo R1.9 last week, saying it wanted to wait until it is “safe to be deployed.”

The weekly updates, sent by the trust chief executive, Tony Halsall, say that 347 improvements will be made over the next month, with 147 in mid-September and an additional 200 in October.

In the emails, Halsall constantly thanks staff for their “continued patience and persistence” and ask them to continue reporting the issues they experience with Lorenzo.

He says: “We would all prefer it if the system worked perfectly straight away but as with any major IT deployment, we were bound to come across problems once we were using it in a live environment."

And he reiterates the trust’s commitment to making the system work. “We cannot change where we are now. What matters is that we continue to work together to identify and solve any problems and get Lorenzo to a place where it is working in the right way for all of us."

Read: A fuller account of how Morecambe Bay’s Lorenzo deployment has unfolded over 14 weeks in our analysis, Lorenzo’s toil.