East and North Herts could face £7m bill to fix Lorenzo issue

East and North Hertfordshire NHS Trust could face a £7 million bill to stabilise its IT systems after it discovered discharge summaries were not being sent consistently.

The Department of Health and Social Care revealed the trust declared a serious incident in July 2018 after discovering it had failed to send a “significant number” of discharge summaries to patients and their GPs.

The problem followed the trust’s implementation of electronic patient record Lorenzo.

Shadow health and social care secretary Jonathan Ashworth raised the issue in a written question to the government.

In response, health minister Caroline Dinenage revealed that of the 48,000 patients discharged from the trust between September 2017 and July 2018, there are approximately 14,600 for which it is not clear if a discharge summary was written and sent.

In response to a follow up question, Ashworth was told the trust currently estimates “the cost of the work required to stabilise its IT systems” at £7 million.

The trust confirmed the incident in a subsequent statement, but emphasised there was no evidence any patients had come to harm as a result.

The statement, which is attributed to medical director Michael Chilvers, says: “The trust is prioritising the review of discharge summaries for those patients where a follow-up action (such as a further appointment or test being carried out) might have been needed.

“These patients will have their records reviewed individually and, should any outstanding actions be discovered, the trust will take the lead in getting them sorted – this will include informing any individual patients involved, as well as their GPs.

“Although the majority are expected not to contain any follow-up actions that have still to take place, where they are identified then the trust will ensure that these are completed as a matter of urgency.

“There is no evidence that any patient has come to harm as a result of not having had their discharge summary. However, this position will be kept under review whilst the incident investigation continues.”

The trust went live with DXC Technology’s Lorenzo in September 2017 after “considerable disruption” from WannaCry caused a delay.

Lorenzo was one of the EPRs due to be deployed under the National Programme for IT, but planned deployments ran into repeated development delays.

A DXC spokesperson said: “Our joint investigations [with East and North Hertfordshire NHS Trust] have ascertained that this is an issue around the configuration of the system which has led to increased processing time for discharge summaries, rather than any bug in the core Lorenzo software. We are working together to bring a quick resolution to this issue.”

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There are currently 21 trusts using Lorenzo.

These are:

• Barnsley Hospital NHS Foundation Trust
• Birmingham Women’s and Children’s NHS Foundation Trust
• East and North Hertfordshire NHS Trust
• East Suffolk and North Essex NHS Foundation Trust
• George Eliot Hospital NHS Trust
• Hull and East Yorkshire Hospitals NHS Trust
• Humber Teaching NHS Foundation Trust
• Mid Essex Hospital Services NHS Trust
• Norfolk and Suffolk NHS Foundation Trust
• North Bristol NHS Trust
• North Staffordshire Combined Healthcare NHS Trust
• Royal Brompton & Harefield NHS Foundation Trust
• Salisbury NHS Foundation Trust
• Sheffield Teaching Hospitals NHS Foundation Trust
• South Warwickshire NHS Foundation Trust
• Tameside and Glossop Integrated Care NHS Foundation Trust
• University Hospitals of Derby and Burton NHS Foundation Trust
• University Hospitals of Morecambe Bay NHS Foundation Trust
• Walsall Healthcare NHS Trust
• Warrington and Halton Hospitals NHS Foundation Trust

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