Royal Berks finances hit by Millennium

Royal Berkshire NHS Foundation Trust is facing significant operational and financial pressures after implementing Cerner Millennium and expects to spend another £6.2m implementing the system this year.

The trust went live with the electronic patient record system in June last year, more than 1,000 days from project start-up.

A brief presented to the trust’s most recent Council of Governors meeting reveals that implementation costs are expected to be £6.2m in 2013, against a budget of £2.5m.

Chief executive Ed Donald’s briefing said the increased costs were due to significant data correction being required each month and an increased number of patient administration staff being needed to run the system.

“The level of issues the trust faces, having implemented Cerner Millenium, is a significant drain on management capacity, despite robust risk mitigation plans,” the briefing document says.

This quarter, the trust is focusing on implementing a Millennium stabilisation plan to “address the problems in respect of the ability of the trust to keep up with patient appointments, and to accurately record activity, income and performance in respect of key targets whilst minimising cost,” the report to governors says.

EHealth Insider revealed last October that the trust had spent nearly £30m on implementing Millennium.

November board minutes say the trust has re-negotiated its contracts with Cerner and CSC to get better value for money.

In a statement, Simon Hill, head of corporate affairs for Cerner, said: “Millennium was installed at Royal Berkshire in June 2012; this is a complex change management process and we are working closely with the trust to address its information needs.

"However, the future running costs of the project represents less than 1% of total trust turnover.”

Royal Berkshire holds a number of contracts relating to its EPR. In mid-2009, the trust signed with University of Pittsburgh Medical Centre to deliver Millennium and in early 2010, it signed a Cerner hosting contract with CSC.

In 2011, the trust signed a separate, seven-year outsourcing deal with CSC, including helpdesk support, worth up to £50m.

Two new contract award notices were then published in June 2012 awarding Cerner £16.5m for the remote hosting of Millennium, a helpdesk and support for the system.

The Board Resources Committee discussed the performance and longer term affordability of Millenium at a meeting on 28 January and a final business case setting out options and costs going forward will be presented to the board this month.

EHI requested copies of four reviews of Royal Berkshire’s Cerner implementation, under the Freedom of Information Act.

Two reviews – both conducted pre-2012 – were released. One was released but heavily redacted and another was held back for reasons of commercial sensitivity.

Nevertheless, they show that the implementation project ran into problems as early as 2010, and that the trust was warned that reporting and clinical engagement would be key issues for go-live.

Read more about Royal Berkshire’s EPR project in Insight.