Cambridge University Hospitals and Papworth Hospital NHS foundation trusts’ joint electronic patient record contract with Epic is under review, while Monitor takes a close look at Cambridge’s finances and performance.
The EPR is a part of Cambridge and Papworth Hospitals’ eHospital programme.
In what was seen by many as one of the most important NHS IT procurements in recent years, the trusts announced in April that they were awarding the software component of the tender to US supplier Epic and the hardware and infrastructure contract to Hewlett Packard.
However, Cambridge has recently come under close scrutiny by NHS foundation trust regulator, Monitor, regarding its performance and finances and has been warned it may be in ‘significant breach’ of its terms of authorisation.
The costs associated with the eHospital programme mean it is the only project that has been flagged for review and eHealth Insider understands that no contracts will be signed until that process is complete.
The review itself appears to have been delayed by changes at the top of the trust. Long-serving chair Dame Mary Archer has recently been replaced by Jane Ramsey, previously vice-chair at University College London Hospitals NHS Foundation Trust; while a new chief executive is to be announced imminently.
Former chief executive Dr Gareth Goodier had said the contract with Epic would be signed in late June, but then left the trust that month to take up a role in Australia.
A spokesperson from Monitor told EHI: “Monitor is currently reviewing its regulatory approach to Cambridge University Hospitals NHS Foundation Trust.
“While this process is taking place, and given recent significant changes to the trust’s leadership, we have advised the trust that we will review the eHospital project when the trust’s new leadership is fully up to speed with the proposals; and if it triggers the appropriate thresholds as set out in our Compliance Framework.
“The trust is currently completing its review of whether it meets these triggers.”
The financial triggers are based on the size of the contract in relation to the trust’s turnover. According to EHI Intelligence, Cambridge had an income of £617m and Papworth £129m for 2011-12.
Sources suggest that the cost of the EPR project is in the region of £30m - £40m.
A spokesperson for Cambridge University Hospitals confirmed that the Epic contract has not yet been signed and that the trust is in talks with Monitor about the borrowing facilities required to finance the IT project.
The trust is reviewing whether the eHospital programme constitutes a “significant transaction” and therefore needs Monitor’s approval to go ahead.
"We are progressing well with eHospital and contract clarifications with our preferred bidders are being finalised now,” she said.
“We are following due process with all our arrangements and discussions continue with Monitor."
A document from the trust’s July board meeting suggests it was aware the EPR programme could prove financially difficult: “The trust’s ability to achieve its cost improvement plans could influence Monitor’s view of its ability to invest in eHospital,” it says.
Cerner and Allscripts were shortlisted with Epic for the Cambridge and Papworth contract.
In July, eHealth Insider reported that Cerner had accused the trust of failing to conduct a fair and transparent tender process for the procurement and of picking a winner in advance.
© 2012 EHealth Media.
What about the VFM question?Charles Gallagher 136 weeks ago
No ones mentioned whether 40m quid for an EPR is good value.
I have no doubt it can be done in 2-3 years but does it represent good value when the functionality already exists closer to home?
The other comment about the US EPR decision being career limiting for CEO's is also true. Of course Cambridge have a new Chairwoman and and an interim CEO so that should make the decision easier....
I am sure it will be finespotlight 136 weeks ago
Why would anyone question bringing in an expensive US system after the experience of Rotherham, London, Berkshire, Barts and others? I wonder if anyone at Cambridge asked Rotherham or the other Cerner, IDX or Meditech sites what it is like spearheading the Anglicisation of an imported system and how much it cost, compared to original estimates. And if you asked the CEOs of these hospitals, coincidently many of whom are now ex CEOs, whether they would do it again, how many would say yes. The NHS has always been good at learning lessons in IT.
Anglicisation is really difficult but....brianjames 136 weeks ago
The fact is that at the time we went out to tender, the NPfIT programme had eliminated any serious UK contenders for such contracts, so we really had little choice. Without doubt the Meditech EPR has been hugely challenging to introduce, but interestingly far bigger problems have been presented by the Choose and Book interface than the anglicisation of the US system. We are however confident that once the system beds down properly we will have a world class and hopefully paperless EPR which is fully SNOMED compatible.
Did we do the right thing? How many are confident about Kelso's position that the NHS will be paperless by 2015? Soory but that view borders on delusional. We have the potential to be paperless and we are way ahead of the majority of other Trusts and even we don't believe paperless is possible by 2015 (and we actually HAVE an EPR).
(but retitement imminent!)
yes it can bePeteMarsh 136 weeks ago
Anglicising (is that a word?) of a US system. Well it worked back in 1989 in Wirral. I dont deny it was hard work, but it became a leader in EPR systems at the time, and still working in inpatient setting whilst Cerner works hard at replacing that functionality. There are 3 pieces to the jigsaw, 1 - the admin (PAS stuff), this is pretty much country specific although the concept of registration, scheduling, wait list is now almost a universal concept world wide, just the specifics that alter it, 2 - the clinicals, worldwide clinicals are generally the same also, Order comms, clinical noting, care planning, nurse documentation, flow sheets,A/E,Theatres etc, the specific flavour and workflows are tailored to a institution not just a country, and 3 - Intense local customisation & ownership which follows after the first 2 are successfully implemented. If 1&2 are not successful 3 never appears, probably a good indicator of a quality mark for a site. I think Frank Burns whilst semi retired, would not argue with the selection, I remember his first day when e was asked to sign the cheque for a EPR we had just bought. He never regretted the decision. So I cant support generic arguments about US software. Its all about the implementation and local ownership.
A Bright but ignored BeaconOzLurker 135 weeks ago
I was a BMA Junior doctor on the Joint Consultants Committee in the early nineties when Ken Calman was in the Chair and one meeting we looked specifically at the systems implemented at the 'Beacon' sites of the Wirral and Nuneaton. Exciting they seemed too, but not to the then Senior leaders of the Profession either from the BMA or Royal Colleges.
I spoke in strong support of investigating how we could disseminate the IT lessons from these two admirable, but unfortunately not very influential hospitals (from London Teaching Hospital Perspective). The committee metaphorically (and perhaps audibly) groaned and little was done. Prof Calman was a bit of a wag, pointing out that I was the only one present likely to be still actively involved in ten years time and that perhaps the JCC should take heed of what I was saying.
Not for the first time in the last thirty years the UK Medical Profession neglected to take up the challenge and the rest is (total car crash) history.
"Leader in EPR Systems"?Daniel Defoe 136 weeks ago
Pete, without wishing to be unduly picky, my recollection is of Wirral being a "beacon" rather than a "leader" since leadership implies followers. I don't recall many despite what Wirral achieved in the circumstances being remarkable.
How long will it takenike 136 weeks ago
How right you are, the trust may also like to ask how long it takes to get a US solution ready for the UK market. I recall that Cerner was going to be deployed across all trusts in London and the South by 2008....
Interesting...Daniel Defoe 136 weeks ago
Epic is well known for its expressed strategy (and indeed its ability) to choose the customers it wants to work with rather than the other way round. I wonder if they're having second thoughts now about continuing?