Three more trusts have had to postpone Fujitsu implementations of Cerner Millennium in the South at short notice, as go-live dates for hospital systems slip further across the region. The delays mean that a key Connecting for Health delivery pledge will be missed.
The three latest sites to announce delays include Taunton and Somerset NHS Trust, which was due to have gone live the weekend of 7-8 October, and Mid Hants, an implementation covering two acute trusts and one primary care trust which was due to have gone live last weekend.
In addition, Worthing and Southlands Hospital has this week told EHI it will no longer implement as scheduled on 2 November and is “waiting for a new date”.
The latest delays make it impossible for the South’s local service provider (LSP), Fujitsu Alliance, to deliver the 12 installations of Cerner that it promised would occur by the end of October. To date, three trusts in the South have implemented Cerner’s Millennium software – two since June.
Mark Wark, Taunton and Somerset’s director of marketing and communications, told E-Health Insider: “We do not have a go live date that we are working towards at present – there are some technical situations that have to be sorted out to our satisfaction first.”
Mid Hants are understood to have had their Fujitsu implementation of Cerner Millennium pulled last Wednesday, three days before they were meant to go live.
Last-minute postponements of hospital trust Cerner implementations have become a hallmark of the Connecting for Health (CfH) programme in the South of England. As previously reported by EHI, Milton Keynes Hospital – which would have been by far the most complex implementation in the South – has twice had its go-live date put back at the eleventh hour.
Hospital PAS go-lives are extremely big projects. Last-minute postponements are costly and disruptive for NHS trusts who have had to extensively plan and prepare, clean data, train staff on new systems, schedule cover and arrange holidays around go live dates. Delays also create additional costs for suppliers.
In June Fujitsu told the House of Commons Public Accounts Committee that they would complete 12 initial Release Zero (R0) implementations of the Cerner Millennium system by the end of October.
One, Nuffield Orthopaedic NHS Trust (NOC), was already live and two more have occurred since: Weston Hospital NHS Trust and Buckinghamshire Hospitals NHS Trust. Nine more trusts were scheduled to have gone live by the end of October but for a variety of reasons have had to delay.
Millennium R0 was intended to be the version of Cerner Millennium already in use at Newham and Homerton hospitals in London, but has since required modification for use in the South. With the R0 releases running so late the subsequent R1 releases, which were to offer more clinical functionality, are getting pushed back.
EHI has been told by sources in the cluster that problems continue to exist with connections to the national Choose and Book system and with generating statutory reports from the software – a problem that caused NOC to be marked down on its performance by regulators at the Healthcare Commission.
Sources indicate that Mid and South Bucks is facing similar problems with reporting.
Problems are also said to exist within the workflow for patient management in Millennium. A well-informed source – who praised the clinical tools provided – told EHI of the difficulty of recording outpatient attendances. “Under Cerner it’s easy to miss out parts of the attendance and in terms of coding. You have to open a separate coding screen, select the patient and attendance and then encode, risking data being missed and taking twice as long as current PAS systems.”
The same source told EHI that delays were being compounded by the lack of technical environments to support the domain-based approach. In practice, this means a live site needs downtime when a new site goes live. “At Weston, for Bath to go live, Weston needs a significant period of downtime, as will any other domains who want other sites to go live,” the source explained.
They added that the generic training environment was also creating difficulties. “There is a generic training environment rather than one based on a local build, leading to generic rather than local process based training based on a local configuration.”
A frustrated LSP insider, however, stressed that that suppliers only want to provide good implementations – “which is why they work hard to support these difficult situations without receiving any additional funding from CfH even though it’s above what was contracted.”
Of the trusts that were meant to go live in October many of those contacted by EHI now appear to be operating a wait-and-see policy, waiting for news on other implementations and for software problems to be fixed before they go live.
Both Milton Keynes and Taunton and Somerset, have told EHI they are waiting for fixes at Mid and South Bucks. These delays are creating a knock-on effect pushing back later R0 implementations.
A spokesperson for Milton Keynes told EHI that the overall CfH project plan “requires a minimum of two weeks between each go-live date.”
Milton Keynes and Taunton and Somerset were due to have been followed by Hampshire, Surrey and Sussex Healthcare NHS Trust and Bath Royal United Hospital NHS Trust. The Medway NHS Trust told EHI that they were aiming to go live sometime in autumn/winter, but could not give a specific date.
Four trusts, Worthing and South West Hospitals NHS Trust and North Devon Healthcare NHS Trust told EHI at the end of September that they hoped to go live in November. Another two trusts, South Devon Healthcare NHS Trust and Yeovil District Hospital NHS Foundation Trust said they planned to go live in December. However, delays at the earlier sites now make these dates look extremely doubtful.
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