Strategic health authorities in the South of England are evaluating alternative software options to the version of Cerner Millennium being offered by Fujitsu under the NHS IT Programme (NPfIT).
Fujitsu, the local service provider for the South, has told E-Health Insider, that it is working with SHAs and trusts to provide them with systems that best meet their needs on mental health services, including examining alternatives to Millennium.
Lester Young, Fujitsu’s programme director for the South, told EHI: “It is the case that trusts are looking at other things, but absolutely no decision has been made.”
Young stressed that while Cerner Millennium was Fujitsu’s preferred offering it was not exclusive. “As an LSP we have not had a definitive strategy on exclusivity. We’ve got a preferred approach but we never said we’d never look at anything else.”
Asked to clarify further he told EHI: “Preferred does not equal exclusive.”
Young said that working with trusts to evaluate alternatives was part of listening to them and responding to their requirements. “NLOP [the NHS local ownership programme] is beginning to change the landscape ever so slightly.”
Asked what systems were being considered for mental health Young said: “Rio is one of the things we are looking at and Millennium is another.” He confirmed that any alternative would be provided by Fujitsu and be compliant with NPfIT standards including the spine.
Young said that discussions were underway on ‘interim’ systems for mental health, “over the next few months we would hope to have something agreed”.
Fujitsu already has a contract in place with INPS to provide what are nominally called ‘interim’ GP systems and have just signed a deal with McKesson to provide its CarePlus system for child health to trusts. McKesson pointed out this week that CarePlus also contains a proven module for mental health.
South Central, one of the three SHAs in the South, confirmed that it is evaluating a range of options on mental health. Stuart Slyfield, the mental health lead for South Central, told EHI: “The preferred option in South Central SHA is Cerner, however we may consider interim solutions to suit business needs.”
EHI has also learned that in addition the other two SHAs in the South have also recently evaluated a number of options for systems to support mental health services. One is understood to still favour Millennium for mental health.
Fujitsu and Cerner have been working on an improved version of the Millennium software, called release 1, containing better tools for mental health. They recently toured the cluster to demonstrate the potential of the new system. Fujitsu sources say that some trusts have been positive about the latest software.
However, one senior mental health trust official, who asked to remain anonymous, told EHI that when he quizzed the development team, he found that there were no specifications set in stone and described the demonstrated option as ‘absolutely dreadful’.
Another told EHI that trusts would increasingly like to move away from waiting for Millennium but fear that intense pressure will be put on them by Connecting for Health and Fujitsu to accept the system.
Release 0 of the Millennium patient administration system has so far been delivered to eight trusts or health communities. Release 1, which is due for release in 2008, is said to include improved support for administrative processes in mental health.
While the R0 version of Millennium does provide some mental health functionality it only partially meets trusts’ needs. Sources at Fujitsu say that reporting requirements created by recent mental health legislation have changed significantly since the initial output based specification (OBS) for the system was agreed over four years ago. The next version of the system, R1 is said to be nearing completion but will not be available to the NHS until 2008.
Of the trusts in the South responsible for mental health services EHI has contacted, none was able to say when it expected the enhanced required mental health functionality in newer version of Millennium to be in place. Privately, several indicated they are now considering purchasing an alternative ‘interim’ system.
A May board paper from East Coast SHA highlighted the delays created by additional work needed on R1 to be able to support mental health services. “The further work refining the deployment process for Cerner Release 0, and the detailed design and build work for Release 1 – particularly in the area of mental health – have resulted in the feasible go live dates for trusts becoming later than originally envisaged.”
To date, only the Mid Hampshire Deployment Family (consisting of three trusts: Winchester and Eastleigh Healthcare NHS Trust, part of Hampshire Partnership Trust and a part of Hampshire Primary Care Trust), have used the mental health functionality provided in R0 of Millennium.
EHI has learnt that clinicians at the Hampshire Partnership Trust have been disappointed with R0’s mental health capabilities and are now looking at CSE-Servelec’s RiO system as a possible alternative.
R1 of Millennium should add Statutory Mental Health data items to the standard PAS, including statutory mental health data items such as Legal Status Classification, registration, admission, discharge and transfer, basic support for Mental Health Act administration, bed management, referral management, outpatient scheduling, community scheduling and contact management and case note tracking.
The RiO system is already the preferred mental health solution offered by BT to the NHS in London.
RiO is already in use in the South, first introduced by the Somerset Partnership NHS and Social Care Trust in April 2001, prior to the NPfIT programme. Ian Halsey, director of corporate development at the trust, told E-Health Insider that the system has helped make sharing of information a lot easier for the trust with over 1200 systems now using the solution trust-wide.
"The timely sharing of information has always been a challenge. However, the aim for us working with CSE-Servelec was to create a trust-wide system that would unify the planning needed for mental health and social care into one single process, for all users to easily be able to operate on.
"What we have created and have helped to upgrade is a clinical information system that enables all information regarding clients to be stored in one central location, accessible to authorised personnel at any time and from anywhere within the trust, as well as away from the NHS premises. We would not want to lose the RiO system, and would have to be looking at a system which is at least as good, if not better to do so."
Halsey said that Fujitsu faced a challenge of meeting the needs of trusts in the South, most of which are located in sparse rural areas. Work with CSE-Servelec had been going on since the late 90s and was continuing as mental health requirements developed.
"Somerset is a fairly large county. We have 50 sites, the GP surgeries and the many different hospitals which all need some sort of access to this one system. It is a key aspect that you have to have a system where you can access information as and when you need to – you can’t just rely on paper records. There is a lack of progress nationally on this, but RiO is doing this and we have lots of interest regionally, nationally and internationally."
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