Mid-Staffs staff using ICM

Barnet and Chase Farm Hospitals NHS Trust has become the first London hospital to go live with Cerner Millennium as part of the multi-billion pound NHS IT programme. 

The trust, created from the merger of two previous hospital trusts, has successfully moved the data from two separate patient administration systems – a McKesson TotalCare system and IRC PAS – onto a single Cerner Millennium PAS for the two main hospitals and four additional sites.

Barnet already had some Cerner clinical systems, including pathology, radiology and order communications, originally provided under a hospital Private Finance Initiative deal.

Remon Gazal, the Australian IM&T director at the trust described the move to a single PAS as the platform for future planned development. He said that being first for the system in London meant the trust had recieved a lot of attention, but had “been a nervous place to be”.

Gazal added that BT and Cerner had been “very responsive to changes” required by the trust either because of the way it does business or the way the product works.

Installation has been carried out over the past two weeks by the trust, BT the company responsible for upgrading NHS IT systems in the capital, and the NHS London IT team.

Ahead of the implementation, nearly a million patient records were transferred from the hospital’s old systems to Millennium system.

Gazal gave a EHI blow-by-blow account of the go live over the past few weeks: “We pulled our legacy PAS system offline on Thursday, 19 July at 6.00pm. We brought A+E up on 21 July at 2.30pm. The wards came up on 22 July during the evening and outpatients on the morning of 24 July.”

Barnet and Chase Farm represents BT’s first deployment of Cerner in London. By the end of the decade BT is due to install more advanced versions of the Millennium software in hospitals across London providing advanced clinical tools and integrated electronic patient records.

BT has provided Barnet and Chase Farm with the same version of Cerner Millennium, called R0, which has already been installed at six sites in the South of England by Fujitsu.  The initial sofrware is not connected to the NHS Spine.

Over a thousand members of hospital staff have been trained to use the system to carry out patient administration work, patient registration, booking future appointments, recording A+E attendances and processing inpatient care events.

Gazal described the change issues involved as huge and varied. Many staff had been using the old systems for years and knew them backwards, making change uncomfortable for some. The issues cover a lot of territory, the IM&T director explained: “We’ve got some staff using a mouse for the first time, through to quite complicated patient care pathways we’ve had to implement into the system.”

The R0 version of Millennium provides core patient administration tools and the foundations for the development of the integrated NHS Care Records Service (CRS) which, when complete, is intended to provide clinicians with secure electronic access to detailed medical records for every individual in England.

If staff are comfortable with the pace of change the aim is to add more advanced clinical tools such as order communications by year end, Gazal told EHI “We’re certainly targeting Christmas as the time we want to give clinicians a big present and that is the kind of thing they are looking for, but we’ve got to get change bedded down first.”

The trust has integrated its existing systems with Millennium itself. Gazal described the systems being run at the trust as “a mixed economy” of NPfIT and legacy clinical systems. “Having Cerner Millennium gives us a platform that enables us to integrate a lot of other systems.”

The trust has also developed its own data warehouse to ensure it has the flexibility of reporting required.

Averil Dongworth, chief executive of Barnet and Chase Farm NHS Trust, said: "We are pleased that our patients will be some of the first people in London to benefit from these new IT systems. It means that the appropriate medical professional will have clear sight of a patient’s medical history at the point of care."

Dongworth said the new system would result in less repetition of information and quicker access to test results with all the information in one place.

"The National Programme for NHS IT is all about making life simpler. We welcome being at the forefront of this transformation. It was a lot of hard work for our people during the transition and naturally with a project of this size there were teething issues. My thanks to everyone involved for patience, good humour and commitment”.

BT signed a contract with Cerner to be its clinical software provider in July 2006, replacing its previous provider IDX, which had been bought by GE in January 2006. BT deployed IDX CareCast at only one NHS trust: Queen Mary’s Sidcup.

Paul White, chief executive of BT’s London Programme, said of the go live at Barnet and Chase Farm: "I’m delighted that the patients and staff at Barnet and Chase Farm NHS Trust will be the first in the capital to benefit from the improvements in patient care this new system will bring. We and the staff at both hospitals along with colleagues from NHS London have been preparing for this for a long time and it has been a lot of hard work from everyone involved."

White described the leadership and commitment of staff at the trust as "outstanding".