The interim child health system in London is creating risks to the effective running of the childhood immunisation programme, according to PCTs.

Ten PCTs in the capital are currently using the troubled Child Health Interim Application (CHIA) provided by BT as part of the NHS National programme for IT as a stop-gap solution.

The ten PCTs are waiting to switch to BT’s preferred solution RiO. However delays to the implementation of RiO have left the PCTs coping with CHIA for much longer than originally planned.

At least three PCTs have now logged CHIA as a risk on their corporate risk registers and the Health Protection Agency has reported problems with supply of childhood immunisation data from the PCTs.

Problems arising from use of CHIA were first reported by PCTs in 2006, leading to fall in immunisation rates in some parts of London.

The latest release of CHIA, introduced at the end of June, has also been “problematic” according to the London Programme for IT. It told EHI Primary Care it was working with BT to take action to address the problems.

The Health Protection Agency has reported that four of the ten PCTs using CHIA were unable to submit data for the last quarter (April –June 2008) because of problems with the system while others using CHIA provided data with caveats.

Redbridge PCT told the HPA: “The current CHIA system does not function adequately as a tool for managing the immunisation programme. There are still great reservations about the reports generated for submission.”

Redbridge has logged its lack of an effective performance management system for its immunisation programme as a high risk.

In her report to the September board Heather O’Meara, chief executive of Redbridge PCT and chair of the CHIA board, said there were “some significant problems” with the latest release.

In Haringey the Teaching PCT (TPCT) reported that the slippage to implementation of RiO, originally planned for December 2008 and now scheduled for July 2009, presented “significant issues for the TPCT in terms of clinical, financial and operational risk.”

Waltham Forest PCT told the Health Protection Agency that its latest data was “particularly unreliable” due to an increase in performance issues of the CHIA system.

In Tower Hamlets CHIA is also on its risk register as an “inadequate” child health system and the PCT identifies a risk that children may not be immunised.

Criticism of CHIA was first raised in February 2006 when it was reported that PCTs were being forced to rely on manual records because of problems with the introduction of the system.

In June of the same year the HPA strongly criticised the system after immunisation rates fell in PCTs using CHIA and in 2007 the ten PCTs agreed to switch to CSE Servelec’s RiO system for child health.

A spokesperson for the London programme for IT told EHI Primary Care that it accepted that there had been problems with the reporting of data to the Health Protection Agency and that LPfIT would work with BT to resolve the situation. “We are confident that these issues will be rectified by the next reporting schedule,” she said.

She added: “We acknowledge that there have been issues with the CHIA system since the latest software release was introduced at the end of June. This has been problematic but we have been taking action with BT to address the performance and functional issues that were identified.”

She added: “BT has been spending time with each PCT child health team to diagnose the problems they were experiencing and generate solutions. This has been monitored on a daily basis by the London Programme for IT. As a result we have seen a dramatic improvement in the performance of CHIA.”

A spokesperson for BT told EHI Primary Care that 15 PCTs in the capital were already using version 4.7 of RiO child health and that it hoped to implement RiO 5.1 in the first of the 10 PCTs currently using CHIA in early 2009. He said the PCTs using CHIA had asked for the additional functionality in 5.1 and agreed to the new deployment schedule.


Agreement reached on CHIA replacement