The Department of Health has said that it remains confident in the potential of both Cerner’s Millennium and iSoft’s Lorenzo to work effectively, once development and testing are completed.
The vote of confidence in the core electronic patient records software chosen for the National Programme for IT in the NHS comes in response to the second report of the Public Accounts Committee’s on NPfIT, which was published in January.
The Department says that although the delivery of the main care records systems is late – with software development yet to be completed and tested; relatively little clinical functionality delivered; and much work still required on clinical engagement – it retains confidence in its suppliers and the programme.
However, it acknowledges it is disappointed in the slow pace of progress thus far. “It is regrettable that the progress has been slower than anticipated with the NHS Care Record Service at a local trust level."
It goes on to say while regrettable, delays are preferable to implementing systems that don’t work.
While the response, provided as a Treasury Minute, accepts many of the recommendations of the PAC report, it also makes clear the DH plans to persist with its two remaining systems integrators – BT and CSC – and their chosen software suppliers – iSoft and Cerner.
The ASCC framework contract awarded last year is described as purely a contingency arrangement.
The DH response, however, says that future plans for deployment of Lorenzo in the North, Midlands and East remain at an early stage, with any future national roll-out dependent on the completion of the softare and the success of initial pilots.
“No trusts will be expected to take a Lorenzo Release until the functionality has been demonstrated to work in practice," it adds. It also says that trusts “will be fully involved in the sign-off processes that lead to the implementation goping live."
The Treasury Minute says the problems with Cerner Millennium that resulted in the Royal Free and Barts and the London trusts facing financial crisis have been fixed.
“In London, an improvement programme for Millennium has been completed successfully in the Royal Free Hospital, resulting in the approval by the NHS of a resumption of deployments to acute trusts across London.”
On the four year delay to the delivery of CRS to trusts, the DH accepts more could be done. “It is true there is potential for greater clinical functionality to be deployed. For both Lorenzo and Millennium, full functionality is planned to be delivered in four releases.”
However, it rejects the PAC’s conclusion that, given the very limited progress on CRS at trust-level, the programme has failed to deliver value for money, and that trusts cannot be expected to take on the burden of deploying CRS systems that do not work effectively.
“The Department agrees with some of the principles behind this recommendation, in particular that trusts should not be expected to deploy care records systems that do not work effectively.
"However, it does not accept that the Programme is not providing value for money at present.” It says “many elements” of the programme have been delivered, pointing to PACS and Rio community systems.
The DH also rejects the PAC’s core recommendation that either CRS deployments improve appreciably within the very near future – the January report recommended a six month deadline be set.
“Although the Department does not agree the six-month timetable, it does agree that the position on the deployment of care records systems needs to improve appreciably over the coming months…”
A promise is made to publish an annual report on progress from the end of the 2009-10 financial year, though the PAC is offered a note on progress at the end of 2009.
Link
Treasury Minutes on the First to the Third Reports from the Committee of Public Accounts 2008-2009