Bellamy learns from Royal Free

  • 1 May 2009

Martin Bellamy has said that lessons learned at the Royal Free Hampstead NHS Trust will inform future system deployments under the National Programme for IT in the NHS.

The head of NHS Connecting for Health and director of programme and systems delivery described the acute sector as the “Achilles heel of the national programme.”

However, he told the Healthcare Computing conference in Harrogate: “We’re on the way, we just need to work together and we need to work faster.”

The Royal Free was plunged into a financial crisis when it went live with Cerner Millennium last year. The problems at the trust and at Barts and the London NHS Trust were so bad that further deployments of the care records service were halted across the capital.

A programme of remedial work was put in place at the Royal Free, and trusts due to take the CRS are now being told to “re-engage” with the programme.

At the conference, director general of informatics Christine Connelly indicated that a measure of the “substantial progress” she expected suppliers to make before November would be to see Millennium deployed in another acute hospital.

Bellamy said: “It’s perfectly acceptable to capture low points that we have had, but unforgiveable if we’re not acting on those and changing our approach.

“What we have learned is the importance of genuine engagement with clinicians and managers, particularly at a senior level and making sure that the organisation is stable and ready to go through a significant change.”

Bellamy highlighted that before a system goes live it is crucial to “check, check and check again” that everything is in place. He referred not just to the components of a system but to everything needed at a whole system level.

The head of CfH also acknowledged that it was essential for “vigorous documented criteria where it can be assessed whether a trust ready to go or not and be prepared to delay the go-live if they are not satisfactorily met.”

Bellamy said that the new systems required a significant change in working, which needed to be supported intensely for at least a period of four months from the initial deployment.

He also stressed the importance of ensuring that staff training is carried out on a system identical to the live system, something that did not happen at the Royal Free and which was initially blamed for many of its problems.

Heather O’Brien, IT director at the Royal Free said: “We had to train over 3,000 staff on a generic database and not on a copy of the real system, so it was a real shock to staff. It’s no secret that we had many problems, using a real-time system was a complete cultural change.”

Last week E-Health Insider spoke to Jeff Townsend, Cerner’s vice president of research and development, who said much had been learned and changed as a result of the failures at the Royal Free, and a more flexible implementation approach would be used.

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