Moves to upgrade NHS organisations in London to the latest NHS Spine-connected version of the RiO community and mental health system have been suspended after a series of performance problems.

The problems are occuring at all the London trusts to have received the latest version of the software. Twelve of the 31 trusts in the capital using RiO have so far switched to version 5.1. Further implementations have been put on hold.

Problems began in April and continued into May, with a software patch provided on 22 April by BT, the London local service provider, now being evaluated.

Version 5.1 of the well regarded RiO system is the first BT-provided version of the software to connect to the full NHS Spine infrastructure.

The upgrade introduces smartcard authentication for the first time, requiring staff to use the NHS smartcard to access the system.

Implementations took longer than expected and were eventually suspended after leading to performance problems, including slow response times and data not being saved by the system.

Asked to elaborate, a London Programme for IT spokesperson said: “In this case perormance has been intermittently slow."

As a result of the difficulties, at least one trust has had to resort to using paper-based data collection. Following the upgrade, clinicians at West London Mental Health NHS Trust found “some entries to care plans and progress notes not being saved."

Problems reported by the trust include: being unable to synchronise with the NHS Spine; RiO running very slowly; clinicians not having full access to key functionality; and difficulties with smartcard access in some areas.

CSE Healthcare Systems, the firm behind RiO, referred queries back to BT and LPfIT. In a statement to E-Health Insider BT said: “There have been intermittent performance issues with RiO in London. The system is available but at certain times of the day performance is degraded. BT is working closely with its partners and LPfIT to resolve the issue.”

LPfIT acknowledged the problems, and said in a statement: “Some trusts are experiencing problems with the performance of RiO version 5.1 – these problems are not untypical with an upgrade of this type. BT and LPfIT are focussing effort on resolving this issue as soon as possible and trusts have already seen substantial improvement.”

LPfIT added a decision had been taken to suspend implementations for two weeks: “Our priority is ensuring that performance is not exacerbated by introducing new trusts to the system and, in consultation with trusts, we have made the decision to take a two-week pause in the programme of upgrading trusts from RiO 4.7 to RiO 5.1. Trusts using version 4.7 remain unaffected.”

Board papers from West London Mental Health NHS Trust state problems identified partly resulted from the failure of a tool developed to merge trust users with the National Spine but “these issues have been largely remedied by BT."

The papers add: “Five technical issues were identified, three of which were addressed by a patch (programme change) applied by BT over the weekend of 11-12 April. A further patch will be applied to RiO V5 in early May which should address the outstanding issues.”

LPfIT described the RiO community and mental health system RiO as “very successful”and added: “We are currently upgrading London trusts to the latest version, version 5.1, which provides compatibility with national infrastructure and provides the benefits of enhanced security and data quality.”

The twelve NHS trusts to have received to RiO upgrade are: Barking and Dagenham PCT; Barnet PCT; Bexley PCT; Camden PCT; City and Hackney Teaching PCT; Hammersmith and Fulham PCT; Islington PCT; Kingston PCT: Southwark PCT; Waltham Forrest PCT; Camden and Islington NHS Foundation Trust; West London Mental Health NHS Trust.

BT was last month awarded a contract extension to install RiO at another 25 sites in the South.