Royal Berkshire NHS Foundation Trust is planning to go live with Cerner Millennium this month.
The trust has confirmed the go-live despite the publication of board minutes that reveal concern about its financial position and the management of such a major project.
The financial concerns follow £5.5m of investment in Millennium, an IT outsourcing contract with CSC, and the new Bracknell Clinic, which provides treatment for cancer and renal patients.
According to minutes from the trust’s January board meeting, chief executive Edward Donald reported that the trust’s financial position for December was a £1.87m deficit for the month, which was £1.198m adverse to forecast.
The year to date position was a deficit of £3.27m which was £0.68m adverse to forecast. Donald told the board that significant investments – in Millennium, CSC and the Bracknell Clinic – had placed a “significant cost pressure” on the trust.
“The chief executive advised that, pre these investments, the surplus of the trust at the end of December was £2.22m versus a prior year deficit of £0.77m. This moved to a deficit of £3.27m after these investments,” the minutes say.
Royal Berkshire made a prominent departure from the National Programme for IT in the NHS in June 2009, when it announced that it had selected University of Pittsburgh Medical Centre as its preferred partner to deliver Millennium.
Subsequently, UPMC has had less involvement in the deployment, which EHI understands is being implemented mainly by Cerner and the trust.
EHI reported last month that the trust had been forced to delay its planned 26 March go-live while it resolved outstanding technical issues.
EHI was told by non-trust sources that there were also questions about whether Royal Berkshire’s £50m outsourcing deal with CSC covers the hosting of the new electronic patient record. But neither CSC nor the trust confirmed a problem with the hosting arrangement.
Sources have previously told EHI that there have been issues regarding ownership of the EPR programme within the trust, that few trust staff were involved, and that there had been an over-reliance on contractors.
In January, the board sought an assurance that the management arrangements for the project were clear and asked for details to be distributed to board members.
The chief executive advised the January meeting that when he had returned to the office, the director of finance was the lead for the project. However, given its scale, he would need to be the overall lead.
According to the local newspaper The Reading Chronicle, Donald resigned in early December following a clash with trust chairman Colin Maclean and a vote of no confidence.
However, a trust spokesman said he was on annual leave and he returned to work two weeks later.
The minutes say Dr John Swinburn – the lead on clinical aspects of the project – was willing to take on the role of associate medical director (Information), but had not yet been formally appointed.
Some members also commented that although it was clear that the chief executive was the sponsor, given the significance of the project, an EPR programme leader was required.