England's chief inspector of hospitals has recommended Walsall Healthcare NHS Trust be placed into special measures, highlighting issues with its electronic patient record as an area for improvement.

The Care Quality Commission has rated the trust as inadequate overall, following inspections in September, which found problems with staffing, workload and incident reporting.

One of the key areas of improvement highlighted by the commission is use of the trust’s EPR, which is supplied by CSC.

The CQC report says the trust is still seeing the effects of implementing Lorenzo 18 months ago, in March 2014.

During inspections, the trust described a “perfect storm” in 2014 as a result of “significant increases in emergency and obstetric activity and problems following the replacement of the patient administration system”.

The CQC says the trust missed opportunities to monitor, identify and manage risks associated with implementing the EPR because the executive board decided not to discuss the risks at the Quality and Safety forum, but instead saw it as a finance and performance issue.

While improvements have been made: “the trust was still struggling with simple tasks (e.g. making patient appointments) as well as experiencing difficulties in gathering accurate information for decision making and performance management”, the report says.

The CQC recommends the patient administration system be reviewed to minimise problems associated with missed patient appointments and says that its data needs to be accurate.

The CQC’s chief inspector of hospitals, Professor Sir Mike Richards, said: “We found a number of serious problems when we inspected the services run by Walsall Healthcare NHS Trust and I have made a recommendation to the Trust Development Authority that the trust should be placed into special measures.  

“We made the TDA aware of our concerns following the inspection and it has started to work with the trust to make sure these are appropriately addressed and that progress is monitored. “  

Walsall was the first combined acute and community trust to deploy Lorenzo.

On deployment, it encountered significant issues with data quality, reporting and backlog and admitted in October of that year that work to stabilise the system “has proved far more challenging than first thought”.