The footprint of Cheshire cannot achieve its regional electronic patient record goal without external funding, according its draft local digital roadmap.

Covering a largely rural area of north England, Cheshire’s LDR says the area needed an “enterprise wide EPR” to provide a single view of patients’ records across care settings, but needs external money to make it work.

The LDR also details that all acute provider organisations either now, or in the near future, need to replace their patient administration systems. Once again, this implementation cannot be achieved without additional cash.

Cheshire has a history of sharing information with the Cheshire Care Record going live last month. The Graphnet CareCentric software covers acute, primary, council, community, mental health and cancer data totalling 44 million clinical records.

What are the challenges facing the footprint?
The central, eastern and western areas of Cheshire contain 600,199 people, where there are significant levels of deprivation and an elderly population. The LDR’s biggest issue is money, as all its organisations are facing financial challenges. Four of the CCGs are planning a deficit, and all four providers are in deficit.

How much money is being spent on IT?
Digital Health Intelligence found a spread of IT spending among the four trusts in the footprint in 2014. Countess of Chester Hospital NHS Foundation Trust forked out the most by spending £5 million, and East Cheshire NHS Trust the least with just £1 million. 

What is on the footprint’s wish list?
Alongside its eye on a replacement EPR and PAS, Cheshire wants to try for an electronic document management system at Mid Cheshire NHS Trust in 2016/17, and the implementation of a clinical portal in 2017/18.

What is the digital maturity within the footprint?
All four trusts have Clinical Digital Maturity Index scores in the Digital Health Intelligence index, with the highest being the Cheshire and Wirral Partnership NHS Foundation Trust that scored 76 and ranked 12/56 for mental health trusts in April this year. The lowest was Mid Cheshire Hospitals NHS Foundation Trust that scored 57, and ranked 136/152 in May.

However, Mid Cheshire’s last CQC report in January rated the trust “good” and called its electronic handover tool “outstanding practice”. In December last year, a CQC inspection found Cheshire and Wirral Partnership was having “some difficulties with their current IT system”.

What systems are some of the bigger organisations using?
Countess of Chester uses a Meditech EPR and PAS, Mid Cheshire uses Silverlink ICS for its EPR and PAS, and Cheshire and Wirral usues Advanced CareNotes.

How will these plans work if no central funding is forthcoming?
It won’t. As with other draft LDRs that Digital Health News reviewed last month, the digital goals cannot be achieved without outside help. Cheshire specifically says the going paperless target will be compromised.

This is the second in a series of stories focusing on local digital roadmaps, the final versions of which will be released this year. To learn more about the Digital Maturity of organisations involved in the Cheshire LDR, visit Digital Health Intelligence (subscription / log-in required).

The main organisations in this LDR footprint include:
-* Two local authorities: Cheshire East Council and Cheshire West and Chester Council
* Trusts: Cheshire and Wirral Partnership NHS Foundation Trust (Mental Health), Countess of Chester Hospital NHS Foundation Trust (Acute), East Cheshire NHS Trust (Acute), Mid Cheshire Hospitals NHS Foundation Trust (Acute)
* CCGs: NHS Eastern Cheshire, NHS South Cheshire, NHS Vale Royal, NHS West Cheshire