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North Bristol Trust

North Bristol Trust management criticised over new IT system

North Bristol Trust’s management failed to recognise the scale of change involved in switching to a new patient record system, leading to months of chaos in theatres and outpatients, an independent review has found.

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PricewaterhouseCoopers was asked to examine the introduction of Cerner’s Millennium electronic patient record system at the trust in last December following ongoing issues with data quality.

Implementation in the emergency department and on the wards, which did not require migration of data from the previous system to Millennium, was largely successful. However, problems arose in theatres and outpatients leading to many patients being sent letters with the wrong dates and times for appointments.

PwC found staff in outpatients and theatres were not fully engaged in the change and the system had not undergone detailed testing of how it would work in these environments.

The reviewers criticised the trust for treating the move to the new system as an IT project and not a “business change programme”. They said other trusts that had implemented Millennium as part of the National Programme for IT project in the South of England had not experienced similar difficulties.

The review also spoke to external stakeholders who felt their advice and offers of help had been ignored.

The report concluded: “For a project of this scale and complexity the management arrangements were not sufficiently extensive or robust… The scale of the issues in this implementation was not properly understood by those with responsibility, and as a result they were not in a position to make sound decisions.”

A separate report on the trust’s performance presented to the Bristol, North Somerset and South Gloucestershire primary care trust cluster’s June meeting said a “significant amount of staff time” was being taken up with manual validation of data.

It added that the situation made predictive modelling “difficult”. Commissioners therefore were unsure that the trust was on course to address its current failure to hit the 18-week referral to treatment target on trauma, orthopaedics and neurosurgery.

The trust has spent £4.6m of its reserves on additional software and support for frontline staff.

Trust chief executive Marie-Noelle Orzel accepted the findings but insisted the system was now working correctly.

“As a result of this review, the trust has now set up a programme management office which operates independently and will rigorously challenge the management of all our projects,” she said.

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