Problems with the implementation of new patient administration systems at Bristol’s acute trusts are threatening the delivery of QIPP plans in the Bristol, North Somerset and South Gloucestershire cluster.

The cluster is aiming to save £11.7m on elective care by 2015, a quarter of its total QIPP target for the period.

However, the strategic health authority has given this workstream an “amber” rating due to delays in getting on top of the 18-week waiting time backlog in the city. This backlog came about in the wake of difficulties in implementing Cerner’s Millennium patient administration system at North Bristol Trust and the introduction of System C’s Medway software at University Hospitals Bristol Foundation Trust.

The management of North Bristol Trust was heavily criticised in a review of the implementation process by PricewaterhouseCoopers earlier this year.

A cluster spokeswoman said the amber rating had been an early “heads up” of potential problems but these had not materialised. “We are on track to meet our QIPP targets,” she added.

The elective workstream also included plans to save money by rolling out a triaging system for GP referrals for pain management. However, an audit of the existing service found 99 per cent of referrals were appropriate. In total, four out of five of the cluster’s “QIPP initiatives” were rated “amber”.

Elsewhere in the south, the South East Coast strategic health authority area was the most consistent regional performer in England.

The Kent and Medway, Surrey, and Sussex PCT clusters between them have savings plans on track worth £452m. Only one workstream in that region, worth £13.2m, was rated “amber”.

In the South Central region, performance was more mixed. One QIPP programme was “red” rated. It seeks to save £8.8m by cutting the level of delayed transfers of care in Oxfordshire.

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Local schemes fall behind in NHS’s drive for efficiency