• CCG raises concerns about issues with IT system Lorenzo at Mid Essex hospital
  • Trust has not reported elective waiting time data since December 2017
  • Trust pledges to be back on track “later this year”

Commissioners have raised concerns about a hospital trust which has failed to report basic waiting time data for almost two years after it went live with a controversial government-subsidised patient records system.

Mid Essex Clinical Commissioning Group said problems with the Lorenzo system had impacted on Mid Essex Hospital Services Trust’s “ability to produce accurate and timely data and… meet local and national reporting requirements”.

The hospital, which went live with the system in May 2017, was one of several trusts which took the controversial system as part of a deal brokered to help the NHS extricate itself from the National Programme for IT (See box: Lorenzo and the NHS).

Mid Essex has failed to report its 18-week referral to treatment data since December 2017, making it one of just a handful of trusts which routinely fails to report on the statutory target.

The CCG’s 2018-19 annual report added: “MEHT [was] given permission to pause some elements of national reporting to give [it] the opportunity to resolve data recording issues.

“This arrangement is still in place and continues to adversely affect the CCG’s ability to effectively plan for activity and achieve NHS constitutional standards.

“The Lorenzo system continues to be highlighted on the [sustainability and transformation partnership] joint committee’s risk register, although the risk rating has reduced as a result of a significant amount of work undertaken.”

The trust acknowledged the problems. It told HSJ it was holding weekly meetings with regulators and staff were receiving “refresher” training as part of efforts to ensure the trust would be reporting RTT data “later this year”.

A trust statement added: “Issues with information in some of our data fields was highlighted within Lorenzo and we have been working closely with the 18-week intensive support team, supported by joint weekly meetings, to ensure the data is scrupulously checked and validated.”

DXC Technology, which owns the Lorenzo system, however said there were “no software issues”. The company declined to explain what was the causing the problem.

It said in a statement: “DXC Technology is working with [the trust] to enable this technology-supported process. It is important to note that there are no software issues with Lorenzo that are preventing the trust from national reporting of RTT information.”

The Lorenzo system was originally purchased centrally by the government as part of the NPfIT.

It faced significant criticism once trusts began deploying the system, which changed ownership in April 2017 following a merger between its developer CSC and HPE Enterprise Service to create DXC Technology.

Trusts were given additional central funding to deploy and support the system under the deal. Then Commons public accounts committee chair Dame Margaret Hodge described the payments as “bribes” designed to make trusts buy a “hopeless system” when news of the deal emerged in 2013.

Lorenzo and the NHS

CSC, which has since become DXC, was granted exclusive rights to supply systems, including Lorenzo, to 160 trusts in the North, Midlands and East in a deal worth £3.8bn in 2012 prices under NPfIT.

However, after development problems and disruptive deployments, Lorenzo was only deployed in a handful of trusts.

As part of extricating the NHS from NPfIT, the DHSC and CSC reached a deal in 2013 where trusts could pick other IT systems but would receive additional central funding if they picked Lorenzo.

The majority of the 21 trusts that run Lorenzo were funded under this arrangement. The DHSC continues to spend tens of millions of pounds a year on NPfIT “legacy contracts”, such as the 2013 agreement with CSC.

System leaders, however, believe they can still develop the system to be among the best in the NHS. The latest central programme to try and get the system to work in a more optimal fashion is the Lorenzo digital exemplar programme.

As revealed by HSJ in May 2018, DXC Technology has been handed about £10m to support deployments at four trusts: Royal Papworth Hospital Foundation Trust; Hull and East Yorkshire Hospitals Trust; North Staffordshire Combined Healthcare Trust; and Warrington and Halton Hospitals FT.

Over the next two to three years, the four organisations will be expected to use the extra DXC support to become some of the most digitally mature trusts in the country and demonstrate how Lorenzo can be used to drive down costs and care variation, and improve efficiency.

UPDATED: This piece was updated to include a statement from DXC Technology, which owns Lorenzo, at 15:05 on 10 July. The statement was issued to HSJ after publication of the original piece.