Three of the seven trusts that were unable to provide waiting times data in time for its planned publication by NHS England last month linked the delay to the implementation of the Lorenzo electronic record system, a technology the Department of Health has paid trusts to adopt.
Derby Hospitals Foundation Trust said “the implementation of Lorenzo” had “hindered the production of referral to treatment and activity data”.
Walsall Healthcare Trust said its Lorenzo implementation had “impacted upon the trust’s ability to report accurate referral to treatment information”. Ipswich Hospital Trust also told HSJ its failure to report March data was linked to implementation of the patient administration system.
All three trusts introduced Lorenzo between February and March.
A fourth trust that failed to report 18 week waiting times data in March – Tameside Hospital Foundation Trust – blamed “data quality” issues.
However, Tameside’s April risk register awarded its Lorenzo project the highest possible risk rating – 25 – citing “potential risks to patient safety quality, information governance and performance trajectories”.
Tameside was the first trust to accept a sweetener payment from the DH to install the system when it introduced the Lorenzo system in October.
HSJ has also uncovered a series of other concerns recorded in recent months by the trusts using the system or with their commissioners.
Walsall’s May board meeting discussed a paper which said it had been forced to “recruit 25 additional staff” to address “a number of issues [which] have arisen as Lorenzo moves to business as usual”. These issues included “backlogs, clinic restructuring and un-outcomed outpatient clinic forms”.
Hull and East Yorkshire Hospitals Trust’s May risk register said its plan to deploy Lorenzo might be “unrealistic”, and that it had “insufficient capacity and insufficient funding” to support the project.
HSJ’s findings come a year after public accounts committee chair Margaret Hodge branded the system “completely useless” and described the £600m the DH set aside to pay trusts to deploy the system as “bribes”.
A spokesperson for CSC, the company behind the Lorenzo system, admitted that some trusts had experienced “bedding in” issues but that these were “inevitable and expected” when implementing large business change programmes, like new record systems.
“The challenges encountered relate to the transition of working methods from the old patient administration systems, and the migration of related unstructured and potentially inaccurate data to the real-time Lorenzo environment, which will provide far more accurate and timely clinical and administrative data,” they added.
“We have worked closely with each of the trusts before, during and after the ‘go live’ of the new systems to anticipate, identify and address any problems.”
Joe McDonald, a senior NHS IT figure who had previously criticised Lorenzo, backed the company’s claim that progress had been made by some trusts which used the system.
Mr McDonald, chair of the Chief Clinical Information Officers Leaders Network said that evidence from the “early adopter” Lorenzo trusts from as a far back as 2010 was encouraging.
“Finally after, admittedly a lot of time and DH money, there are very encouraging signs that the system is delivering,” he said.
Mr McDonald said he had changed his opinion after attending CSC user group meetings in recent months.