• Royal United Hospital Bath Foundation Trust’s emergency department performance plummeted after deploying new IT system
  • Performance has yet to recover but trust says impact ”minimal”
  • Trust reports three black alerts in the past week

A trust has reported three black alerts in the past week, after a new IT system contributed to delays in its emergency department.

Royal United Hospital Bath Foundation Trust upgraded the electronic patient record in its emergency department on 7 November, along with new IT systems for pathology, radiology, and prescribing and medicine administration.

A plan to correct the trust’s deteriorating performance against the four hour target, presented to the board on 20 December, said deploying the new system had a “negative impact” on urgent care performance, disrupting early flow, time to assessment and time to treatment.

”The emergency department achieve time to assessment in November was not met, due to the impact of the Big 3 implementation and additional time taken to complete tasks involving IT,” it said.

Other factors in the poor performance included high delays in transfers of care and bed closures due to infection.

In response to questions from HSJ, a trust spokesman said the impact of the new IT system had been “minimal” and the trust had still met quality standards for access and time to treatment.

However, trust figures show performance against the four hour target dropped from more than 90 per cent to below 75 per cent in the week the new system was deployed and has not substantially recovered.

The trust’s performance against the four hour target in December was 76.9 per cent (72.3 per cent for type one admissions) – substantially below the 95 per cent target.

Since then, the trust has also declared three “black alerts” in the past week, most recently on Monday.

“Like other trusts in the region we are experiencing a period of sustained pressure following the Christmas and new year period,” the spokesman said.

He also defended the decision to deploy a new IT system in the emergency department heading into what was expected to be a particularly difficult winter.

“The process and timings were agreed and overseen by an EPR [electronic patient record] programme board which included clinical staff, led by an executive director. The trust anticipated an impact on performance whilst the changes are embedded across the organisation. This was planned for and additional capacity put in place to support deployment,” he added.

The deployment was part of the “Big 3” project to expand the trust’s electronic patient record, Cerner Millennium, into parts of the hospital using other clinical IT systems.