Bellamy learns from Royal Free

Tags: Cerner CfH Connelly Informatics London Millennium

01 May 2009

Martin Bellamy has said that lessons learned at the Royal Free Hampstead NHS Trust will inform future system deployments under the National Programme for IT in the NHS.

The head of NHS Connecting for Health and director of programme and systems delivery described the acute sector as the “Achilles heel of the national programme.”

However, he told the Healthcare Computing conference in Harrogate: “We’re on the way, we just need to work together and we need to work faster.”

The Royal Free was plunged into a financial crisis when it went live with Cerner Millennium last year. The problems at the trust and at Barts and the London NHS Trust were so bad that further deployments of the care records service were halted across the capital.

A programme of remedial work was put in place at the Royal Free, and trusts due to take the CRS are now being told to “re-engage” with the programme.

At the conference, director general of informatics Christine Connelly indicated that a measure of the “substantial progress” she expected suppliers to make before November would be to see Millennium deployed in another acute hospital.

Bellamy said: “It’s perfectly acceptable to capture low points that we have had, but unforgiveable if we’re not acting on those and changing our approach.

“What we have learned is the importance of genuine engagement with clinicians and managers, particularly at a senior level and making sure that the organisation is stable and ready to go through a significant change.”

Bellamy highlighted that before a system goes live it is crucial to “check, check and check again” that everything is in place. He referred not just to the components of a system but to everything needed at a whole system level.

The head of CfH also acknowledged that it was essential for “vigorous documented criteria where it can be assessed whether a trust ready to go or not and be prepared to delay the go-live if they are not satisfactorily met.”

Bellamy said that the new systems required a significant change in working, which needed to be supported intensely for at least a period of four months from the initial deployment.

He also stressed the importance of ensuring that staff training is carried out on a system identical to the live system, something that did not happen at the Royal Free and which was initially blamed for many of its problems.

Heather O’Brien, IT director at the Royal Free said: “We had to train over 3,000 staff on a generic database and not on a copy of the real system, so it was a real shock to staff. It’s no secret that we had many problems, using a real-time system was a complete cultural change.”

Last week E-Health Insider spoke to Jeff Townsend, Cerner’s vice president of research and development, who said much had been learned and changed as a result of the failures at the Royal Free, and a more flexible implementation approach would be used.

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Reader's Comments

Clearly not!

01 May 09 22:05

nuff said

revised headline

05 May 09 08:05

everywhere that CFH have put this system in (as opposed to Trusts who seem to manage it fine) it has been an unmitigated disaster - NOC, Worthing, Barts, Royal Free all telling the same story. And yet here we are plowing on regardless. So a rather better headline would be:

"Bellamy fails to learn from Royal Free"

Training

05 May 09 11:05

Quote from Martin Bellamy.......

..........and yet CSC and CfH have apparently signed a contract to provide a generic training environment!!

Do they never learn/listen?

Cerner a success

06 May 09 09:05

This system is in operation throughout the world; only in the UK have we cocked it up - why?

No one listening???

07 May 09 16:05

In response to the previous comment - "we cocked it up?"

The reason is because the UK Healthcare model is very different from the rest of the world......and the streets strewn with examples of "anglicising" software which was designed from the bottom up to serve a different business model (and always fails).

Achilles Heel!

tony.ive@optimize-roster.co.uk

08 May 09 09:05

The acute sector is the "Achilles heel of the national programme"? That's like saying the heart is the Achilles heel! You might as well say "Delivering systems is the Achilles heel of Connecting for Health" or "Providing healthcare is the Achilles heel of the NHS".

Lessons not learned

08 May 09 22:05

Achilles heel. Hmmn, I can remember about 3 years ago getting very cross that the Southern contract only had one generic training environment, not allowing users to experience the same configuration that they would have for live. Something we specified in our procurements 15 years ago.

Learning the lessons is something NPfIT has proved oblivious to. Going faster and drowning everyone in extra paperwork will not help much either.

But I have always said (strongly through these pages, since there was no-one listening at the centre for a long time) that this was a doomed approach to progressing electronic practice. Which is a great shame as I am a strong advocate of doing it at a pace and in a manner that Clinicians are hungry for.