‘Flawed’ patient record system led to crisis on jubilee weekend

The electronic patient record system, which had taken four years to develop, went live at Rotherham’s hospital over the Queen’s jubilee weekend in June 2012 but rapidly developed serious problems, forcing its suspension.

The problems meant around 5,000 fewer outpatient appointments were booked than expected between June and August 2012, leaving the trust £1.4 million out of pocket, while significant numbers of patients also turned up for clinics unexpectedly and the crucial two-week target for cancer treatment was compromised.

Efforts to make the system work will leave taxpayers with a bill for at least £40m - £10m more than expected.

A report in May last year by internal auditors PwC into a deal between US firm Meditech and bosses at the Rotherham NHS Foundation Trust found it did not include specific targets for the delivery of the system designed to improve patient services. There were penalty clauses but these were “vague and non-specific so difficult to enact”, with no definition of what failure meant. It said it was also unrealistic to implement the system, which had never before been deployed in the NHS or the UK, within 18 months.

It said: “The scale and size of the project and the delivery time required appears to have been grossly underestimated by the trust. We noted that a very ambitious project timescale was proposed given the level of configuration, customisation and process redevelopment that was identified from the beginning.”

It said that “throughout the project there does not appear to be any detailed financial management”, while “many of the expected savings identified in the original business case cannot ever be achieved and operating costs across the whole clinical systems infrastructure may have increased overall”. Testing of the system was described by staff as “abysmal”.

Following Press interest in the project and growing staff disengagement, it was felt pressure was applied to make sure the system would go live in June 2012 on the bank holiday weekend when it was believed the hospital would be quieter “regardless of the risks and issues still outstanding”. The trust decided to go for a “big bang” and assumed it would be business as usual within two weeks.

But problems experienced with the system meant A&E had to revert back to its existing system within hours.

“There did not appear to be any contingency plans in place for go live and just after go live a number of key people went on leave and or were not available during a critical period,” the report said.

“The scale of issues in this implementation was not properly understood by those with responsibility, and as a result they were not in a position to make sound decisions.”