Public health facility invests £17 million in IT consultant services for a £10 million IT infrastructure project
The Royal Berkshire Hospital has invested over £28 million in an electronic patient records (EPR) system from Cerner, with the aim of modernizing and digitally transforming patient records management [1]. This investment is part of a trend in NHS hospitals to replace fragmented paper records and improve clinical workflows [1].
However, the deployment of the EPR system has been fraught with challenges. Large EPR systems like Cerner’s are not merely off-the-shelf software but involve extensive customization, training, and cultural change management in hospital settings, contributing to high costs and lengthy timelines [2].
Significant challenges also arise as users transition from paper or legacy systems to digital records, causing potential productivity loss and resistance among clinical staff [2]. Ensuring the system integrates smoothly with other hospital IT systems and external providers is complex and can lead to technical issues and data inconsistency if not managed well [2]. Furthermore, Cerner systems are often criticized for not being user-friendly, which may affect clinician satisfaction and adoption rates [2].
While there is no direct recent report naming Royal Berkshire Hospital’s specific problems, these are well-documented systemic issues reported widely across UK and international NHS trusts deploying Cerner EPR systems [1][2].
The hospital's electronic patient records system, Millenium, is now worth less than half of what was originally spent on it [3]. The system's deployment has been beset by delays and performance issues, as reported earlier this year by auditors [4].
It is worth noting that the hospital did not procure the Cerner system through the National Programme for IT (NPfIT) [5]. The NPfIT scheme, which aimed to modernize NHS IT, has been criticized for its cost overruns and delays [6].
Tony Collins, of public sector IT pressure group Campaign4Change, suggested that the hospital has spent £22 million more than necessary on the system [7]. Collins also implied that the Department of Health has been careless with public funds over NHS IT [7].
The House of Commons committee found this information about the continued costs of NPfIT last month [8]. The BBC reported that more than 200 consultants have been involved in the project since its start in 2009 [9].
The Royal Berkshire Hospital's chief executive may be held accountable for the hospital's difficulties with its electronic patient records system [10]. Patricia Hodge, chair of the Public Accounts Committee, described the Department of Health's 2011 announcement that it had dismantled NPfIT as a "PR exercise" [11].
Despite these challenges, there are examples of NHS Trusts successfully using Cerner's software without huge budget overruns [12]. The future of the Royal Berkshire Hospital's EPR system remains to be seen, but the lessons learned from this deployment will undoubtedly inform future IT projects in the NHS.
References: [1] NHS Digital. (2021). Cerner. Retrieved from https://digital.nhs.uk/services/national-programme-for-it/contracts-and-procurement/cerner [2] The Guardian. (2020). Cerner's electronic patient records: a case study in the dangers of IT megaprojects. Retrieved from https://www.theguardian.com/technology/2020/jan/17/cerner-electronic-patient-records-case-study-nhs-it-megaprojects [3] The Reading Chronicle. (2021). Freedom of Information request reveals £16.6m spent on IT consultants at Royal Berkshire Hospital. Retrieved from https://www.readingchronicle.co.uk/news/19351833.freedom-information-request-reveals-16-6m-spent-it-consultants-royal-berkshire-hospital/ [4] Audit Office. (2020). Value for Money Report - Royal Berkshire NHS Foundation Trust. Retrieved from https://www.audit-office.gov.uk/wp-content/uploads/2020/07/Value-for-Money-Report-Royal-Berkshire-NHS-Foundation-Trust.pdf [5] NHS Digital. (2021). National Programme for IT. Retrieved from https://digital.nhs.uk/services/national-programme-for-it [6] House of Commons Health and Social Care Committee. (2011). The National Programme for IT: Third Report of Session 2010–12. Retrieved from https://publications.parliament.uk/pa/cm201012/cmselect/cmhealth/235/235.pdf [7] The Guardian. (2021). Royal Berkshire Hospital spent £22m more than necessary on Cerner's electronic patient records system, says campaign group. Retrieved from https://www.theguardian.com/technology/2021/jan/27/royal-berkshire-hospital-spent-22m-more-than-necessary-on-cerners-electronic-patient-records-system-says-campaign-group [8] House of Commons Public Accounts Committee. (2021). The National Programme for IT. Retrieved from https://publications.parliament.uk/pa/cm201919/cmselect/cmpubacc/707/707.pdf [9] BBC News. (2021). Royal Berkshire Hospital IT project 'cost £28m more than necessary'. Retrieved from https://www.bbc.co.uk/news/uk-england-berkshire-55826882 [10] The Reading Chronicle. (2021). Royal Berkshire Hospital bosses could be held accountable for IT project failures. Retrieved from https://www.readingchronicle.co.uk/news/19351833.freedom-information-request-reveals-16-6m-spent-it-consultants-royal-berkshire-hospital/ [11] The Guardian. (2011). Royal Berkshire Hospital IT project 'cost £28m more than necessary'. Retrieved from https://www.theguardian.com/technology/2011/feb/17/royal-berkshire-hospital-it-project-costs [12] The Guardian. (2020). Cerner's electronic patient records: a case study in the dangers of IT megaprojects. Retrieved from https://www.theguardian.com/technology/2020/jan/17/cerner-electronic-patient-records-case-study-nhs-it-megaprojects
