Nine-month delay for 'common solution' IT implementation

Delivery of the 'common solution', the standardised clinical IT system being developed for London and the south of England, will be delayed by at least nine months. The delay is the latest to affect the national programme for IT, following problems with the delivery of choose and book and the NHS 'data spine'. Originally due by this October, the 'common solution', which will eventually deliver a fully integrated patient records system, now looks unlikely to be available until June 2006 at the earliest.
Trusts that had been planning to implement the new system from this autumn were suddenly informed of the delay only two weeks ago. An e-mail, seen by HSJ, from Thames Valley strategic health authority chief information officer Mike Part, describes the delay as 'extremely bad news'.
The e-mail goes on to state: 'The earliest possible go live date for this release now appears to be the middle of June 2006. This date is well outside the window that had previously been signalled'.
An national IT programme spokesperson confirmed that some systems for London and the South 'may now be delayed from autumn 2005 to late spring 2006'. He said the delays had arisen because consultation with clinicians had 'identified the need for additional testing to be carried out and therefore dates for deployment are being reviewed'.
One hospital IT director told HSJ: 'We had been planning to go in October 2005, but now won't be going until June 2006 at the earliest.' He said the delay would 'have a huge impact on clinical support'.
Surrey and Sussex SHA chief information officer Tad Matus said the IT plans of three trusts in the area, due to have gone live by late spring 2005, would be delayed. Mr Matus said new deployment dates were being worked on. 'The issue is that if we concertina up timings we can't all go live at the same time.'
The delays affect the Carecast clinical system being provided by US-based IDX Systems as a standardised 'common solution' for London and the south of England. The system development is being managed by BT, but will be implemented in the south by Fujitsu Services.
This 'common solution' is meant to be delivered in five progressively more advanced software 'releases' leading to a fully integrated electronic patient records system. It is the second of these releases that has been delayed.
Only at this stage will the system move beyond basic patient administration and provide new clinical tools, beginning with order communications, which enables hospital doctors to electronically order tests and receive results.

http://www.hsj.co.uk/nav?page=hsj.news.story&resource=1990648

Ten government IT projects hit 'red light' status

Whitehall has revealed some details of its 10 most 'at-risk' IT projects, following a Freedom of Information request. The Office of Government Commerce (OGC) has released details of IT projects found to be most at risk across Whitehall, but is keeping the projects' identities secret.
The OGC has listed 10 IT projects to receive consecutive red lights under its Gateway Review process which checks for signs of failure during an initiative's development.
In response to a Freedom of Information request submitted by Government Computing News, the OGC revealed that over the last three months, two IT projects have received consecutive red lights. However, it would not give details of their identities.
The two projects are in addition to eight IT initiatives revealed by the National Audit Office in November last year to have received consecutive red lights. The 10 represent IT projects which the OGC is most concerned about. According to the OGC's official guidance, a red signifies that "remedial action" must be taken immediately - although it does not necessarily mean that a project must be stopped.
The OGC revealed the stages at which the projects had received a second red. One project received two reds at 'gate zero', while the others were given between gates one and four. Gate zero is the initial sanity check for a project. It assesses the funding, leadership and purpose of an initiative.
Two initiatives failed at gate four, which means they were unready for service after earlier stages of development.
The OGC refused to release further details as it judged the "public interest in disclosure was significantly outweighed by the public interest in non-disclosure".
In justifying its decision to withhold information, the OGC said: "An important general consideration in the balancing exercise was the clear public interest in maintaining the integrity of the Gateway Process as an effective and prompt peer review process producing reports based on candid interviews for the benefit of Senior Responsible Owners and which has led to demonstrable VFM [value for money] gains.
"Gate interviewees must be able to be candid about matters which could lead to serious recommendations being made to the Senior Responsible Owner of the projects/programmes. This would particularly be the case with the recommendations and RAG [red, amber, green] statuses that you have requested."

http://management.silicon.com/government/0,39024677,39128275,00.htm

MPs told prescribers plans may jeopardise patient choice

Pharmacist representatives have told MPs that plans to allow GPs and other prescribers to nominate a patient’s pharmacy for electronic transmission of prescriptions (ETP) will jeopardise patient choice.
The Pharmaceutical Services Negotiating Committee (PSNC) is lobbying the Department of Health and the National Programme for IT (NPfIT) to change the system so that choice of pharmacy lies solely with patients. Lindsay McClure, head of information services for the PSNC, told an All Party Pharmacy Group meeting on NPfIT last week that patients should continue to have the choice of which pharmacy to have their prescriptions dispensed at and not have that decision made for them.
She told EHI Primary Care: “We do have concern that prescriber nomination of a patient’s pharmacy will lead to direction of prescriptions rather than patients having a genuine choice. We don’t believe any prescribers, including GPs, nurses or pharmacist prescribers, should be able to nominate a pharmacy and if that does go ahead there needs to be systems in place to prevent abuse.”
Current plans for ETP, which began implementation at one early adopter site this week, are that patients will eventually be able to nominate a pharmacy via the internet, in their GP surgery or at their pharmacy. Those who do not wish to nominate a preferred pharmacy will be given an ‘e-prescription token’ – currently a prescription with a barcode – that can be presented at any pharmacy for the prescription to be dispensed.
An NPfIT spokesperson told EHI Primary Care that prescribers will also be able to nominate pharmacies. He added: “The ETP model supports the nomination of pharmacies by prescribers. The process surrounding nomination has yet to be defined and is currently under discussion with both GP and pharmacy user groups.”
McClure told the All Party Pharmacy Group meeting that the PSNC was also concerned that during the roll- out of ETP a level playing field was maintained between ETP-enabled and non-ETP-enabled practices.
Later she told EHI Primary Care: “There is a risk there but we have been talking to the National Programme about this and we do feel slightly more positive about that.”
McClure also told MPs that NPfIT needed to improve clinical engagement with pharmacists and called for the programme to appoint a national clinical lead for pharmacy.
She added: “ETP itself is only the tip of the iceberg of what the National Programme can offer pharmacies. The NHS Care Records Service and access to patient information has the potential to realise many more benefits for the profession.”
She said the PSNC was expecting the Department of Health to consult shortly on community pharmacy access to patient records.
Harry Cayton, chair of the Care Record Development Board, also spoke at the All Party Pharmacy group meeting. He told MPs that the Care Record Guarantee is currently awaiting ministerial approval. This will lay down a framework for how records will be created and shared, how they will be used, how consent will be obtained and confidentiality achieved.
The All Party Pharmacy group is writing a report to ministers following the meeting which it expects to finalise by the end of the week. A spokesman for APPG said the report is likely to share concerns expressed at the meeting about the implications of prescribers being able to nominate pharmacies.
He added: “A system in which electronic scrips are sent to a central point for pharmacies then to pull down would maintain patient choice and avoid the potential problems associated with nomination.”
The report will also back calls for a national clinical lead for pharmacy. A spokesperson for NPfIT said the appointment of a clinical lead for pharmacists was currently being considered.

http://www.e-health-insider.com/news/item.cfm?ID=1069

Hundreds of babies hit by MRSA hospital superbug

HUNDREDS of babies, many just a few days old, have been infected with the deadly superbug MRSA in hospitals across Britain. A study by the Patients Association has found that it is now commonplace for babies aged from a few days to four weeks to catch MRSA.
The Department of Health is so concerned about the increased number of cases of babies with MRSA — methicillin-resistant staphylococcus aureus — that it has commissioned a £140,000 study into the problem.
Some babies have caught the infection from their mothers but others have picked it up in neonatal units. The trend has surprised health experts because neonatal units are considered to be the cleanest wards in a hospital.
Professor Hugh Pennington of Aberdeen University, a microbiologist and expert in hospital-acquired infection, said: “If babies are getting MRSA, that is of concern because it shows there is something seriously wrong with the infection control procedures.”
He said it was likely the infection had been carried into the neonatal units by people walking from ward to ward. “If we had been more aggressive in tackling the problem, like the Dutch and the Scandinavians, this would not have happened.”
Hospitals in the survey refused to say whether any babies had died from the bug, citing patient confidentiality.
Babies who catch MRSA from their mothers carry the bug from the moment they are born. This only puts them at risk, however, if the MRSA gets into a wound or the bloodstream.
But hospitals questioned by the Patients Association have disclosed that babies are being infected with wound and bloodstream infections while being treated on neonatal units. A baby being cared for by Portsmouth Hospitals NHS Trust was found to have MRSA at just eight days old. In the past three years the trust said 38 babies aged under four weeks had been found to have MRSA while being treated by the trust.
At the University Hospital of North Staffordshire NHS Trust, the youngest baby found to have MRSA in the bloodstream was 19 days old. Over the past three years two other babies of less than four weeks had contracted MRSA in their bloodstreams while being treated.
The picture is similar in hospitals across England. Eastbourne District General hospital admitted it had to close its baby unit for a week last year because five babies were carrying MRSA.
The Patients Association questioned the 30 NHS hospitals with the worst MRSA records to gather information for its Clean Hospital Summit due in April. The conference is being chaired by Claire Rayner, the association’s president, who herself became infected with MRSA during a routine operation at an NHS hospital.
Katherine Murphy, communications director of the association, said: “We would not previously have contemplated that babies being treated in neonatal units, which we think of as being scrupulously clean, could be infected with MRSA.
Dr Mike Sharland, a paediatric infectious disease consultant at St George’s hospital in south London, where six babies aged less than a year old have caught MRSA in the past year, said the NHS accepted that infant infections were a growing problem.
Earlier this month it emerged that a boy aged three who banged his head in a playground accident died five weeks later after picking up the MRSA superbug in hospital.
The number of people dying from MRSA has doubled in the past five years from 487 to 955, according to the Office for National Statistics. Experts believe the actual number is much higher as MRSA is not always mentioned on death certificates. The National Audit Office has estimated 5,000 deaths a year from hospital-acquired infections.

Review of Mental Health Bill after knife killing

John Reid, the Secretary of State for Health, has ordered a review of proposed changes to the law covering mental patients after the case of John Barrett, the paranoid schizophrenic who released himself from care and stabbed a banker to death in a London park.
Changes to the draft Mental Health Bill could be introduced to give doctors greater powers to detain patients such as Barrett who volunteer for treatment for mental illness and then discharge themselves.
The case raised far-reaching questions, reported in The Independent on Saturday, about whether the care in the community system for treating mentally ill patients was working, and whether it needed a fundamental overhaul.
Mr Reid revealed yesterday that he was asking the same far-reaching questions. A routine "local" inquiry has been ordered by health officials into alleged failures by doctors to pick up the warning signs before Barrett, 42, discharged himself and stabbed Denis Finnegan, 50, as he cycled through Richmond Park last September.
Mr Reid has also ordered his officials to review the national implications for care in the community after Barrett pleaded guilty to manslaughter in court on Friday on grounds of diminished responsibility.
"I don't want to prejudge this, but some of the matters relating to this that I have read about are worrying," he said on BBC1's The Politics Show.
"I have asked for an urgent report to be compiled. I want the local strategic health authority to carry out an independent inquiry, not only into the local implications but some of the national implications. On face value there are difficult questions that have to be asked."
The Independent has learnt that Mr Reid will focus on the limited powers of doctors to detain voluntary patients. He is keen to strengthen those powers if the review of the Barrett case recommends it.
The case goes to the heart of the problems encountered by the Government with its Mental Health Bill, which ran into enormous opposition from mental health groups when it was unveiled in 2002. The Bill tried to close a loophole in the law which the former home secretary Jack Straw believed had led to the release of Michael Stone before he killed Lin Russell and her daughter Megan in a hammer attack in Kent in 1996. Stone was left free to commit the murder because his severe personality disorder was considered untreatable. It was estimated there were more than 600 similar, dangerous cases in Britain and the first draft of the Bill proposed new powers to detain such people. But the proposals were watered down after an outcry from mental health professionals, charities and patients.
A government source said yesterday the difficulty remained over the need to strike the right balance between protecting the public and caring for the patient. The Bill is still in draft form, and changes resulting from the Barrett case could be introduced after the election.
Despite Barrett's long history of mental illness and his violent past, doctors at Springfield Hospital in Tooting, south London, had no power to keep him against his will and he was allowed to wander the hospital complex unescorted. Instead, he walked out and the following day stabbed Mr Finnegan to death.

http://news.independent.co.uk/uk/health_medical/story.jsp?story=615452