PwC to review North Bristol's go-live

North Bristol NHS Trust has commissioned PricewaterhouseCoopers to conduct an independent review of the issues, including clinical incidents and missed appointments, that followed the December implementation of Cerner Millennium.

EHealth Insider reported last month that trust chief executive Ruth Brunt had called for a review into what went wrong following the go-live of the electronic patient record system at the end of 2011.

The trust told EHI on that PricewaterhouseCoopers would carry out the review and that terms of reference were being finalised.

A spokesperson said the outcome of the review would be “published in due course” and the trust could not make further comment until its conclusion. The process was expected to take “several weeks”.

The trust experienced the most significant problems post go-live in outpatients. This was caused by the incorrect configuration of clinic lists, which meant staff could not access the system, and in the data migration of existing appointments.

As a result, there were problems with how the trust’s new Millennium system interacted with the Choose and Book system, causing patients to receive the wrong appointment dates, no confirmation of appointment or letters being sent out in error.

A recent FOI request revealed there were 16 clinical incidents during December and up to January 17 relating to Cerner Millennium.

These were all clinical incidents where the new system was cited as a causal factor, such as wrong patient wrong notes, lack of notes or incorrect clinic lists having been set up. They were logged as clinical incidents because they involved a clinical process.

The trust said its “robust safeguarding processes”, and additional checks and balances in all departments, ensured that clinical safety was not compromised and no patients were put at risk.

The latest update from the trust says 100% of outpatient clinics are now using Millennium as of the 24 February.

The emergency department and two minor injuries units are using the system effectively along with the maternity department at Southmead, all theatres and 65 wards.

A February report says the trust had engineers and technicians, working closely with Cerner and BT, either re-building the clinics’ system or on the floor in clinics correcting problems as they happened.

Sources familiar with Cerner Millennium say that the software is extremely powerful but hugely complex and does need expert knowledge when setting it up and getting clinics configured.

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