Lorenzo stalled at Morecambe Bay

21 Oct 2008

The latest deadline for the implementation of Lorenzo at University Hospitals of Morecambe Bay NHS Trust has passed and there is currently no go-live date.

Health minister Ben Bradshaw indicated that Morecambe Bay would become the first large NHS hospital to use the first version of iSoft’s Lorenzo electronic patient record by the end of the summer.

However, there is no published timetable for the key National Programme for IT in the NHS software to go live in its first acute reference site. The software is eventually due to be used across three-fifths of the English NHS.

The latest delays to the first version of Lorenzo will innevitably push back the planned schedule for adding key clinical functionality to the software in three further releases, under a programme known as Penfield. This, in turn, raises doubts over the achievability of the current 2012 completion date for Lorenzo.

Bradshaw told the House of Commons this spring that, after lengthy delays, the Lorenzo software would go live at three pilot sites, including Morecambe Bay, by the end of the summer. The other two sites are South Birmingham Primary Care Trust and Bradford and Airedale Teaching Primary Care Trust.

In March, the minister said the software would be live by June: ““The first implementation of release 1 is due in June this year in Morecambe Bay, South Birmingham and Bradford.”

In April, Bradshaw was still telling Parliament that go live was planned for the summer: “It is understood that the development plans will enable the deployment of Release 1 of Lorenzo into early adopter sites in the North, Midlands and East Programme for Information Technology, formerly North West and West Midlands, North East and the East Midlands, in the summer.”

Only South Birmingham PCT is so far using a version of the software, initially for a small number of podiatrists. Local service provider Computer Sciences Corporation is offering no date by which Lorenzo will start to be used in its acute NHS reference site.

A statement issued to E-Health Insider said: "CSC, NHS Connecting for Health, the relevant SHAs and the trusts themselves are working together in a strong collaboration to ensure that the system goes live at all three sites.”

One industry source told EHI: “As ever, the answer to the question ‘when is Lorenzo going live’ is ‘three months time’. It’s been ‘three months time’ for years.”

The latest CSC statement suggests that technical issues may be contributing to delays: “As expected, deployment testing is identifying technical issues which are being resolved on an ongoing basis.”

And it says addressing such issues are more important than working to a timetable: “Collectively, the early adopter trusts, SHAs, NHS CFH and CSC recognise the need to achieve the necessary quality criteria for go-live and view this as more important than a particular date."

The continuing delays mean there is now almost no chance that the second release of Lorenzo, with more patient administration and and clinical functionality, will happen this autumn. In April, Bradshaw said : “Release 2 of Lorenzo is due to be ready for deployment in the autumn.”

Release 1 of Lorenzo is understood to include electronic requesting and some reporting, clinical documentation and assessments. This would be delivered ahead of an integrated Lorenzo PAS becoming available

Release 2 is due to begin to add an integrated patient administration system, and more clinical functionality. Release 3 is then meant to add drugs management, scheduling and beds management. Finally release 4, due by 2012, is meant to provide integrated care pathways and an integrated GP system, providing a full detailed Care Records Service.

Reader's Comments

By the end of the summer !

21 Oct 08 10:57

Given that the summer never started I suppose they could argue that the end could never arrive

Laugh... else you'll cry

21 Oct 08 11:03

Is it time for someone to put their foot down?

Putting ones foot down

nigel@nigelcox.com

21 Oct 08 13:58

Should South Birmingham PCT be invited to put one's foot down? If there is any injury or pain then perhaps their podiatrists can use Lorenzo to demonstrate it working!

I wonder

21 Oct 08 16:36

if the costs of equivalent podiatry systems have been compared with the cost of Lorenzo? Mind you, as they are best of breed and deliver rich functionality (presumably) in that area it is probably not a fair comparison as they should be more expensive....................oh

Key Quality Metric - It Works

21 Oct 08 17:09

Something of a statement of the bleeding obvious from CSC. I think most customers would rather the system actually works, but that does not excuse non delivery of planned dates. It would appear that the simple fact is that CSC don’t have a clue when this software is going to be fit for purpose.

I wonder if anyone else is going to have the neck to state 'yet another' delivery date. Or has the era of 'delivery dates' past and we are in a new nebulous cloud world, where the only importance is 'meeting the quality criteria' and dates are far too rigid a criteria. Maybe we should all sit in a circle and hold hands until Lorenzo arrives?

Delay and obfuscation!

21 Oct 08 17:20

CSC are a US-based company, so should be aware of the old US saying "S**t or get off the pot!" Never before has this been so apt.

How many LHCs are burning project resource waiting for Release One and Two to be released?

Will they receive compensation for marking time?

Will Trusts who have had to extend their existing (and often obsolescent) system contracts be compensated for the opportunity costs?

Is there a correlation between this delayed go-live and the delayed sign off of the CSC contract by the DH - which was also due "by the end of Summer"?

Does anyone care?

Is Lorenzo still the detailed care record in Bradford?

maryhawking@tigers.demon.co.uk

21 Oct 08 20:16

Oddly enough, Bradford and Airedale have a section on their nww website on the changes due to be implemented in SystmOne release 3.01 - and refer to it as the detailed care record..

http://nww.bradfordairedale-pct.nhs.uk/Primary+Care+Contractors/Care+records+service/Changes+to+local+Record+Sharing.htm

How sure is anyone that they are still down as early implementers of Lorenzo?

seasons

21 Oct 08 20:36

It has been very warm recently. Perhaps summer isnt over yet

good old project management

richardbak@lineone.net

23 Oct 08 20:44

i'm old style, spend the right amount of time in workshops reviewing the tasks behind delivering each function mapped to he corresponding service,

include testing everything only signed off by the users when working.

add in available resources, estimate timescales with REALISTIC contingency (black magic with lorenzo) and report the critical path to the board with risks attached. if they dont want to buy into it its there shout

it will probably be far longer than the ill published timescales of go-live being spouted by senior management and the LSP's but should show REALITY, which is something the CFH programme has never wanted to live in

Lorenzo the new CERNER?

23 Oct 08 21:34

Plus ca change, plus la meme chose

Surprised?

23 Oct 08 21:48

After all this time and Lorenzo still hasn't achieved a valid 'Live' status! Just how long do we have to wait before somebody realises that they paid for vapour ware?

How overdue is Lorenzo now, what 4 years?

IMHO this is the type of delay you are going to have to deal with when the goverment dictates to the NHS which software it has to use and then grants the contract to a company in turmoil that's development work is carried out in India by a team that has appeared to have absolutely no idea how the UK health system works, and appeared to lack any basic understanding of the messaging mechanism used by the spine or PDS.

(post edited by EHI)

Re: Surprised

24 Oct 08 09:37

The comment identifies a number of factors that contribute to where we are now (which is pretty well nowhere!).

What isn't said is that the root cause of ALL these is poor programme management! Or perhaps that's what was edited out?

Poor Programme Management

27 Oct 08 12:08

Yes there has been a load of poor programme management and a load of other mistakes but they don’t lie at the heart of what is wrong with CfH. Its far more fundamental than that and its a hard one to swallow (that’s why they haven’t and wont swallow it).

Basically the whole project was built on the premise that you could define a system that would meet all of the operational needs of the NHS. Well this premise is simple not true. You cant do it. No matter how much money you throw at it and how powerful the person is who says you can do it.

Now I know why it is not possible, but in the words of Fermat, I cant be bothered to write it down here. Nobodies listening anyway.