Agenda item

The Chairman invited to the table:

• Dr Steve Shaw – Chief Executive of Barnet Hospital, Royal Free London NHS Foundation Trust.

Dr Steve Shaw updated the Committee on the new Electronic Patient Record (EPR) system which was scheduled to go live over the weekend of November 17-18 2018 at Barnet Hospital. He explained that the EPR introduces one single, integrated Electronic Patient Record system which is available for all staff to access when and where required.

The EPR is then set to go live at Chase Farm Hospital, Edgware Community hospital theatres, Finchley Memorial Hospital and the Royal Free Hospital Maternity department. The remainder of the Royal Free Hospital will follow during 2019.

Dr Shaw said that implementing the system had involved good staff engagement as this would be a major change in the way staff work and that issues would be flagged and resolved as they arose. He said the main focus was on ensuring patient safety was upheld. Dr Shaw said they did anticipate a slowing of performance and flow through the hospital during the initial stages of implementation, due to staff getting to grips with the new technology. The Royal Free would be communicating with patients to apologise for any delays and would explain the reasons behind these. He said that “super users” had been trained to provide guidance to other staff, with junior doctors often very quick to adapt to new technology and that an extensive training programme had been provided for all users. Additional staff had also been asked to work around the go-live date.

Dr Shaw explained that the EPR system would provide more accurate data on each patient and enable real-time viewing of clinical documents and correspondence to GPs. Integrated medical devices would upload readings, reducing potential human errors when inputting and be a much more efficient use of time for clinicians. Moving to EPR would also lead to a more integrated approach to care across North Central London.

Dr Shaw explained that Clinical Practice Groups (CPGs) had also been established to address unwarranted clinical variation and ensure healthcare teams use the best evidence-based treatments. The Multidisciplinary Clinical Practice Group care pathways would be embedded into the EPR, meaning patients would receive the same standard of care regardless of where they were treated across the Trust’s group of hospitals. 

The Committee asked what the back-up plans and risk management were for instances of IT failures. Dr Shaw said risks would be reviewed on a weekly basis and that there were more than enough computers and hardware on site. He said in the event of a computer failure there was a clear policy on what to do, with paper records available and a master computer that could be used with 24/7 access to records in the event of a power outage. He said that the 24/7 access computers were strategically located within the hospital and had their own power source. He said the Chief Information Officer for governance had been monitoring the system throughout the process to ensure it met all data protection requirements.

The Committee asked how training was managed in relation to agency staff. Dr Shaw said all agency staff had to have received training on the system before being employed.

The Committee asked if patient information could be easily shared with hospitals outside the Royal Free or if the system was customised specifically for them. Dr Shaw said E-mist software allowed 13 GP Practices to share information and that the aim was to extend this out to all GP Practices in Barnet. Dr Shaw said the ambition was to one day make records accessible throughout the country. However, in order to provide national coverage, other parts of the country would need to implement similar software. The Committee asked if the information on Quality vs Reference Costs 2017/18 for the Royal Free Group could be broken down into individual hospitals. Dr Shaw said he would look into whether that detail was available.

The Committee asked if further developments in technology were being researched. Dr Shaw said that recently Chief Clinical Information Officers had been appointed, comprising both doctors and nurses, who had a special interest in IT and technology to look at future developments. He said a mobile phone app had already been devised which offered guidance on how to use the system.

The Chairman asked Dr Shaw to provide an update on the parking planning at Barnet Hospital. She asked if the hospital had observed any missed appointments since the implementation of the CPZ in the area. Dr Shaw said there was no data that indicated there had been any impact on appointments because of the CPZ. He said that anecdotally, however, staff had found it more difficult to find parking and now had to park further away from the site and had experienced some abuse from local residents which was a concern. Dr Shaw said that an extensive review of staff parking was taking place and that incentives to use other types of transport or pooling of cars were being investigated. However, many staff were coming from north of London and were therefore reliant on the use of cars.

Dr Shaw said options for parking were being investigated, such as stackable car parks for which suppliers were being sought. He said that this option would still take around 6 months to approve and install and was not without cost. The hospital was also having conversations with the British Army Transport Squadron who have a base 15 minutes from the hospital, about the possibility of using 100 spaces in their car park for staff. This would free up spaces for patients in the Hospital car park. He said further work needed to be done regarding the utilisation of space, as there was variation around the use in various areas of the hospital.

The Chairman asked that Dr Shaw look at the Planning Application carefully and ensure that more car parking spaces would be provided than are currently on site. Dr Shaw agreed to take this message onboard. The Committee also queried whether key essential workers would be eligible for dispensations on parking or permits. Dr Shaw said that the consultation around parking had been requested to be brought forward to three months, rather than the usual six months, so that permits for staff could be considered.

The Chairman asked if any update could be provided on the long-term patient at Barnet Hospital recently in the news. Dr Shaw said he could not say much due to confidential reasons, however the case was more complex than described in the news and that the hospital was working closely with North Lincolnshire Council and making progress towards resolving the situation.

RESOLVED that the Committee noted the report.