RiO is an information system designed for use across the community health sector. Data are recorded to support the key functions of providing secure access to patients' care records, to allocate, share and reassign cases, to record treatments, and to book appointments. As well as recording clinical information it provides clinical and administrative functionality to support care professionals, working in teams, with features such as diary, referral and caseload management, progress notes and care plans. Child health functionality includes the scheduling, recording and outcome of immunisations, health reviews and development checks, registration of birth details, screening tests and special needs.
RiO is the strategic community health information solution for London. Its features and functionality will continue to be developed with the input of national health service staff in London.
The Department's NHS Connecting for Health Agency is responsible both for ensuring delivery of the information technology (IT) systems under the national programme for IT (NPfIT), and for maintaining the critical business systems previously provided to the national health service by the former NHS Information Authority. Information covering all the agency's responsibilities is in the tables.
Actual expenditure Forecast outturn 2004-05 2005-06 2006-07 2007-08 Capital 360.0 429.0 589.0 826.0 Revenue 260.0 539.0 528.0 500.0
Planned expenditure 2008-09 2009-10 2010-11 Capital 826.0 1,049.7 835.8 Revenue 703.5 786.9 785.9 Notes: 1. All sums exclude capital charges. 2. The amounts include the original costs of NPfIT contracts, which have not changed, but also include new and additional requirements that have been added, supported by separate business cases and funding, as reported by the National Audit Office. 3. With the exception of planned revenue expenditure in 2008-09, figures for 2008-09 to 2010-11 are those used to inform the comprehensive spending review and are subject to revision in light of the evolving IT needs of the NHS. 4. Budgets for years beyond 2010-11 are dependent on the outcome of future spending reviews.
Cerner is the chosen subcontractor of two of the local service providers (LSPs) under the national programme for information technology (NPfIT) for the provision of health care IT systems, Fujitsu in the south of England and BT in London.
Nine health communities have to date gone live with the Cerner Millennium system provided through the national programme. Each health community typically comprises an acute national health service trust and the associated primary care trust sites in its area. Details are provided in the following table.
Trust Total users Peak users Average users Go live date Buckinghamshire Hospitals NHS Trust 880 700 450 25 September 2006 Milton Keynes General Hospital NHS Trust 2,000 980 420 24 February 2007 Nuffield Orthopaedic Centre NHS Trust 900 170 130 22 December 2005 Surrey and Sussex Healthcare NHS Trust 2,875 620 400 20 April 2007 Weston Area Health NHS Trust 1,700 1,400 450 29 July 2006 Winchester and Eastleigh Healthcare NHS Trust 1,820 980 360 10 February 2007 Worthing and Southlands Hospitals 3,750 300 180 29 September 2007 Barnet and Chase Farm NHS Trust 4,580 410 110 24 July 2007 Queen Mary's Sidcup NHS Trust 2,050 170 50 29 October 2007 Total 20,555 5,730 2,550 —
In addition two London NHS hospital trusts, the Homerton University Hospital NHS Foundation Trust, and Newham University Hospital Trust, had initiated procurements of the Millennium system before the national programme.
To date, some 2.7 million patient records have been entered in the systems currently in use.
Four further trusts are currently expected to go live with the existing release (release 0) of the Millennium system by the early part of 2008. These are Taunton and Somerset NHS Trust in 2007, and the Royal United Hospital Bath NHS Trust, the Royal West Sussex Hospital Trust, and Barts and the London NHS Trust in 2008. Thereafter, release 1 of the system will form the basis for other implementations across both LSP areas in 2008-09 and beyond. Specific go-live dates in each strategic health authority area will be determined by local agreement with the NHS bodies concerned.
All matters to do with the national programme fall within my portfolio of departmental responsibilities as the Minister of State.
Details of clinical representation on bodies responsible for overseeing local implementation of NPfIT systems are not held centrally.
While Ministers have not received any direct representations, we are aware that users in the early deployments expressed some concerns about the system's management and statutory reporting functionality, and some of its usability features, for example the number of key strokes required for certain functions. Action has been taken to address these concerns and to enhance these areas. This is making a positive impact. Many users who have become familiar with Millennium over time have expressed satisfaction with the system.
From the inception of the IT programme relevant and experienced clinicians have contributed to the effective identification of requirements, design and testing of all systems wherever across the NHS these are being delivered. This continues to be the case. NHS Connecting for Health has appointed a chief clinical officer to lead the clinical engagement and clinical contribution to the programme.