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NHS: ICT

Volume 473: debated on Wednesday 12 March 2008

To ask the Secretary of State for Health (1) what elements of the Lorenzo software package are expected to be delivered to trusts after July 2010; (192708)

(2) in how many stages it is expected that the Lorenzo clinical software package will be delivered for use as part of the National Health Service Programme for IT; what the expected date for delivery of each stage is; and what functionality is expected at each stage;

(3) how many (a) trusts and (b) other users are planned for each of the stages of delivery of the Lorenzo software package under the Penfield scheme by (i) July 2008, (ii) January 2009, (iii) July 2009, (iv) January 2010 and (v) July 2010;

(4) when it is expected the (a) the first NHS trust and (b) the first 10 trusts will have deployed elements of the Lorenzo software package under the Penfield scheme;

(5) by what date it is expected that three-quarters of NHS trusts in (a) the North West region, (b) the North East region and (c) the Eastern region will have had their patient administration systems and clinical systems replaced by the Lorenzo clinical software package under the Penfield scheme.

The software underpinning the Lorenzo regional care solution for the North, Midlands and East (NME) programme for information technology (IT) area—previously comprising the North West/West Midlands, North East and Eastern national programme for IT regions—is currently scheduled to be delivered in four stages, or ‘releases’, as follows:

release 1: from June 2008;

release 2: from November 2008;

release 3: from July 2009; and

release 4: from March 2010.

The software for release 1 will initially be made available to three ‘early adopter’ sites. Following a period of live running within these sites, the release will be rolled out progressively across NME trusts. A similar approach is envisaged for subsequent releases. This staged approach is consistent with best practice and the recommendation from the Health Select Committee.

Functionality for release 1, which will be deployed over legacy patient administration systems (PAS), will enable the ordering of tests and reporting of results for pathology and radiology, supported through interfaces to legacy departmental systems. This functionality will also support ordering of a range of other patient-based services such as physiotherapy, occupational therapy and nursing interventions. The release will facilitate the building of a wide range of clinical documentation that will begin to replace the paper-based records, or the multiple clinical applications, which are currently used throughout the national health service.

Release 2 will replace legacy PAS systems by supporting an additional range of key functions both within and across NHS organisations. The release will include referral management, access planning and waiting lists, complex scheduling, out-patient in-patient and day-care case load management, care planning, case note tracking and contract management functionality. Functionality will also be available for those trusts that need to record Mental Health Act administration details and undertake mental health reviews and tribunals.

This release also aims to include the ability to record prescriptions and medications issued to patients on discharge using a formulary-based catalogue which identifies interactions that could arise due to the combination of drugs being prescribed, and other checking functionality to reduce clinical errors. In addition, emergency care functionality should be supported for those organisations looking to replace their current departmental systems.

Release 3 will build on the functionality delivered in release 2 by providing full in-patient prescribing and medication administration functionality, and maternity and theatre management functionality intended to replace legacy systems. The release will, in addition, provide the capability to schedule multiple resources such as people, rooms and equipment, and also deliver enhanced bed management capability.

Release 4 aims to provide functionality to support general practitioner practices, health screening, integrated care pathways, commissioning, theatre tray management and stock management. It will also provide the ability to link to remote devices to facilitate telemetry, and for working when disconnected from a network.

At present, development plans extend to July 2010. New requirements after July 2010 will need to be specified and supported by an appropriate business case and approval.

It is not possible to provide the details requested of the future number, location and sequencing of longer-term deployments. This is because meeting the needs and priorities of individual trusts which are maintaining normal business operations requires flexibility in the deployment planning and inevitably means that plans will always be subject to potential change. Detailed implementation planning became the responsibility of individual trusts and the chief executives of strategic health authorities from April 2007.