From the coalface

I have received this e-mail from a junior doctor at a nearby NHS hospital:

Dear Dr Monk,

I'm an SHO in T&O at ******* *******, and I've seen the disaster that is CfH first hand - the Millennium CRS system. Apart from the bizarre name (or is it 7 years late!), it just does not do what it is supposed to.

It was first introduced in A&E as a patient record, and hospital-wide as a PAS system to track notes & patients, etc. In A&E, the consultants have stopped using it as an EPR, as they found that it took 5 minutes to see the pt and 20 minutes to do the computer work! It is now just being used as a PAS system, and the rumour is that this is only because the old PAS has been erased from the hospital systems.

The software is completely user-unfriendly and counter-intuitive - whoever wrote it will obviously never use it. You may remember that it featured in an article in the Times - one consultant described it as "clunky" and "not fit for purpose".

On the wards - we as doctors do not really see the chaos that is caused, but the ward clerks are all tearing their hair out. They say it's impossible to use. However, we as SHOs used to be able to get a printout of our consultant's patients, which is useful if they're spread around as outliers, and the new system won't let us do this. Seems insignificant, but it is annoying.

In clinics, it is downright dangerous. We will have a clinic list printed the day before, and obviously those notes are prepared. Few of these patients will turn up - they say they have not received an appointment. We see lots of patients attending the wrong clinic (dermatology follow-up in the orthopaedic new patient clinic, for example). Then another cohort of patients WILL attend, with a letter conforming the clinic and date, but not on the list and therefore no notes available. Finally, the "codes" for clinic that all staff, including clinic staff and ward clerks knew (eg "code" LW210 meant Mr X's knee clinic) are incompatible with the new CRS system and have been scrapped.