In the annual report of the London’s St Bartholomew’s Hospital (Barts), the interim director of finance Azara Mukhtar wrote: “Key finance and investment directorate achievements for 2006/07 include achieving the planned savings and efficiencies resulting from the Oracle-based financial ledger. Its reporting and other features will also be essential as we move towards foundation trust status.”

NHS Foundation Trusts are a new type of NHS Trust in England and have been created to devolve decision-making from central government to local organisations and communities.

Barts and The London NHS Trust consist of three hospitals in the east end of London: St Bartholomew’s; The Royal London; and The London Chest. Founded in 1123, Barts is Britain’s oldest hospital. The Trust’s 7,800 staff handle nearly 800,000 patient attendances each year. It recorded a surplus on its income and expenditure account of £5.3m in 2006-2007.

The trust continues to improve efficiency through a range of ongoing initiatives. Unprecedented capital investment in new hospital buildings and information technology infrastructure is leading to long-term improvements, freeing up resources for direct patient care. In 2006-2007, it reached its target for the year with cost reductions of £26.2m and has targeted another £26.8m in 2007-2008.

As part of this process, in May 2005 the Trust replaced its old mainframe-based financial system with Oracle e-Business Suite running on industry-standard Linux servers. The suite includes integrated general ledger, accounts receivable, accounts payable, purchase order, iProcurement, daily business intelligence, financial statement generator and business intelligence discoverer.

“We took the decision to move to a much more flexible and solid system,” says Keith Miller, the trust’s financial controller. “It gives us better and more advanced ways of dealing with transaction processing. We are able to receive and generate documents and journal entries electronically through gateways into the system, instead of printing them or keying them in manually. Instead of inputting data, people are reinvesting their time in analysing the output, which is of much more benefit to the overall management process.”

Because staff now use an electronic catalogue, requisitions no longer have to be processed by the central procurement department. “We have been able to take two posts out of the establishment,” says Mario Varela, director of procurement and e-commerce. “We also have the data to make better and more informed decisions on our sourcing strategy.”

The old system used to be updated by batch at the end of each month, whereas the new integrated system is updated in real-time. This makes it much quicker at making information available during the month for reporting and analysis into useful data for the organisation.

Oracle general ledger financial statement generator is used to produce the trust’s monthly and annual profit and loss account, balance sheet and cash flow statements. Another benefit of the new system is that the trust is able to publish its monthly and annual accounts five working days earlier than previously. Oracle business intelligence discoverer is a more flexible tool used for ad hoc query, analysis and reporting.

“Discoverer produces tailored reports for individual sub-systems or in transaction detail,” says Mr Miller. “It brings various sources of data together in a single report for analysis. We are able to extract much more relevant information in a much more controlled fashion than before.”

The trust uses cumulative actuals, trend data and current knowledge of what will happen to produce detailed forecasts for each directorate for the full year. This provides accurate forecasts that are then reported back to the board.

The daily business intelligence for procurement module was implemented first and reports key performance indicators. Mr Varela has found them useful for: tracking contract leakages (purchases outside the approved relationship); for identifying areas of expenditure with the potential for proper competitive procurement processes; and areas where purchase volumes can be aggregated across the whole organisation. These had all been very difficult to identify in the past.

The trust is currently planning to implement Oracle financial analyser, the multi-dimensional analysis and reporting module. It has set up some test data structures and Mr Miller is very pleased with the results and the potential benefits they reveal. The trust is currently planning how it can be used to best effect in the organisation.

“The new financial system has been a very good move,” concludes Mr Miller. “It has already delivered benefits, but we have more work to do to realise the full potential. We are much better able to serve the information requirements of the organisation for its decision-making process. We are confident that future changes within the organisation will be matched by the system’s flexibility, so it has delivered what we wanted.”