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Thousands of patients potentially harmed by undelivered NHS mail

19 Feb 2020, 14:46

https://www.theguardian.com/society/202 ... al-letters

The NHS has launched a patient safety inquiry after a private contractor failed to send more than 28,000 pieces of confidential medical correspondence to GPs, the Guardian can reveal.

NHS bosses are trying to find out if any patients have been harmed after 28,563 letters detailing discussions at outpatient appointments were not sent because of a mistake by Cerner, an IT company.

The letters should have been sent by doctors at Barnet and Chase Farm hospitals in north London to GPs after consultations with 22,144 patients between June last year and last month.

However, a “clinical harm review” is under way after it was found they had not been dispatched.

The 22,144 patients live in the London boroughs of Camden, Islington, Haringey, Barnet and Enfield.

The incident has prompted concern among GPs and patient representatives. “Patients who have attended these two hospitals will now be very worried about whether their care might have been compromised by this IT bungle”, said Rachel Power, the chief executive of the Patients Association.

“We know that sharing information to join up patient care is a major weakness of the NHS, so it is very disappointing to see that this failure took over six months to be detected. All affected patients must be told what this means for them as soon as possible.”

The Guardian has seen a leaked memo that details this latest incident involving sensitive communications involving the NHS. It was sent on 7 February by Caroline Clarke, the chief executive of the Royal Free London group of hospitals, which include Barnet and Chase Farm.

In the memo Clarke says the 28,563 letters were not sent because of “a technical error, which happened when our IT partner, Cerner, implemented a customised update on the system we use for distributing outpatient summary letters”.

The Royal Free decided the failure to inform GPs by letter about what patients discussed with their consultants about their diagnosis and treatment involved such a clear risk that it constituted a patient safety “serious incident”.

It also reported the mistake to NHS England, the national body that oversees the health service, and NHS Improvement, which scrutinises patient safety.

“We have set up a clinical task and finish group, chaired by Dr Alan McGlennan, the medical director of Chase Farm hospital, to carry out a clinical harm review. The process is expected to take approximately six weeks,” Clarke added.

While senior doctors and Cerner had been trying to identify how such a large amount of correspondence in effect went missing, “a fix has been put in place and new letters are now being issued as normal”, she said.

Sharon Grant, the chair of the patient watchdog Healthwatch Haringey, said: “We were alarmed to hear that so many letters had been left unsent over such a long period of time, and that this went undetected for some six months.

“Our concern is that the continuity of some patient care may have been affected by this oversight, and we want assurances that the Royal Free has the capacity to effectively monitor its contracts with outsourced service providers.”

The inquiry should be undertaken by an outside body, to safeguard its independence, and not be an internal investigation by the Royal Free trust, Grant said.

Prof Martin Marshall, the chair of the Royal College of GPs, said the incident highlighted again the risks of private companies being given contracts to carry out work on the NHS’s behalf.

“This is another example of an NHS contract being awarded to a private company which seems unable to deliver on the work they’re contracted to so. GPs, our teams and our patients are suffering the consequences of a failed NHS procurement system,” he said.

“Outpatient summary letters play a core role in delivering high quality coordinated care and it’s concerning to hear that a number of these letters are not being sent out. Alongside treatment summaries, these letters highlight common side-effects and provide patients with instructions on what to do should symptoms of a condition reoccur.

“If GPs, patients and other healthcare professionals are not receiving this vital information, put simply this threatens patient safety.”

Cerner said that the incident was “due to the unique design of a custom script” and that the issue has been fixed.

A spokesperson for the Royal Free said: “This was declared a serious incident due to the possibility of harm being caused and because of the number of letters involved. No harm has been discovered to date.”


• This article was amended on 18 February 2020 to clarify that no letters were physically misplaced.

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