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Five years of missed EHR issue at Newcastle Hospitals

26/09/23

Gary Flood Correspondent

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An entrance sign for the Royal Victoria Infirmary, an NHS teaching hospital with an accident and emergency department
Image source: istock.com/georgeclerk

Newcastle upon Tyne Hospitals NHS Foundation Trust is in the eye of the hurricane this morning as IT problems that date back to at least 2018 are hitting national headlines.

The BBC’s lead story this morning is on how a computer error led to 24,000 post-discharge care patient letters not being issued. The problem is allegedly related to the trust’s electronic health record — and what seems to be functionality that was not properly explained to users.

This morning, the trust has said that it is working quickly to review documents from its electronic records.

“We have thoroughly investigated these matters and would like to reassure our patients that we are taking immediate steps to address the issue. We sincerely apologise for any anxiety or inconvenience this may cause.

“Every single patient contact is very important to us, and we are working to understand if there has been any impact to ongoing care and treatment.

“This review is already underway and will be completed as quickly as possible over the next two months. If any concerns are identified, we will inform patients and their GPs directly.

“We are taking this issue very seriously and are working quickly to put things right.”

The most serious fallout of the hitherto unsuspected issue is the failure to send no less than 24,000 letters from senior doctors to patients and their GPs in that time period.

It is now dealing with a 6,000-letter backlog from just the last 12 months.

However, says the trust, which includes Freeman Hospitals, Royal Victoria Infirmary and Great Northern Children's Hospital, 24,000 documents would account for less than 0.3% of all contact with patients.

The BBC — which broke the story this morning — says that the letters telling GPs and patients what should happen when someone was discharged from hospital failed to be issued.

Worryingly, a “significant number” of the unsent letters were written by specialist clinics spelling out care that is needed for patients, which means that “some crucial tests and results” may have been missed by patients.

More than 1,200 of these relate to medicine and emergency care. Some letters may be duplicates or created in error.

The BBC claims the error occurred when letters requiring sign-off from a senior doctor were placed into a “folder” few staff knew existed.

Apparently, the ongoing runtime error in the system’s use only came to light after a Summer 2023 routine Care Quality Commission (CQC) inspection.

The CQC rated it as outstanding.

Then, staff raised concerns about the problem, which led to a review of the trust's consultants uncovered that most had unsent letters in their electronic records.

A source at Newcastle upon Tyne Hospitals NHS Foundation Trust told the BBC that consultants had raised issues about the electronic patient record system for years, complaining it was slow and hard to use “but had not been listened to”.

Sarah Dronsfield, the CQC's interim director of operations in the North, said: "We took immediate action to request further detail from the trust to understand the extent to which people may be at risk, and evidence of the steps being taken to review the impact on patients, ensure people are safe and mitigate any risk of avoidable delays in treatment going forward."

Her office says Newcastle upon Tyne Hospitals NHS Foundation Trust has submitted an action plan and volunteered to provide weekly updates on its progress against that plan.

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