Healthcare regulator the Care Quality Commission (CQC) has highlighted a series of failures in the use of electronic records systems at a major hospital trust.
It has published a report on Newcastle upon Tyne Hospitals NHS Foundation Trust, based on an inspection last year, that drops its overall rating from ‘outstanding’ to ‘needs improvement’ and includes indications of shortcomings in how the electronic patient records are used.
This is despite the trust having had systems in place for several years: in 2009 it went live with the Cerner Millenium hospital information system, and in 2019 took a lead role in working with the company to deliver the Great North Care Record.
The report documents a number of instances in which digital systems have not been used effectively. These include: the electronic recording system for medical care, with staff using it in different ways; the care plan system was not used in most of the services inspected; and the system for DNACPR (do not attempt cardiopulmonary resuscitation) in surgery, for which one aspect remains paper based.
Inconsistencies
“We found some of the trust’s systems and processes for recording inconsistent, for example the lack of electronic recording systems in theatres,” the report says. “Consequently, ward staff spent time transferring paper based information into the electronic recording systems which posed a risk of lost information during the transfer process.
“We saw staff confidence using the electronic systems varied from ward to ward. All staff we asked to guide us through the electronic systems told us there were sections of the systems they had not accessed before.”
On a broader front, the CQC points to a deterioration in leadership at the trust, a culture in which staff could not raise concerns openly, and that governance processes have not always operated effectively.
Improvement effort
In response, the trust published a statement saying: “The inspectors found that overall Newcastle Hospitals’ ‘requires improvement’. They also highlighted issues with the way some services are run and that changes are required to ensure we always learn properly from issues or problems.
“A focused programme of improvement is underway, to address the report recommendations, and this will continue until we are satisfied that all of the issues raised have been addressed.”
In September of last year Newcastle Hospitals was at the centre of reports of failures of post-discharge letters for patients not being sent out, which was related to problems with its electronic records.
