Exclusive Hospital trusts across the country have failed to deliver at least 724,000 patient letters to GPs, in several almost identical incidents, a Pulse investigation has found.
FOI data from hospital trusts in England, obtained by Pulse, discovered similar incidents across the country dating back to 2013, with at least 18 trusts experiencing IT failures which led to thousands of letters not reaching GPs.
GPs warned that the incidents meant that clinical information was not passed and acted on as a result, causing a threat to patient safety and ‘anxiety’ for patients, and some practices had to deal with the delayed letters, which substantially increased their workload.
NHS England told Pulse it does not gather data centrally about the issue because ‘IT communications systems are managed locally’ but added that it is ‘essential’ that all local NHS organisations ensure their processes for sending correspondence to GPs ‘are operating as they should’.
The systemic issue came to light last year when Pulse exclusively revealed that a Mid and South Essex Foundation Trust failed to send communications relating to more than 50,000 patients – dating back to 2008 – to GPs due to an IT fault.
The trust has since confirmed to Pulse that the incident affected approximately 100,000 pieces of patient communications.
In April this year, the same trust disclosed that it had recently discovered a backlog of around 30,000 patient documents which it failed to deliver to local GP practices, an issue which was separate from the previous incident.
Pulse’s FOI request to hospital trusts in England revealed that similar issues have been happening for the past 10 years across the whole country, affecting trusts in:
- London
- Surrey
- Hampshire
- Oxfordshire
- Yorkshire
- Birmingham
- Northamptonshire
- Nottingham
- Newcastle
- Somerset
Londonwide LMCs CEO Dr Michelle Drage told Pulse that delayed test results ‘mean anxiety for patients’, as well as the potential for late diagnosis and GPs having to work through ‘huge tranches of results when they do finally arrive’, often with no extra resourcing to do so.
She said: ‘We know hospital IT systems are under-resourced as capital spending has been gutted across the NHS and we do try to work with trusts when unforeseen circumstances occur.
‘But in many cases the same or similar problems have occurred repeatedly and there really does need to be some accountability for the effect this has on patients and their GPs.’
Surrey GP partner Dr Dave Triska, whose practice had to deal with the delayed letters, said that the issue has been ‘a real headache’, with ‘hundreds of letters in a backlog’.
He told Pulse: ‘The workload is immense, it’s a real worry that we can’t rely on that communication – for us, there are no safety issues as of yet but lots of delayed actions.’
Dr Neil Bhatia, a GP and records access lead at his practice in Hampshire told Pulse that surgeries receiving hundreds of letters ‘suddenly’ to sort through creates ‘immense’ workload.
He said: ‘There could be important or crucial information in those letters. Patients could quite conceivably come to harm.
‘Usually the letters are sent to the patient, and the GP CC’d, or the other way round. However, many patients don’t understand the letters, they’re still written in a way for doctors to understand, and might not realise when action is needed, or might just wait for their GP to contact them about it.’
An NHS England spokesperson said: ‘Timely, high-quality communications for patients and everyone working in the NHS remains of the utmost importance to ensure the best possible care and services for all.
‘These IT communications systems are managed locally, and it is essential that all local NHS organisations ensure their processes for sending correspondence to GPs are operating as they should.’
When asked by Pulse if the new Government is planning to look into the issue, the Department of Health and Social Care said that it is ‘committed to fixing all aspects of the NHS’ and mentioned Lord Darzi’s investigation launched last week. It also said that risks-related IT failures are managed locally.
A spokesperson said: ‘This Government is committed to fixing all aspects of the NHS which is why we have commissioned an independent investigation, led by Professor Lord Darzi, to help inform a new 10-year plan for the health service.’
You will be able to read the full Pulse analysis on missing and delayed letters across England on our website this afternoon.
One might initially think it is a relief dealing with unsent letters, since if it has not been set, we do not have to worry about it needing any time to deal with the information and, undoubtedly, requests for action therein, seeing as it will not be received if unsent.
But in reality, we have already spent a great deal of time and effort dealing with the contents of the unsent letters before hospitals noticed they were not sent ! Patients and GPs actually do tend to notice some of the lack of appropriate correspondence, and have to manage situations without letters, and chase up letters, or obtain information in other ways. We have already dealt with most of them already. By the time they do get sent, they will be outdated, and need no further attention than checking the date to ensure they are not recent, and then ignoring them. We probably already re-referred the patient anyways! (unless they died in the meantime)
Actually, here is a thought :
What if hospitals were required to go through each delayed letter and find out if GP has dealt with it, and have patient come back for consultant review to find out if the advice in letter is still current or needs changing BEFORE they send out what are now erroneous and faulty letters with bad advice in them?