A new computer system caused the loss of 2400 letters from senior doctors to patients and their GPs. The problem was discovered when letters that needed approval from senior doctors were placed in a folder accessible to only a limited number of staff members. Newcastle Hospitals flagged this problem as a significant issue dating back to 2018.
While the majority of the letters pertained to the procedures for patient discharge from the hospital, a significant number of them originated from specialist clinics, offering information regarding the required care – resulting in patients missing important test results, scans and X-rays, according to the Daily Mail. To ensure prompt addressing, instructions have been provided for recording any subsequent incidents of medical negligence by members of staff.
After discussions with the Care Quality Commission (CQC), the trust came to realise that certain documents, including clinic letters and internal records within its electronic patient record, had not been transmitted to GPs. It was discovered that most of the unsent letters were in their electronic record, following a review of all trust’s consultants. This issue was brought up years ago when consultants complained about the slow and challenging usability of the record system, according to a source at Newcastle Hospitals who spoke to the BBC.
How it should function:
If a staff member creates a letter, it would need validation from a second clinician, who must subsequently change their user status to “signing clinician” before sending it. Failing to do this would result in the letter being placed in a consultant’s document folder and remaining unsent until it is signed off.
Impact on patients and measures being implemented:
The CQC’s interim director of operations in the North, Sarah Dronsfield, mentioned that the trust had submitted an action plan and had voluntarily committed to supplying weekly updates on its progress in implementing that plan. With some being duplicates or created in error, there were more than 1,200 letters related to emergency care and medicine.
She also stated the following: “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.”
Courtesy Apology Issued by Chief operating officer:
Newcastle Hospitals’ Chief operating officer, Martin Wilson, since made a statement to apologise for the issue that occurred. He said, “we sincerely apologise for any anxiety or inconvenience this may cause.” The hospital trust said it was working to understand if there had been any impact to ongoing care and treatment of patients. It is currently reviewing 24,000 documents from its electronic records, which accounts for less than 0.3% of all contact with patients, the trust says. “If any concerns are identified, we will inform patients and their GPs directly,” Mr Wilson said.
