NHS England was ‘far too slow’ in taking the issue of misdirected clinical correspondence ‘seriously’, which resulted in delayed ‘remedial action’ and wasted millions of taxpayer funds, influential MPs have said.
This is the finding of the latest report from the Public Accounts Committee’s inquiry into the progress of the recovered patient records previously lost by NHS Shared Business Services dating back to 2011.
Today’s report found that:
- The NHS has wasted nearly £2.5m reviewing the handling of misdirected clinical correspondence.
- NHS England was ‘far too slow to treat the issue seriously and take action’, which resulted in the problem getting ‘worse’ and a delay to the ‘remedial action for patients’.
- One million pieces of clinical correspondence ‘have not been handled appropriately’, with the PAC demanding further assurance that NHS England has ‘finally got a grip of the problem’.
- NHS England is still assessing nearly 2,000 cases to determine whether there has been harm to patients. So far two incidents have been indentified where an expert consultant review has concluded that patient harm cannot be ruled out.
The PAC further found that after the issue was finally identified in 2016, it was compounded by GP practices wrongly sending correspondence received in error onto Primary Care Support England (PCSE) rather than the originator.
The report said this led to accumulation of almost 400,000 clinial letters, which PCSE provider Capita was not contracted to sort through.
The PAC blamed NHS England’s failure to communicate ‘effectively with GP practices about how they should handle misdirected clinical correspondence’ for the issue.
The PAC report concluded: ‘In view of the record of failings and number of unresolved cases, we will need further assurance that NHS England has finally got a grip of the problem when it reports back to us later this year.’
As of 1 May this year, Capita has taken over the task of sorting and redirecting mail mistakenly sent to them, a role which previously sat with the NHS England incidence team.
BMA GP committee chair Dr Richard Vautrey said the PAC report was ‘another damning indictment of NHS England’s inability to deliver basic administrative efficiency in back-office systems’.
This followed the recent National Audit Office report into NHS England’s handling of the PCSE outsourcing contract with Capita, which found the botched handover ‘potentially compromised patient safety’.
Dr Vautrey said: ‘Given the ongoing confusion and lack of effective communication, it is regrettable yet understandable that some practices may have, in good faith, sent misdirected correspondence on to PCSE.
‘This would have been the arrangement before NHS England tried to cut costs by commissioning PCSE services to Capita two years ago.’
He added: ‘Overall this report underlines the need for NHS England to get to grips with a problem that has been disrupting general practice for years, and to introduce an effective system that guarantees safe and efficient care for patients.’
The PAC’s findings come after NHS England said they would reclaim approximately £260,000 from GP practices that it claimed had not reviewed lost patient correspondence as directed.
An NHS England spokesperson said: ‘In March 2016 NHS England established a team to review a backlog of clinical correspondence, reported at that time, by the SBS company.
‘Since then, NHS England and the review team has worked closely with other GPs and contractors to review and assess 99.6% of SBS and Primary Care Support correspondence issues, putting in place clear processes to ensure correspondence is redirected where necessary, without delay.’
The NHS SBS mail redirection blunder
Since 2015, 709,000 items of clinical correspondence were lost in transit between hospitals and GP practices – with a further 162,000 pieces unveiled in November. First uncovered in 2016, the issue affected areas including East Midlands, North of England, North East London and South West England.
When a patient changed practice the mail redirection service was intended to ensure continuity by redirecting correspondence returned by their old GP to the new one.
But the documents were instead stored in a warehouse and unearthed in 2015. This included temporary resident forms, patient test results and communications about treatment.
No cases of patient harm have been reported but, by November last year, it had cost £6.6m to find and assess correspondence, with NHS England estimating it would cost another £1m.