This site is intended for health professionals only

Practices resort to pen and paper as five-day IT failure caused ‘utter breakdown’ of services

Practices resort to pen and paper as five-day IT failure caused ‘utter breakdown’ of services

A five-day IT failure forced GP practices across Kent and Medway to raise alerts about patient safety, as the ICB told them to ‘return to pen and paper’ until the issues were resolved. 

The outage, which began on 16 March, was reportedly caused by a ‘faulty firewall’ and led to the area’s first GPAS black alert declaration, as GPs reported risks to patient safety and an ‘utter breakdown’ of their services. 

Kent LMC said it affected all clinical and non-clinical internet reliant systems, meaning practices lost access to email services, EMIS capability was ‘vastly reduced’, and the ability to manage prescriptions and results was impacted.

As well as core patient-facing services, GPs reported issues with meeting QOF and payroll year end reporting as a result of the IT failure. 

In their GPAS reports, GPs also said their phone lines were affected and they could not access accuRx, Kent’s Document Organisation, Referral and Information Service (DORIS), and Docman, which is used for clinical letters and discharge summaries.

They also said that NHS Kent and Medway ICB had issued guidance to GP practices during the outage which suggested they return to ‘pen and paper’ in order to continue providing services.

Kent LMC has been in discussion with the ICB about ‘what measures can be taken to help deal with the backlog of work and how practices should be recompensed’.

Kent and Medway’s GPAS return for the week commencing 20 March had a 56% return rate and was rated black overall, which means the ‘practice may fail within one month’ and ‘urgent system intervention’ is needed. 

A spokesperson for Kent LMC said: ‘The LMC have worked with the ICB over the event and the ICB have now resolved the IT issues. All practice systems are now functioning. 

‘Assurance is being sought that this never happens again. We are continuing to support practices as they manage the backlog.’

One of the comments from practices on the return said: ‘The catastrophic failure by the ICB to safeguard GP practice’s connectivity has led to an utter breakdown of the services we can provide.’

It added: ‘The length of time it has taken for the connectivity issue to be resolved is unacceptable and someone needs to be held accountable. 

‘Furthermore, the advice provided in one of the General Practice Bulletins suggested that we may have to revert to a paper based system is downright insulting and ridiculous.

‘Complaints from patients are coming in thick and fast about the lack of service. It is unsustainable for any GP practice to operate with any level of efficiency if we are not supported by the ICB.’

A spokesperson for NHS Kent and Medway ICB said: ‘The last few days have been challenging because of a problem affecting internet access. This has now been resolved. 

‘The issue, caused by a faulty firewall, did not affect the NHS network, which is used to access clinical systems such as patient records and issuing prescriptions.

‘We would also like to thank practice staff for their patience while we worked as quickly as possible to fix this complex problem and restore access.’

Full internet access was restored for practices on Tuesday 21 March after several fixes were applied.

A recent RCGP survey highlighting the mounting pressures on general practice found that 42% of GPs and practice staff say their IT suppliers and support services are not for purpose.

As part of NHS England’s new contract for 2023/24 announced earlier this month, practices must procure cloud-based telephony once their current telephone contracts expire in order to provide ‘greater functionality for practices and patients’.

Earlier this month, Pulse revealed that a major Essex hospital had failed to send more than 50,000 patient letters to GPs due to an IT fault.



Please note, only GPs are permitted to add comments to articles

Gerard Bulger 28 March, 2023 5:53 pm

I was on various Connecting For health Committees and railed again the requirement to be rid of any kind of server on the GP premises. Cfh was determined to centralise. Some providers wanted to, provide to provide local store and forward to the cloud, make the system faster, in effect backing up to the cloud. Cfh said no. With such a system If the cloud service went down the practice would continue to function. If one of the caching on premises server failed the one practice would be affected alone and fall back to the cloud. Now if there is a failure a whole cluster or district goes down.
It was nutty policy.

David Church 28 March, 2023 5:55 pm

I don’t see any benefits whatsoever to ‘cloud-based telephony’ besides the gimmick factor, and assuming that prices are fairly set (which I do not think BT’s prices are, as they unfairly increase by more than inflation every year, while income does not).
I cannot see why we would want to introduce an extra, and unreliable (from experience) step into our telephone systems, which could go wrong, inviting patient complaints and deaths, and put us at the mercy of expensive IT-fixing consultants to put right the inevitable outages at extra costs.
It would be rather like sending a telegraph when a telephone call would be quicker and easier, or going on holiday in Spain by flying via the Philippines in each direction. (nothing against the Philippines as a destination, but as a stopover between Heathrow and Madrid, they really do offer no great attractions)

Northern Trainer 28 March, 2023 7:08 pm

ICB. Accountability. Hmmm.

Jolyon Miles 28 March, 2023 8:59 pm

Gerard Bulger. I completely agree and made the same arguments at a local level until I was blue in the face. Politics and power games very much in play.

Sam Macphie 29 March, 2023 6:30 pm

Right Hon Steve Barclaybanker for Health needs to be accountable in government and parliament for this catastrophic failure which has strangled GPs in their efforts just to do their job. Also, how soon until we have the next, and even bigger, so-called ‘fault in a firewall’ in the NHS? In addition, more MPs need to question this in the Commons Chamber, to hold Nouveau Riche ( Mr Integrity ) Sanuk and Mr Barclaybanker to account, and they need to hear some of the very many accounts of how this has affected patients’ lives, circumstances and health outcomes. Simply atrocious. How many more times will this kind of strangulation affect GPs, and probably, to some extent, hospital doctors too, just trying to do their jobs. 5-day IT failure: unbelievable: 1 day would be bad enough.