Hospital trust failed to send another 30,000 patient documents to GPs

Exclusive A major Essex hospital trust has revealed it has discovered a backlog of around 30,000 patient documents which it failed to deliver to local GP practices.

Mid and South Essex Foundation Trust wrote to local GPs to alert them of the issue, which relates to a backlog of letters which have not been sent within seven days of an outpatient attendance as required by the NHS contract.

This issue is separate to a previous incident at the same trust, revealed exclusively by Pulse last year, when at least 50,000 letters were not sent to practices due to an IT system failure.

The trust said that it ‘will not know the level of harm’ to patients ‘resulting from these delays’ until the process to clear the backlog is complete.

Each of the delayed letters will need to be individually reviewed by a hospital clinician before being sent to GP practices, so the trust said it ‘expects it to take some time to clear the backlog’ and letters will not be sent to practices in batches.

GPs have been asked to inform the trust if they receive any delayed patient correspondence and ‘believe that harm has occurred as a result of the delay’.

However, the trust also said that other NHS trusts ‘who have reviewed much larger numbers of delayed letters’ have reported ‘no or very low incidences of harm’.

Dr Tayyab Haider, acting chief medical officer at the trust, said: ‘We send out more than a million letters and discharge summaries a year, and use a number of different dictation and software packages. 

‘We recognised that we had a backlog against the contract standard of sending the letters within seven days so we validated all of the data across all of our different systems. 

‘We currently have an overall backlog of around 30,000 documents – although not all of those will be clinic letters. To put this into context, our clinicians create more than 10,000 documents every week after interactions with patients.’

The trust also stressed that ‘historically’ each of their hospitals ‘has had a backlog of letters’ against the contract standard so this is ‘not a new issue’.

Dr Haider said that now the trust ‘have a clear plan to manage the issue’ and that ‘a new standard operating procedure’ has been implemented.

This requires:

• Any letters that have not been sent within 21 days to be marked as a ‘delayed letter’
• For the relevant hospital clinician to review for ‘any harm that may have been caused by the delay’. Where there is found to be ‘potential harm’, the trust’s incident process will apply.

‘Our local GPs have been made aware of the issue and invited to contact us if they have any queries or concerns,’ Dr Haider added.  

Due to the size of the backlog for ‘an interim period’ the trust is working to a timescale of 21 days – with letters delayed beyond 21 days considered to be ‘delayed’.

This extended timeframe will be brought down to the contract requirement of seven days once the backlog of delayed letters has reduced, the trust added.

This is the latest of a series of incidents relating to delayed patient communications across England.

Earlier this year, a London hospital trust failed to deliver 22,000 patient letters to GPs due to a ‘system breakdown’.

Similarly, a Newcastle trust failed to send 24,000 electronic patient documents to GPs, including discharge summaries and clinic letters, and in Nottingham 400,000 letters and documents intended for GPs were also delayed.

Following the first incident in Essex, GPs had warned that clinical information was not passed and acted on as a result and the trust had promised ‘administrative and clinical support’ would be given to GPs in dealing with the backlog of information.

GPs dealt with the letters as they ‘have unique knowledge of individual patients which is not available to secondary care’ and they were given payment for processing letters on a sliding scale starting at £10 per letter for first 50, then £7 per letter up to 100 then further sliding scale after that. 

At the time, Mid and South Essex ICB said that it would take ‘over a year’ for the issue to be solved.