"Deeply unimpressed" by handling of clinical correspondence
The failures in the handling of sensitive clinical data by NHS SBS are staggering. Even as the Committee was looking into problems dating back at least three years, NHS England was uncovering more mishandled correspondence.
We were deeply unimpressed by the lack of grip NHS England still has on the handling of clinical correspondence, and dismayed to be informed of a further backlog of 162,000 items which need to be assessed.
Our evidence session was frustrated by the late provision of additional information by the NHS England Chief Executive. It would have been more helpful if this information had been supplied in time to allow Members to consider it. The Committee will return to this subject once it has further information.
NHS England and Department failed in their oversight
Proper handling of clinical correspondence is an essential part of administering care for patients. NHS Shared Business Services Limited (NHS SBS), the company contracted to redirect up to 700,000 items of mail a year, badly failed the patients and General Practitioners for whom it was supposed to be redirecting correspondence.
Almost 2,000 patients are still being assessed by NHS England to determine whether they have suffered harm as a result of the delay in handling their correspondence. NHS England has assumed without evidence that a further 102,000 patients have suffered no harm as a result of the delay.
We welcome NHS SBS's admission that it made mistakes and that the service it delivered was not good enough. However, NHS England and the Department of Health both failed in their oversight of NHS SBS.
709,000 items of correspondence mishandled
The Department of Health is ultimately responsible for securing value for money for spending on all health services. NHS England has responsibility for arranging the provision of health services in England and for commissioning their provision. This includes primary care support services, for example, updating patient registration lists, processing contractual payments to GPs and redirecting correspondence.
Until April 2016, NHS England contracted NHS SBS—a private company part owned by the Department—to make sure that misdirected clinical correspondence was sent on to the correct GP in the East Midlands, South West and North East London.
In March 2016, NHS SBS informed NHS England and the Department that it had found a backlog of correspondence which had not been redirected, some of which dated back several years.
A total of 709,000 items of correspondence were eventually found to have been mishandled. NHS SBS missed many opportunities over at least five years to identify and rectify the problem.
Comment from Public Accounts Committee Chair, Meg Hillier MP:
"We will never know the scale of emotional distress caused to patients by the shoddy handling of NHS clinical mail—a failure in service delivery which stretches back years and has still to run its course.
It beggars belief that those tasked with tackling a rapidly expanding backlog of correspondence did not recognise its real-world significance.
NHS England eventually stepped in but, even now, huge volumes of mail are still to be properly assessed and we are far from confident health officials are on top of the issues. The hunt for further correspondence, and therefore potential cases of harm to patients, continues.
NHS England is keen to conclude investigations into the earlier backlog, yet its proposed method for doing so—effectively assuming some 100,000 patients have suffered no harm—is highly questionable.
NHS England must obtain positive assurance from every GP reviewing correspondence that they have completed their checks and whether they have identified any cases where patients may have been harmed.
While we recognise the potential impact on GPs’ workload, this is work GPs have already been paid to carry out. It is vital to the well-being and peace of mind of patients that all necessary steps are taken—and quickly.
Even then, taxpayers could be landed with the bill for further costs arising from fines or negligence claims."