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NHS England ‘wasted millions’ in handling of misdirected correspondence

Patient harm can’t be ruled out either, concludes Public Accounts Committee

Caroline White

Wednesday, 06 June 2018

The NHS has wasted nearly £2.5 million reviewing the handling of misdirected clinical correspondence─ funds which could have been used for frontline care─ an influential panel of MPs has concluded in a report* published today.

Clinical correspondence went "missing" when NHS England outsourced certain primary care support services.

The Public Accounts Committee (PAC) previously reported that NHS Shared Business Services mishandled sensitive clinical correspondence relating to patients. But this time it was NHS England which was far too slow to treat the issue seriously and take action, it said.

As a result, this only made the problem worse and delayed remedial action for patients.

Over the course of the two incidents, one million pieces of clinical correspondence have not been handled appropriately, says the report.

NHS England is still assessing nearly 2,000 cases to find out if patients have been harmed as a result, and has so far identified two incidents where expert consultant review has concluded that patient harm cannot be ruled out, it says.

In view of the record of failings and number of unresolved cases, the PAC has demanded further assurance that NHS England has finally got a grip of the problem when it reports back later this year.

Committee chair, Meg Hillier commented: "NHS England was slow to tackle this incident with the regrettable consequence that many patients are still in the dark about potentially critical correspondence.

“Up to 2,000 cases are still to be assessed by NHS England; in at least two of those reviewed so far, harm to patients cannot be ruled out. Nor can the possibility of still more cases coming to light.”

She added: “There is a grim irony in the fact that a mass breakdown in communication should then be compounded by poor communication between NHS England and GPs.

“Basic administrative efficiency should not be difficult to deliver. The systemic nature of this incident is a big concern and money which should have been spent on patients has instead been spent cleaning up the mess.”

She added: “NHS England must move to resolve this definitively and keep us abreast of the progress being made."

BMA GP committee chair Dr Richard Vautrey commented: “Amid the longstanding chaos caused by the outsourcing of GP support services, as clearly exposed by the recent National Audit Office report, this further publication is another damning indictment of NHS England’s inability to deliver basic administrative efficiency in back-office systems.”

He continued: “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 [Primary Care Support England]. This would have been the arrangement before NHS England tried to cut costs by commissioning PCSE services to Capita two years ago.

“Ever since the scale of the problem became clear, the BMA has been pressuring NHS England to get an action plan in place, including a guarantee of proper funding for practices to deal with the resulting increase in workload. However, if NHS England had managed the situation properly then it would not have needed to spend £2.4m resolving the issue, and this could have been money instead spent on patient services and practices struggling with unmanageable workloads and bureaucracy.”

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.”


*Clinical correspondence handling in the NHS. A report prepared by the Public Accounts Committee, June 2018.

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