Unprocessed letters to cost NHS at least £6.6m

28 Jun 17

NHS mistakes that meant 709,000 medical letters failed to reach their intended destination will cost the health services at least £6.6m, say government auditors.

A National Audit Office report follows an investigation into how NHS Shared Business Services [NHS SBS] handled unprocessed clinical correspondence.

It found the Department for Health waited three months before informing Parliament about the incident because “at that point, there had been no cases of actual harm uncovered”.

The company, which is 49.99% owned by the Department for Health and the remainder by private firm Sopra Steria, had contracts with 26 primary care trusts between 2008 and 2012 to provide primary are support services, including redirecting medical letters.

However, in March last year NHS SBS told the department that it had discovered a backlog of around 435,000 items of unprocessed clinical correspondence but this rose to 709,000 items after more boxes of correspondence were uncovered in archives.

Investigators now believe this backlog could have potentially harmed 1,788 patients and will cost at least £6.6m for administration alone.

NHS SBS has borne £2.26m of this estimated cost so far but this does not include any contribution towards the costs incurred by NHS England. The report says negotiations between the two parties are ongoing.

It also found that, when NHS SBS took over the work of forwarding misdirected clinical letters from certain PCTs, it inherited a backlog of unprocessed mail but failed to address this issue and backlogs grew.

While only 21 of the 26 contracts explicitly required redirection services none of the contracts contained key performance indicators to measure how well NHS SBS was delivering the redirection service and there were no direct financial incentives or penalties attached to NHS SBS’s performance in redirecting mail.

When PCTs were abolished in 2013, NHS SBS continued its services with NHS England which had taken over the contracts.

The report states: “Managers at NHS SBS had been aware of the clinical risk to patients since January 2014 but did not develop a plan to deal with the backlog. NHS SBS informed NHS England and the Department about the problem in March 2016.”

A Department of Health spokesman said: “As the NAO report highlights, patient safety has been our first priority and no cases of harm have been identified to date.

“Alongside NHS England, we have been very mindful of appropriate transparency while working to make sure this does not happen again – last year the health secretary updated Parliament and the Public Accounts Committee was informed.”

The department said a clinical review is ongoing and stressed that data has not been lost, but some items of correspondence were not re-directed or forwarded on to the correct recipient.

Following a review, all items were located either in secure conditions on NHS premises or in archive facilities, it added.

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