NHS England rejects “data loss” claims after patient mail disruption
Existing arrangements with third parties being reviewed as NHS SBS joint venture is found to have failed to redirect certain confidential information during five year period
NHS England is reviewing its contract management arrangements with numerous external suppliers after it emerged last year that certain information for relocated patients had not been redirected or forwarded to GPs between 2011 and 2015 under a now defunct arrangement.
According to NHS England, correspondence forwarded to NHS Shared Business Services (SBS) - a joint venture involving the Department of Health (DH) and Sopra Steria – was not always sent on to surgeries or linked to a medical record for affected patients. The joint venture had previously been chosen to oversee a redirection service for these patients in the East Midlands, the South West and North East London.
However, the organisation has rejected news reports that there has been a loss of data, despite failing to deliver documentation for patients that have moved away from a surgery area or where their current living arrangements are not known.
NHS England is believed to have been notified that the documentation in question had not been redirected as intended on March 16, 2016. The health secretary was then said to have been informed days later, with details withheld from patients based on advice from care authorities to prevent overwhelming GP surgeries with patient requests before the exact scale of issues had been uncovered.
“A team including clinical experts has reviewed that old correspondence and it has now all been delivered wherever possible to the correct practice. SBS have expressed regret for this situation,” said an NHS England statement.
Parliament held an urgent question on the contract on February 27 on the back of news reports about the incident, while authorities are looking at whether there have been any direct impacts on care from a failure to redeliver the information. It is understood at present that no cases of direct patient harm have been identified as a result of the issue, although investigations are continuing, according to the DH.
On the back of a procurement process undertaken in 2015, NHS England is understood to no longer rely on an external contractor for the redirection service as part of Primary Care Services work, with a new arrangement handling the function in-house.
As a result of the redirect functions being transferred to Primary Care Support England (PCSE) last April, the sender of patient correspondence is now charged with responsibility for making sure mail reaches the correct GP.
Speaking before parliament, health secretary Jeremy Hunt today said that a total of 708,000 items were thought to be affected under the handling of the contract, with 2,500 pieces of correspondence that were not delivered seen as posing potential harm and requiring further investigation.
Some 2,000 of these items were now believed to be cleared of resulting in direct harm, following work by authorities after the DH established an incident team to review the mail redirection service last year, Hunt said. Investigations into the remaining cases were said to be ongoing.
Hunt said he was notified on March 24, 2016 of a “serious incident” of a large backlog of unprocessed NHS patient correspondence that arose from the Primacy Care Services redirection service that NHS SBS was contracted to manage between 2011 and 2016.
“None of the documents were lost and all were kept in secure storage. But my immediate concern was patient safety might have been compromised by the delay in forwarding correspondence. So a rapid process was started to identify if anyone had been put at risk,” he said.
Playing up a commitment to transparency, Hunt argued that he had been advised by officials not to make the issue public until an assessment of risks to public safety had been completed and relevant GP surgeries were made aware of the issue.
“I accepted that advice for the simple reason that publishing the issue could have meant GP surgeries being inundated with enquiries from worried patients which would have prevented them from doing the most important work – namely investigating the named patients who were potentially at risk,” he argued.
In response, MP and shadow health sectary Jonathan Ashworth accused the government of a “catastrophic breach of data protection” that saw over half a million cases of patient data, which includes blood test results and cancer screening, languishing in a warehouse.
Ashworth claimed that despite promising transparency, the health secretary had been part of a cover up after having known about the issue for over a year without informing parliament of the numbers of documents involved.
He asked, “What guarantees can he give that us no further warehouses of letters are yet to be discovered? Was the private contractor involved paid for the delivery of these letters? And if so, what steps are being taken to recover the money?”
Questions were also asked about when full details would be provided other whether there was any direct harm to patients due to the mailing failures, as well the role of contractor Capita in potentially handling the functions.
Ashworth therefore asked if more services should be brought in-house.
Hunt responded that Capita was not involved in the mail redirection service , which was now being operated internally, with the company handling unrelated components of a broader contract.
Conservative MP Dr Sarah Wollaston, the chair of parliament's Health Committee, said she welcomed the “detailed” steps set out by the health secretary in parliament around protecting patient safety.
“However, [Hunt] will know that there are ongoing problems with the transfer of patient records. GPs and hospitals spend endless hours chasing up results and investigations and letters on a daily basis,” she said. “Isn’t it time patients were given direct control of their own records?”
Hunt maintained that the government remained committed to extending access, particularly through online channels, for patients to be able to access these records.
Amidst questions of data use in the health sector, the Royal Society is presently conducting a joint investigation with the British Academy focused on the governance and ethics of data use in Whitehall in order to set out a new methodology for a more context-based approach to information sharing.
UK national data guardian Dame Fiona Caldicott last year launched a consultation around the future direction for patient data sharing programmes and how individuals should be informed about them. The findings are yet to be released.