The must-read stories and debate in health policy and leadership.

The road towards digitising Norfolk and Waveney, aka “the digital desert”, will continue to be long and winding, but an oasis is shimmering in the middle distance…

As we revealed yesterday, the patch’s three acute trusts got the green light to go to market to tender for a joint electronic patient record system with a £155m budget for a 10-year deal.

A fully functioning EPR could be transformational for Norfolk and Norwich University Hospitals, Queen Elizabeth Hospital King’s Lynn and James Paget University Hospitals foundation trusts, with the trusts currently run on some ancient PAS systems and heaps of paper notes.

The project represents the first time all three trusts in an integrated care system have gone out to tender for a joint EPR. The trusts hope to get the procurement notice out by March, a preferred provider selected by autumn and to begin deployment in early 2025.

A tough journey lies ahead, but signoff for the outline business case represents some really good news in amongst all the gloom for one of the NHS’s most challenged systems.

Lost in transmission

An IT issue has stopped patients receiving appointment letters at a hospital named a “global digital exemplar” seven years ago.

Bedfordshire Hospitals Trust discovered the problem while looking into high levels of missed appointments at Luton and Dunstable hospital.

“Did not attend” rates had been hovering between 10 and 12 per cent at the site, compared to a national average of around 7 per cent.

The trust, which sends letters for printing in Scotland, found there had been intermittent failures in a server used to transmit them. When this happened, letters were getting lost.

But it is not easy to work out exactly whose letters were lost in the ether. It is also not yet clear how many patients were affected.

The trust is now looking into the “labour intensive” exercise of writing to everyone with an appointment booked this year to make sure they know when it is, according to its deputy chief executive.

Also on today

In our expert briefing The Integrator, Dave West reports on the two schools of thought regarding the return of payment by results, and in Comment, patient safety commissioner Dr Henrietta Hughes says a seismic shift is needed in the way that patients’ and families’ voices are heard.