The biggest stories and talking points in health policy

Tip of the iceberg?

The shortage of radiology staff across the NHS is no secret, but the fatal consequences of the problem have been underlined at one trust.

After being ordered to review its backlog of 30,000 unreported plain films (X-rays of patients’ chest, spine, and abdomen), Portsmouth Hospitals Trust found a handful of patients who have either died or suffered severe harm due to their scans being inappropriately reviewed.

While there have been previous examples of huge backlogs discovered at trusts, the findings at Portsmouth were so concerning to the Care Quality Commission that it launched a national review last year.

This review is expected to report back in the summer.

Portsmouth’s leadership have apologised “unreservedly” for the failings, but have also pointed to a report by consultancy Verita that concluded the number of patients affected was within the “accepted error rate of a qualified radiologist”.

The trust says it has strengthened governance processes, which were criticised by Verita for not offering the board enough oversight of the decision by the radiology department to deprioritise reporting of plain films back in 2007.

However, this will be scant consolation to the patients affected and their families.

Additionally, it is not known what the impact of this deprioritisation was on patients treated prior to March 2016 – as the trust did not review X-rays that were done before that date.

Last week, HSJ revealed that trusts had an average backlog of unreported scans of around 2,800 in 2016-17 – more than double the tally in 2015-16.

It remains to be seen whether Portsmouth is an outlier or if the problems there are only the tip of the iceberg.

Fraud crackdown

Five current or former directors of NHS organisations are being investigated by the national NHS fraud agency.

The NHS Counter Fraud Authority said in information released to Parliament that in November, when it was established, five NHS directors, one doctor, 23 “other medical professionals” and 12 “other NHS staff” were under investigation for fraud.

The authority confirmed to HSJ this week that five NHS directors remain under investigation.

It is not known how many of the individuals still work in the NHS nor, in relation to the directors, the mix of executives and non-executives.

Richard Rippin, its head of operations, said the numbers demonstrated it was “determined to fully investigate allegations of serious and complex fraud against NHS funds. This is regardless of the suspected individual’s role, location or status. NHS funds are there to meet the healthcare needs of everyone, not to be diverted for personal gain.”