- KCH discovers 637 dermatology patients whose follow-ups it lost track of
- Harm review process underway at London trust
- Trust proposes “amnesty” for other specialties to reveal patients they have lost for follow-ups
A teaching hospital has discovered more than 630 patients which it failed to follow up “as a result of a high turnover of locums and failure of a trust process”.
King’s College Hospital Foundation Trust is carrying out a harm review on 637 dermatology patients it discovered in October 2018, its board minutes reveal. The results of the assessment are not yet known.
The trust’s quality and safety committee has also asked managers to find out the cause of death for patients from this group who had died since their treatment ceased.
The service at KCH’s Princess Royal University Hospital has been made the subject of a serious incident investigation and the committee was told in August extra clinics had been put in place using medics from King’s College Hospital and a locum from a neighbouring trust.
The report, presented to the KCH FT board in October, said: “The committee heard that the sourcing of consultant dermatologists is fragile on a national basis. There has also been an influx of new referrals. Nationally, there has been a 40 per cent increase in new referrals. Other London trusts are in a similar position in terms of the backlog within dermatology and discussions are taking place at [sustainability and transformation partnership] level.
“The committee was concerned that no time scale could be given as to how long it would take to see all patients concerned. It also requested an explanation for the length of time taken for this issue to come to the attention of this committee.”
The report said the matter had not been escalated when it was discovered because “the executive medical director was led to believe that the action plan was being taken forward and so the matter was not escalated”.
KCH’s most recent performance against the 18-week elective care target is 78 per cent. Last month, it declared an “amnesty” for other service lines to come forward if they had lost track of patients.
The report said the committee chair, Jon Cohen, “was not satisfied that the processes in place are robust enough to address the concerns”.
It added: “The committee could not take assurance that an amnesty will be a solution to the problem. The chair suggested that it should be acknowledged that harm should include the fact that patients are left worrying whilst waiting to be seen by the service.”
Across all its specialties, KCH had 131 patients waiting more than a year for treatment, according to the latest available data.
The trust, the fifth largest in the country for elective treatment, has developed recovery plans for trauma and orthopaedic, ophthalmology, dermatology and neurosurgery services at its Denmark Hill site and is investigating “fragile specialties” including dermatology, endocrinology, general and colorectal surgery at the PRUH.
Another report said: “There has been a lack of a robust clinical team at the PRUH [in neurology] for five to seven years.”
Elsewhere in the board papers, it was noted orthopaedics and ophthalmology currently had the highest number of complaints.
The trust reported problems with a high turnover of administrative staff in bookings across lots of specialties.
The report added the trust had received recommendations from the Getting it Right First Time team across a number of specialties, but had limited capacity, and was asking NHS Improvement for advice on which ones to implement.
Update on 4 November 2019
After this story went to press, the trust confirmed 24 patients had come to harm as a result of the administrative failures.
A spokesman said in a statement: “Last October, we identified a number of dermatology patients whose follow-up appointments had not been scheduled due to high turnover of clinical staff and administrative failures. Post validation the number of patients requiring an appointment reduced to 441.
“The trust immediately launched a harm review and also arranged a number of additional dermatology clinics to ensure there are no further delays. To date, 150 patients have had an appointment and so far 24 patients have been identified as coming to minor harm.
“We are still arranging appointments for the remaining patients as quickly as possible and apologise the distress this will have caused.”