Essential insight into England’s biggest health economy, by Ben Clover

‘Severe harm’ to patients from data screw-up at St George’s

Sadly, the data problems HSJ has recently been reporting on have led to real-world pain for patients at St George’s University Hospitals Foundation Trust.

The south London teaching hospital confirmed earlier this week that two patients had suffered “severe harm” as a result of their data going missing.

The trust has had to validate 2 million patient records (this is not 2 million individual patients, it is 2 million data points – thought to be around 140,000 people)

St George’s still has a lot of questions to answer on this investigation but it is puzzling that this is the first trust to uncover any significant patient harm after a waiting list screw up.

Many other trusts have had to check great swathes of patient data after finding patient pathways had not been closed properly – that doesn’t mean people weren’t treated, it just means the trusts don’t know whether they were treated or not.

Great Ormond Street Hospital has had to validate like this; Barking, Havering and Redbridge University Hospitals has had to validate like this; and London North West Healthcare Trust has had to validate like this. None found any significant patient harm, which is fortunate, considering the tens of thousands of records involved.

St George’s has proved sadly adept at showing the human cost of NHS policy things that can seem a bit abstract.

The agency cap was part of a set of a problems that contributed to an avoidable stillbirth there.

Now at least two patients have come to “severe harm” as a result of a data problem. Last year the trust told HSJ it was working on implementing a less chaotic system that didn’t involve well meaning records keepers performing workaround after workaround.

There was a clean sweep of the trust’s informatics people until the appointment of Larry Murphy in April last year. The trust still does not appear to have a deputy chief information officer or an operations lead for this job.

The trust might not be up to speed on reporting this information until 2019.

But the damage already done to patients may yet be worse than we know at the moment.

Good news from the CQC

For those familiar with the history of the NHS in London, the news that Barking, Havering and Redbridge University Hospitals Trust was out of special measures was big news.

The trust has long been famous for poor performance, terrible finances (it has a bad private finance initiative) and a selection of other disasters. With some blips and hiccups, things have improved at the zone six trust.

A lack of management stability was an issue for some time. So full credit to staff, chief executive Matthew Hopkins and the team that started in April 2014.

There is a truism that if a job has defeated three capable people then maybe it is impossible. Coming out of special measures doesn’t prove the top job at BHRUT isn’t impossible, but it’s a strong start.

Staying in outer east London, London Eye has written at length about the agonising procurement battle to run the ISTC up there. While Care UK and BHRUT are both squaring up for another run at it, rumour is there is a third challenger.

STP leadership changes

To lose one STP leader in a week might be bad luck, London has seen two of its five move on recently.

Sarah Blow takes over from Kathryn Magson in south west London, while Sir David Sloman has stepped back from running the one in north central London.

The Royal Free, of which Sir David is chief executive, had an uncomfortable set of quarter three results. The organisation is also (maybe) taking over/federating/chaining with/mega-buddying/running a franchise operation with at least two other trusts. That’s a lot to do, without also wrestling with five clinical commissioning groups, some of which have members confused about whether as statutory bodies they should be quite as cluster-emasculated as they are.

We expect news this month on whether plucky north London specialist the Royal National Orthopaedic Hospital Trust throws its lot in with the Royal Free also.

This could see it dissolved as a statutory body or joined with the Hampstead trust in a less formal way (see above).

Either way, chief executive Rob Hurd and surgeon Professor Tim Briggs will be busy elsewhere with the Getting It Right First Time programme. This quietly, hugely impactful programme (more than £40m in funding) will be confronting clinicians in departments across the land with the sometimes difficult truths about being sub-scale. From the data.

RNOH got good at benchmarking data because, as a small trust in WWII buildings in north west London, it was always having to prove its worth to high-ups who wanted to bundle it with some other organisation.