Trust raises alarm after Lorenzo glitch fails to send 14,000 patient letters

Sheffield Teaching Hospitals Foundation Trust declared a serious incident after uncovering the “create but not print” glitch in its Lorenzo patient administration system, its April board papers said.

Staff created outpatient appointments on the system but letters failed to print and send automatically to 14,588 patients.

Ten patients waited more than a year to be seen, breaching the 52 week standard, including one with glaucoma whose vision deteriorated during the delay. The trust discovered the fault in December.

The trust is now sharing a new computer programme with other trusts after narrowing down the large volume of patient records to identify 116 patients still needing appointments.

Deputy chief executive Kirsten Major told HSJ this week: “Some patient appointment letters were showing as being created on the system but in actual fact they were not automatically printed and sent to patients.

“We quickly developed a computer programme which enabled us to determine which patients this involved and, as a consequence, we were able to conduct a robust review and offer patients another appointment if they still needed it.”

Sheffield picked up the problem after noticing a spike in missed appointments at its outpatient clinics.

Most patients who did not receive letters still attended appointments because they were picked up by the trust’s reminder service or had already been seen by the specialty. Others no longer needed to be seen.

The remaining 116 patients, none of whom were emergency or cancer cases, were offered new appointments in January and February, and none came to “direct harm” because of the delay.

However, the vision of one patient with glaucoma had deteriorated and the trust could not rule out the delay contributing to the worsening of the condition in one eye. A clinician met the patient to discuss the case.

Twenty-five pathways had to be reopened with 10 patients waiting longer than a year resulting in a “significant impact on performance”, the trust said.

These patients did not receive appointment letters and were taken off the system when they did not attend the booked appointments.

When new appointments were entered in the system, it calculated the wait from time of first referral, breaching the 52 week standard. All 10 patients have now been seen.

Sheffield worked with Lorenzo supplier DXC Technology, which merged with CSC this month, to change the process of creating appointment letters and has contacted other trusts to share the programme.

Ms Major said: “The system supplier worked with us to put in a fix which means the process of creating and printing a letter is different now and includes additional checks to prevent the same situation happening.

“We were aware the same patient administration system is used by some other hospitals so we proactively contacted the trusts and shared the computer programme, which we developed along with the learning from our experience.”

A spokeswoman for NHS Digital confirmed they were aware of the issue.

DXC Technology did not respond to HSJ in time for publication.