• Child comes to ‘severe harm’ at St George’s University Hospitals Foundation Trust, clinical harm process finds
  • Revealed as trust examines hundreds of thousands of patient histories to see if they received treatment they were referred for
  • Total number coming to ‘severe harm’ now four

Two more patients, including a child, came to ‘severe harm’ as a result of a teaching trust losing track of their records

The cases take the number of patients coming to severe harm at St George’s University Hospitals FT to four, as the trust continues its efforts to get on top of huge data problems.

A report to its July board meeting said a “comprehensive review – conducted by MBI – identified multiple operational processes and technology issues at every stage of the elective care pathway that posed significant risks to the quality of care and safety of patients”.

It continued: “There is a lack of clarity about demand and capacity and, as a result, the trust’s ability to reduce at pace the backlog of patients currently waiting for treatment.”

“Severe harm” is defined by the NHS National Reporting and Learning Service as “permanent harm”. The two new cases are in paediatrics and gastroenterology.

Earlier this year, non-executive director at the trust Sir Norman Williams, former president of the Royal College of Surgeons, asked the board about the “potential liability and what arrangements the trust had in place to manage this”. The trust has not confirmed what these arrangements are.

The trust has been unable to assure itself that any patients admitted to elective waiting lists since 2010 have actually been treated after a botched IT installation and inadequate recordkeeping.

The organisation is now working to track down how many patients who needed treatment did not get it, and treat those that require it.

A harm review process is being carried out alongside this.

The number of patients awaiting treatment at the end of May was nearly 60,000.

In May 2016, the last time it reported the data, the trust had 37,000 patients on its waiting list. The total made it the fifth largest waiting list in the country and it treated 8,200 patients in May 2016 – giving it a very significant run rate backlog.

The trust would not disclose how many patients were being transferred to private treatment or how much that would cost. It also would not say how many patients it had identified in the data clean up who needed urgent treatment but had not yet received it.

A spokesman said 74 patients were currently waiting more than 52 weeks for treatment – but it is not known how many patients will have been waiting more than a year when the data is all validated.

The trust would not confirm how many of the patients it has treated had waited more than a year.

In a paper sent to the trust’s last board meeting, the team leading the data clean up asked for a “substantial budget” for the work. The trust would not confirm whether this was granted, what was asked for or the current budget for the process.

A trust spokesman said: “We are working hard to address data quality problems at the trust, including the recent challenges we’ve identified at Queen Mary’s Hospital, Roehampton.

“This is an absolute priority for the trust. We report on progress with our Elective Care Recovery Programme to the trust board on a monthly basis, including the steps we are taking to rectify the problems we’ve identified. Our focus at all times is on making sure patients are safe, and getting the care and treatment they need.

“We said from the outset that there would be no quick fix to the data quality problems we face, and this remains the case. However, we are making progress, and our plan is to ensure we deliver real and sustainable improvements to the patient tracking systems we use.”

The trust’s harm review group is led by Nicola Payne from NHS England.

This month, the trust was due to start an “external review of clinical harm review process”. The reviewers have not yet been appointed.

Similar scandals have taken place at Kettering General Hospital FT, North West London Hospitals Trust, Great Ormond Street Hospital for Children FT, Barts Health Trust and Gloucestershire Hospitals FT. The latter two and St George’s are still not reporting their waiting times to the national dataset.

Updated on 8 August after receiving additional information