NHS England wasted millions on letters backlog investigation - MPs

A report of the Commons public accounts committee, published on Wednesday, has found that the national commissioning board had vastly “understated” the number of letters to GPs that had been lost, sometimes for years.

In February last year, it was revealed that NHS Shared Business Services, which holds a contract for redirecting clinical correspondence sent to the wrong GP, had discovered a backlog of hundreds of thousands of pieces of clinical correspondence, many of them containing sensitive patient information.

Eventually, more than 709,000 pieces of clinical correspondence, containing more than 1.1m separate documents, were found to not have reached their destination.

A subsequent committee hearing into NHS England’s response to this error found that the organisation had provided conflicting and “understated” evidence about the scale of clinical correspondence lost and the number being reviewed for patient harm.

During delays between NHS England being informed by NHS SBS in May 2016, and escalating the matter internally to senior management in August 2017, the backlog had more than doubled.

“The problem got worse and remedial action for patients was delayed because it took NHS England too long to escalate the issue internally.”

NHS England has also yet to assess 1,821 cases for harm to patients, the report said, and delays in dealing with the backlog had made the problem worse.

So far two cases of potential patient harm have been identified, but further harm could yet be discovered. 

NHS England had so far “wasted” £2.4m, trying to fix the problem with GPs, but with little success.

Each month, GP practices were still incorrectly sending up to 10,000 pieces of clinical correspondence received in error to support service provider Capita, a practice that led to the original backlog.

“NHS England has not communicated effectively with GP practices about how they should handle misdirected clinical correspondence,” the report said.

NHS England told the committee it is planning to identify “worst offender” GP practices that were redirecting correspondence to Capita incorrectly and inform their local clinical commissioning group.

Committee chair, Meg Hillier MP, said: “NHS England was slow to tackle this incident with the regrettable consequence that many patients are still in the dark about potentially critical correspondence.

“Up to 2,000 cases are still to be assessed by NHS England; in at least two of those reviewed so far, harm to patients cannot be ruled out. Nor can the possibility of still more cases coming to light.”

An NHS England spokesperson said: ”NHS England and the review team has worked closely with other GPs and contractors to review and assess 99.6 per cent of SBS and Primary Care Support correspondence issues, putting in place clear processes to ensure correspondence is redirected where necessary, without delay.”