It is nothing short of a scandal that thousands of patients may have suffered harm as a result of more than 700,000 documents – including details such as cancer test results and child protection issues – failed to reach GPs and were left in a warehouse over a five year period.
Even more shocking is the fact that the company responsible for delivering the documents – part owned by the Department of Health – allegedly became aware of the issue in January 2014, but took two years to come clean and inform the Government and NHS England.
It has been called a ‘colossal blunder’ by politicians and a ‘disastrous situation’ by the British Medical Association.
Quite simply, it appears an astonishing case of negligence, worsened by an apparent lack of care and consideration for those put at risk by not informing key people of concerns earlier.
By keeping matter ‘secret’ the significant risk to patients was ignored
In our work as medical negligence claims specialists, our team see day to day the need for speedy diagnosis of serious conditions such as cancer. Early detection is vital and impacts the level of treatment patients may have to undergo.
The National Audit Office (NAO), which has investigated this matter, says the company involved, NHS Shared Business Services (SBS), had become aware of a risk to patients in January 2014.
However, senior managers had not developed a plan to deal with it or tell the government or NHS England for another two years, and only told NHS England and the Department of Health of the issue in March 2016.
Even then, neither Parliament nor the public – the people put at risk by these potentially grave errors – were told. The issue only came publicly to light in February after the Guardian newspaper reported it.
It has been suggested there was a ‘conflict of interest’ between the health secretary’s responsibility for the health service as a whole and his department’s position as a shareholder in NHS SBS.
However, a Department of Health spokeswoman said it was committed to being transparent over the handling of the issue, saying it was given advice not to raise the alarm publicly until it had a better understanding of the problem.
It claimed concerns about patient safety ‘would always outweigh its role as a shareholder in the company’, and that as yet there had still been no proof of harm to patients.
However, given doctors have already raised concerns in 1,788 cases, which are now being individually investigated and overseen by NHS England, that approach already looks a serious error of judgment.
NHS England also said the company had been “obstructive and unhelpful” when it had tried to investigate the issue.
It is a shocking, inexcusable, and unforgiveable situation.
How many have suffered as a result of lost medical records?
The question now is how many people have suffered due to this error?
There are still over 200,000 records which went missing to be reviewed by GPs, and therefore it is highly likely that many more cases in which there is genuine concern will be uncovered.
NHS SBS was employed in the East Midlands, South West and north-west London to redirect mail for the health service between 2011 and 2016.
It was meant to pass on documents that had either been incorrectly addressed or needed re-routing because the patient had moved to a new GP surgery.
People diagnosed with conditions in recent years could now discover it should have been treated much earlier. Even worse, some may never have known their health was a concern at all.
The report by the NAO found the cost of dealing with this incident was likely to be in the region of at least £6.6m.
The human cost, sadly, could prove to be much more, and for that, those found responsible must be held to account.