By Tony Collins
It sounded serious. Under the headline
“Cancer patients in limbo as five hospitals suffer ‘major’ IT crash”
the Daily Telegraph said,
“Hundreds of cancer patients have been denied treatment at one of England’s biggest hospital trusts due to a major IT failure that ground basic services to a halt.
“Doctors at five large London hospitals have reported 11 days of “chaos” after the systems used to prescribe chemotherapy doses and share x-ray and MRI images broke down on April 20.
“Barts Health NHS Trust said at least 136 operations had been cancelled due to the crash, as well as “hundreds” of cancer treatment sessions.
“The computer failure also means frantic staff have been unable to process blood tests for all but the most critical cases…
“A doctor at the Royal London Hospital told the Daily Telegraph: ‘We have been forced to leave sick patients on the ward while we go down 16 floors to catch a glance at an x-ray image, then come back and make treatment decisions based on a hazy recollection of it…
“An email sent by managers to staff last week said the crisis had forced cancer teams to rebuild patient records ‘from scratch’.
A medic at Whipps Cross hospital was quoted as saying that a lot of people were stuck in hospital needlessly which increased the likelihood of infection.
The trust runs Mile End Hospital, Newham University Hospital, The Royal London Hospital, St Bartholomew’s Hospital and Whipps Cross University Hospital as well as other NHS sites.
The Barts trust website says it delivers “high quality compassionate care to the 2.5 million people of east London and beyond”.
It has a turnover of £1.25 bn and a workforce of 15,000, making it the largest NHS trust in the country.
According to Health Service Journal, an internal email from Barts’ chief clinical information officer Tim Peachy said the IT failure was primarily a result of an “unexpected failure of a small number of physical disks on which data is stored”.
At one point the trust was manually processing blood test results and X-rays, and arranging for porters at its hospitals to hand deliver paperwork to clinicians.
In the light of the failure and disclosures in Health Service Journal, Barts confirmed the IT problems in statements to the media. It also contacted patients who were affected by the problems. A Barts statement this week said,
“A major computer equipment failure on Thursday 20 April resulted in a number of IT applications being unavailable to staff.
“‘Unfortunately, it has been necessary to cancel 136 operations, representing about 2.5% of our usual weekly in-patient activity. Several hundred chemotherapy appointments have been cancelled, however we have now recovered the chemotherapy prescribing database.
“Clinical teams have completed a patient-by-patient review to ensure that the appropriate course of action is taken for each of them, endeavouring to keep the disruption to an absolute minimum.
“We apologise to those affected and will reschedule their appointment for as soon as we are able.
“A number of applications have been affected to varying degrees. We have made significant progress in many areas including pathology (blood testing), with image viewing now also restored across the Trust. There are still some other areas where it will take time before we are on track again.”
“We continue to work urgently to maintain the operational resilience of our services, using tried and tested contingency plans to keep our patients safe.”
Despite the seriousness of the problems, the effect on patients and the uncertainties that media coverage might have created in the minds of those intending to go to Barts’ hospitals, the trust made no mention of the difficulties on its website – where it has a “latest news” section – or on Twitter.
Barts uses Twitter for good news announcements, comments and congratulations, sometimes with dozens of daily tweets.
But why no mention of the IT problems?
On this point, a Barts spokeswoman said,
“We do not rely on social media to update patients. As a proportionately small number of people will be impacted on by the IT situation we are communicating directly to those affected including at outpatients clinics and via phone, letter as well as through communications with our healthcare partners including GPs.”
In its media statements Barts has been more open than some NHS organisations.
The usual NHS cycle after a major IT-related failure is a statement saying teething problems have been resolved, or are being resolved, followed by a succession of similar statements over the next few days, weeks or months when it becomes clear the problems haven’t been resolved.
This is what happened with e-Referral Service and Capita’s problems handling GP support services.
That hasn’t happened at Barts. But despite its openness with the media, it’s odd the trust has published many congratulatory tweets in the past two weeks without a mention of any IT-related problems. They are not even alluded to.
It’s also odd that on its website the Barts “Latest News” section has no mention of the difficulties. But the website does have various good news announcements, including a reference to a positive Care Quality Commission report in April 2007.
Trusts do not have to account to patients, Parliament or anybody for IT-related problems. They are under no obligation to apologise to patients whose stays in hospital are unnecessarily prolonged, or whose appointments, operations and blood tests are cancelled or delayed because of IT-related difficulties.
They also have no obligation to give the public any reason for the failure or explain why there was no back-up system that ensured patients were unaffected.
But amid so many positive announcements, statements and comments to the public on its website and on Twitter, should Barts have left out the other side of the story?
The NHS is an organisation that’s attuned to promulgating good news. It’s rare for a trust board paper and or a trust website to have anything but a good news feel to it.
But telling the public one side of the story does not encourage the public to believe officialdom when it says: “Trust us. We know what we’re talking about.”
Thank you to Zara Pradyer for letting me know about the Daily Telegraph article.