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NHS computer problems put patients at risk

Image source, Errol Smith

Image caption, Darnell Smith died in hospital at the age of 22

  • Author, Sharon Barbor
  • Role, Health Correspondent

IT system failures have been linked to the deaths of three patients and more than 100 cases of serious harm at NHS hospital trusts in England, BBC News has discovered.

A Freedom of Information request also revealed that 200,000 medical letters had not been sent due to widespread problems with NHS computer systems.

Nearly half of hospital trusts with electronic patient systems reported issues that could impact patients.

NHS England says it has invested £900 million over the past two years to help introduce new and improved systems.

Computerized data entry and making the NHS paperless are a government priority in England. The goal is for everyone’s health information to be accessible to general practitioners, hospitals and nursing homes at the touch of a button.

But there have been countless false starts. The latest deadline, set by the Department of Health and Social Care, is now 2026.

Some hospital trusts have spent hundreds of millions of pounds on new electronic health record (EPR) systems, but BBC News has discovered that many are experiencing major problems with the way they work.

‘He was our rock’

Image source, Errol Smith

Image caption, Hospital staff were unable to view key information about Darnell Smith on their computer system

Separately from our FOI investigation, coroners have highlighted the role that hospital IT systems played in the deaths of some patients. The case of twenty-two year old Darnell Smith is an example of this.

“He was our rock, you know. He had a great personality. Words can’t really explain how much he meant to us…’ says Erroll Smith of his son Darnell.

Darnell had sickle cell disease, cerebral palsy and was non-verbal. He was admitted to the Royal Hallamshire Hospital in Sheffield in November 2022 with cough and cold symptoms and a loss of appetite.

He should have had his vital signs – heart rate, blood pressure and temperature – checked by staff every hour for at least six hours, but there were no checks for more than 12 hours.

Staff were unaware of Darnell’s specific needs because his personal care plan was not visible in the hospital’s computerized records, a coroner later concluded.

His father told BBC News: “For me, the IT system has to be set up in such a way that you have to see it… you know – it just doesn’t let you go any further until you’ve read what you’re doing. should read.”

Just hours after his care plan came to light, Darnell was admitted to the intensive care unit and placed on a ventilator the next morning. Two weeks later he died of pneumonia.

Following an inquest, the coroner warned of a “real risk of further deaths” if doctors were not given access to important information about patients’ care needs.

Sheffield Teaching Hospitals Trust has apologized for the care Darnell received. They say they have already made changes to reduce the chance of this happening again and a new IT system will be introduced this year.

Image source, Getty Images

Image caption, In most hospitals, staff use electronic patient record systems

Serious harm to the patient

A Freedom of Information request sent to all acute hospital trusts in England, from which 116 responded, revealed that these were not isolated incidents:

  • 89 trusts confirmed they were monitoring and recording cases where patients could be harmed as a result of problems with their electronic health record (EPR) systems
  • almost half recorded cases of potential harm to patients related to their systems
  • almost 60 trusts reported IT issues that could impact patient care
  • more than 200,000 letters have not been sent to 21 trusts
  • there were 126 cases of serious harm linked to IT problems, across 31 trusts
  • and three deaths in two trusts related to EPR problems

‘Keep people safe’

When hospitals fail to send letters to GPs and patients, it can mean anything from an appointment to a cancer diagnosis or missing a medication change.

The Royal College of GPs said it was shocked and surprised by the findings.

“Now that we know there is a problem, it is madness not to do something quickly to save lives and keep people safe,” said Prof. Kamila Hawthorne, president of the college.

In addition, a number of doctors contacted BBC News about electronic health record systems. None of them wanted to be named because they were afraid to speak out.

Some of their concerns about the computer systems include:

  • “It makes finding crucial information very difficult or impossible”
  • “Medication errors have occurred, missed doses of antibiotics have occurred”
  • “Clinical information can be buried anywhere”
  • “Incorrect patient details on theater lists, incorrect operations stated, incorrect allergy status”

‘Culture of cover-up’

Professor Joe McDonald, a former clinical lead for the NHS, says the financial costs of the systems are enormous, but there are also worrying costs for patients.

“The nice thing about paper is that if you make a mistake, you make them one by one,” he said.

“Unfortunately, with electronic health record systems you have the opportunity to make the same mistake thousands of times.”

Professor McDonald says the current rollout of electronic health records within trusts is “a broken puzzle” because very few people can get in touch with each other, making information sharing a real challenge.

He also believes there are echoes of the Horizon scandal at the Post Office.

“There is undoubtedly a culture of cover-up within the NHS and nowhere is this stronger than in the healthcare IT sector,” he added.

“It’s not safe. It’s really not safe.”

Image source, Family ceremony

Image caption, Emily died in 2022 from a blood clot

When 31-year-old Emily Harkleroad collapsed in December 2022, she was taken to the emergency department at North Durham University Hospital where she was diagnosed with a blood clot in her lung, known as a pulmonary embolism.

But there were mistakes and delays in getting Emily the blood-thinning treatment she desperately needed. She died the next morning.

A new computer system, installed just months earlier, failed to clearly identify which patients were most seriously ill and should be prioritized by senior doctors, an inquest heard.

Doctors had previously expressed concerns about the system.

The coroner called on hospital trust and software supplier Cerner, now owned by Oracle, to take action to prevent future deaths.

Oracle told BBC News: “We extend our condolences to the family of the deceased and other surviving relatives.

“While there is no suggestion that software was to blame in this case, we continue to work closely with our NHS partners to implement successful programs that help them provide the safest and most effective care to the 16 million citizens who use our systems across Great Britain. support Britain. ”

County Durham and Darlington NHS Foundation Trust told BBC News they were taking the coroner’s report very seriously.

Through our Freedom of Information request, the BBC has also learned that more than 2,000 incidents of potential harm to patients at the Durham Trust were related to the new IT system, and three of these were serious incidents.

‘Ticking time bomb’

The Royal College of Emergency Medicine said the coroners’ findings into the deaths of Emily and Darnell were “shocking and deeply concerning”.

“It is essential that our members and their colleagues have access to reliable technology and effective systems that they can trust, and that do not compromise patient safety,” said chairman Dr Adrian Boyle.

Systems should be designed with input from doctors and there should be the ability to make urgent adjustments if problems are identified, he added.

“This is a ticking time bomb,” says Clive Flashman, an expert in IT and patient safety for thirty years.

“If you look at the kind of serious problems that are happening across the country, where patients are suffering harm and in some cases death as a result of these systems not working properly, I would imagine that there are tens of thousands of these who are sick are. happen that will probably never be talked about.”

Provide support

NHS England said electronic health record systems have been shown to improve patient safety and care, by helping doctors detect people at risk of conditions such as sepsis.

“The NHS has invested almost £900 million over the past two years to help local organizations introduce new and improved systems so they no longer have to rely on paper records or patchwork systems – which pose much greater risks to safety, delays in patient care and privacy. ” says Professor Erika Denton, National Medical Director for Transformation at NHS England.

“However, like any other system, it is essential that they are introduced and operated to high standards, and NHS England is working closely with trusts to assess any concerns raised and, where necessary, provide additional support and guidance on the safe use of their systems.”

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