NHS suffering from broken spine

NHS sites experienced acute spine problems in the week before Christmas, resulting in key systems being unavailable to NHS staff, and other sites having their access suspended. 

E-Health Insider has learned that a number of systems connected to NHS Connecting for Health’s (CfH) data spine were last week left unable to look up patients’ demographic details on the Personal Demographic Service (PDS). Others could not use the national Choose and Book service or the national Electronic Prescription Service, or were unable to access clinical systems hosted by their local service provider (LSP).

Particularly severe problems were experienced by users of InPractice Systems (IPS) primary care system, who were unable to access the spine. The problems were so bad that NHS CfH temporarily cut off access to its services to all IPS sites.

The problems are now said to have been largely resolved.  According to NHS CfH by 30 December the spine had been 100% available for the past seven days, though there remain some difficulties in updating details to the PDS service. 

The spine, which provides core national services such as a database of all patients’ demographic details, forms a vital component of plans to build a national system of electronic care records. The spine is designed to enable the NHS to work with common systems and securely share patient data.

EHI understands that the suspension of service last week was due to problems with transaction messages coming through from IPS systems. These could not be processed by the spine and rapidly caused long error queues.

In the South of England staff at eight NHS trusts were unable to log onto their radiology information system (RIS). The eight trusts affected were Basingstoke, Yeovil, Nuffield, Gloucester Royal, Royal Surrey and Oxford hospitals – were unable to access their LSP-hosted RIS system.

BT is responsible for building and maintaining the data spine on behalf of the Department of Health’s IT agency, CfH.

An NHS CfH spokesperson initially told EHI last week that the problems were created by work to upgrade the spine.

The CfH spokesperson later added: "NHS Connecting for Health can confirm that some of the NHS organisations using our systems and services have this week been experiencing some intermittent interruptions, for example, when using the Personal Demographic Service of the Spine."

The spokesperson continued: "In particular, InPractice Systems users have experienced access problems to NHS CfH systems. This is currently being addressed and to help with that process NHS CfH has temporarily suspended access to its services from InPractice Systems sites until the matter can be rectified. "

IPS is understood to have contacted all of its users to make them aware of the suspension of service and to ask them not to attempt to access CfH services until the problems were resolved.

The spokesperson added that the problems had also "impacted on some users of Choose and Book and the Electronic Prescription Service". They added that NHS CfH and BT were working closely to bring service levels back to normal as quickly as possible.

Last week several readers contacted E-Health Insider regarding their frustrations caused by the unavailability of the NHS spine. On Wednesday, 22 December both the national Choose and Book service and Spine were out of action. Their respective NHS CfH websites showed both national services with the status of ‘red’, meaning "the service is unavailable".

One NHS IT manager told EHI that on Thursday, 22 December the system had been unavailable for local use from 7.00am until mid-afternoon. "Those of us that previously had reliable local systems are struggling to find value in this investment," said the NHS IT manager, who asked to remain anonymous.

Another IT manager told EHI that in the South of England that on 22 December they were experiencing persistent problems with the unavailability of remotely-hosted systems provided by their LSP, which had been unavailable for half the day, with staff reporting being unable to log-on to the system from 7am.

The NHS IT manager said there had now been "four major outages on the data centre RIS operation".

Gordon Hextall, chief operating officer for NHS Connecting for Health, said last week: “We are working closely with BT, InPractice Systems and LSPs to resolve the issues with access to the Personal Demographics Service as quickly as possible." He added that the problems "have no impact on the clinical care of patients".

On 30 December CfH issued an update to EHI that said as at 7.30am "all Spine services had been 100 per cent available for the whole of the week". It added that there remained "a few minor problems on updating the Personal Demographics Service, but not in accessing it".