E-mail reveals outage disrupted patient care

One week on from the computer failure that left 80 trusts in the North-west and West Midlands without access to their IT systems the extent of the disruption to patient care of the biggest ever NHS IT failure is coming to light.

Despite claims to the contrary by NHS Connecting for Health, E-Health Insider has received documentation showing the failure disrupted patient care at Birmingham Children’s Hospital (BCH) NHS Trust – one of eight acute trusts that lost access to patient data last week. As a result BCH has begun a review of its contingency arrangements.

The trust has stated that the unavailability of its patient computer system, and the consequent inability to track case notes had an impact in both out patient and inpatient care. As a result of the failure the trust is now reviewing contingency arrangements.

An internal e-mail from Richard Beekan, the trust’s director of operations, is explicit about the impact the loss of the Lorenzo patient administration system had. Once the trust lost access to the patient administration system (PAS) it had to revert to paper based “business continuity systems.”

“This system was introduced expecting the system only ever to be unavailable for a maximum of 12 hours and therefore during the last three days we have experienced issues we had not planned for. In particular the absence of our case note tracking system and an ability to know where notes were had an impact in both out patients and inpatient areas.”

Last week NHS Connecting for Health (CfH), the agency responsible for the NHS IT modernisation project, publicly stated in bulletins that the failure at the CSC data centres had no impact on patient care. On 2 August, CfH said: “To date no impact on the delivery of patient care has been reported.”

As well as stressing that the outage, which some trusts without systems and access to patient data for up to five days, had had minimal impact CfH said all affected trusts: “are continuing to provide normal service by operating manual contingency systems.”

In his note to BCH staff Beekan made clear that the extent of the outage contradicted the assurances the trust had been given: “Although the trust has always been informed that Lorenzo will always be available and there should not be any significant unplanned down time we are now acutely aware that this is not the case.”

Following the events of last week the trust is now carrying out a review with staff of the issues that arose during the time Lorenzo was not available “so that appropriate business continuity plans can be agreed and so we can inform the relevant parties of the issues.”

Beekan says that UBCH’s executive team “will be taking any issues raised forward with Connecting for Health and the Strategic Health Authority.”

On late Thursday afternoon an NHS Connecting for Health spokesperson told E-Health Insider that all the trusts had systems available again to them. : “All trusts and PCTs now have access to services.” The spokesperson declined to confirm though whether systems had been fully restored.

A spokesperson for Birmingham Children’s Hospital NHS Trust confirmed on Thursday that “in critical areas the system had been restored by late yesterday afternoon”, and that by late yesterday the trust’s IT department was working on the “backlog of data” that had built up.

University Hospital Birmingham NHS Foundation Trust told EHI that its PAS had been restored on late Tuesday and that the impact on patient care had been minimal. “But it will take to the end of the week to update the data that had to be recorded manually.”

The spokesperson added: “The main disruption to us was that when patients were admitted we couldn’t see what beds were available.” They said far more disruption would have occurred if the problem had gone on for more than three days.

Meanwhile the Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust in Shropshire was fully back up and running by mid-Thursday morning.