NHS IT problems put patients at risk of harm

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

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

Nearly half of hospitals with electronic patient systems reported problems that could affect patients.

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

The introduction of computerized records and the dematerialization of the NHS are a priority for the English government. The aim is for everyone’s health information to be accessible to GPs, hospitals and care homes at the touch of a button.

But there were many false starts. The latest deadline, set by the Ministry of Health and Social Affairs, is now 2026.

Some hospital trusts have spent hundreds of millions of pounds on new electronic patient records (EPR) systems, but BBC News has discovered many are having major problems with their operation.

Alongside our FOI investigation, coroners highlighted the role that hospital IT systems played in the deaths of some patients. The case of Darnell Smith, 22, is an example.

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

Darnell suffered from sickle cell anemia, cerebral palsy and was nonverbal. He was admitted to the Royal Hallamshire Hospital, Sheffield, with cough and cold symptoms and loss of appetite, in November 2022.

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

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

His father told BBC News: “For me, the computer system should be set up in a way that you have to see it… you know, it just doesn’t allow you to go any further until you have read what you are. supposed to read.

Several hours after his care plan was revealed, Darnell was admitted to intensive care and was put on a ventilator the next morning. He died of pneumonia two weeks later.

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

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

A Freedom of Information request sent to all acute hospitals in England, to which 116 responded, found these were not isolated incidents:

The inability of hospitals to send letters to GPs and patients could mean missing an appointment, a cancer diagnosis or a change in medication.

The Royal College of General Practitioners said it was shocked and surprised by the results.

“Now that we know there is a problem, it makes no sense to not act quickly to save lives and keep people safe,” said Professor Kamila Hawthorne, president of the college.

Separately, a number of clinicians have contacted BBC News about electronic patient record systems. None of them wanted to be named for fear of speaking out.

Some of their concerns regarding computer systems include:

Professor Joe McDonald, a former NHS clinical lead, says the financial costs of the systems are huge, but they also come with worrying costs for patients.

“The problem with paper is that when you make a mistake, you make it one at a time,” he said.

“With electronic patient record systems, you unfortunately have the opportunity to make the same mistake thousands of times. »

Professor McDonald says the current rollout of electronic patient records across trusts is ‘a broken puzzle’ because very few of them are able to connect with each other, making information sharing a real challenge .

He also believes that 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 it stronger than in health IT,” he added.

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

When Emily Harkleroad, 31, collapsed in December 2022, she was taken to the emergency room at North Durham University Hospital, where a blood clot on her lung, known as a pulmonary embolism, caused been diagnosed.

But there were errors and delays in giving Emily the blood thinner treatment she urgently needed. She died the next morning.

A new computer system, installed just months earlier, did not clearly identify which patients were most seriously ill and should be prioritized by senior doctors, an investigation found.

Clinicians had previously raised concerns about the system.

The coroner called on hospital trust and software provider 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 bereaved people.

“While there is no suggestion that the software was at fault in this matter, we continue to work closely with our NHS partners to implement effective programs that help them provide the safest and most effective care to 16 million citizens supported by our systems in the UK.”

County Durham and Darlington NHS Foundation Trust told BBC News they were taking the coroner’s report extremely 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 have been linked to the new IT system, as well as three other serious incidents.

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

“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 put patient safety at risk,” said President Dr Adrian Boyle.

Systems should be designed with input from clinicians and it should be possible to make urgent adaptations if problems are identified, he added.

“It’s a ticking time bomb,” said Clive Flashman of the organization Patient Safety Learning.

“If you look at the kinds of serious problems that are happening across the country where patients are being harmed and even dying because of these systems not working, I imagine there are tens of thousands who are events that we probably never talk about. »

NHS England said electronic patient record systems have been shown to improve patient safety and care, helping clinicians detect people at risk due to 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 are no longer reliant on paper records or disparate systems – which carry risks much more important for safety, delays in care and patient privacy. ” said Professor Erika Denton, National Medical Director for Transformation at NHS England.

“However, like any system, it is essential that they are introduced and operated to high standards, and NHS England is working closely with trusts to review any concerns raised and provide further support and advice on use secure their systems if necessary.”