Clinics in chaos from computer update failures

An attempt to update computer systems during management restructuring and loss of key staff failed disastrously, leading to failures classed as severe by administrators.

But a series of blunders in the introduction of a new computer system at the Mid Yorkshire Hospitals NHS Trust caused chaos and meant thousands of patients saw delays to their care after they were not given appointments, or given too little notice of consultations, wrongly told they were due appointments, or mistakenly told they were not.

The failures were classed as “severe” by the trust which declared a serious incident.

It followed the trust’s patient administration system being switched from an outdated computer programme to a new model. The system is a vital part of the way hospitals are run, not only to deliver prompt treatment, but to ensure they are paid for the work they do.

Making changes is highly complex in part due to the huge numbers involved. Some 1.4 million patient records were switched over by the trust, which deals with 520,000 outpatients a year at its hospitals in Dewsbury, Wakefield and Pontefract.

The system went live in September 2013 but within weeks patients reported they were receiving up to four letters for the same appointment including some giving a date and cancelling it in the same envelope.

Staff were alerted to further difficulties when a patient arrived for a consultation but said they had not received an appointment letter. It emerged that all patients who had follow-up appointments made under the old system had not received confirmation or reminder letters from the new system, leading to a decision by managers to send 12,000 letters in October to ensure all would receive details of their consultation.

Meanwhile, managers became puzzled at a 50 per cent fall in numbers of people ringing a call centre at Pinderfields Hospital which processed appointments.

In the first week of November, doctors began complaining of empty slots in their clinics. But it was only on November 5 that it was discovered that appointment letters had not been printed for five weeks as it emerged no checks were being made on the numbers despatched.

In total, 16,437 letters were not printed over the period, affecting 9,000 patients whose care was delayed. It triggered widespread upheaval for hospital staff tasked with making new appointments but no planning was made for the impact on the call centre.

In one week, only a quarter of 12,600 callers were answered. Some waited more than half an hour to be answered, with 86 people in a queue at one stage.

Anxious patients began calling the hospital to complain. A report into the failures said: “The patients were very concerned that they could not make their appointment and in some cases were concerned that they would have their care transferred back to their GP.”

The knock-on impact meant as many as 20 per cent of appointments were cancelled in December 2013 and January 2014 – three times as many as usual.

The problems were blamed on management restructuring, the loss of key administrative staff in efficiencies ordered to tackle the trust’s long-standing financial crisis, as well as mistakes in the implementation and switch over to the new system. There was also a lack of engagement with staff.

Among a list of 12 recommendations, the report said: “When planning any major change to systems that this is undertaken with involvement throughout the process from key users and that adequate time is built into the plan to enable robust testing and validation to take place.”