To ask the Secretary of State for Health, how often he has received updates on the work of NHS Shared Business Services as required under the contract signed by Sopra Steria; and if he will publish any reports relating to data loss which have been received by NHS Shared Business Services or his Department since 2011.
To ask the Secretary of State for Health, how many incidents of patient harm have been identified as a result of the loss of confidential NHS correspondence by NHS Shared Business Services; and whether any compensation will be paid to patients who have been found to have been harmed as a result of that lost correspondence.
NHS Shared Business Services (NHS SBS) were originally set up as a joint venture in 2005 and were contracted from 2011-2016, through 26 separate contracts with primary care trust organisations (PCTs), to carry out a number of services including redirection of correspondence to general practice (GP) surgeries. These contracts were novated to NHS England in April 2013 when PCTs were abolished.
Some of these contracts required NHS SBS to provide a redirection service for the East Midlands, North of England, North-East London and South West of England regions, for correspondence relating to a patient received by the wrong GP. The service required NHS SBS to attempt to identify the correct registered GP and redirect the correspondence.
The contracts did not specify specific numbers of documentation to be redirected as this was variable. Approximately 708,000 pieces of correspondence (including letters) have been identified as not being redirected during this period.
Of these 708,000 items, approximately 190,000 were identified as not having clinical significance, so were sent to archive, and have not been sorted by region. The remaining correspondence has been reviewed and returned to GPs. The attached table shows the approximate figures for correspondence repatriated to each of the affected regions because it had not previously been redirected as intended. Disaggregated data at constituency level is not held.
There has been no loss of correspondence. All correspondence has been securely held, and has now been returned to GP practices or to archives, as appropriate.
NHS England and the Department were informed, by letter on 16 March 2016, of the discovery of a backlog of unprocessed documentation within the redirection service by the Managing Director of NHS SBS. NHS England immediately established a National Incident Team to lead resolution and work with NHS SBS to remedy the problem.
The Department’s immediate concern was that patient safety might have been compromised by the delay in forwarding correspondence so a rapid process was started to identify whether anyone had been put at risk.
Publicising the issue at the time could have meant GP surgeries being inundated with inquiries from worried patients which would have prevented them doing the most important work, namely investigating the named patients who were potentially at risk.
Although there was no loss of confidential NHS correspondence, NHS SBS carried out a full investigation into the incident. The scope of the terms of reference were agreed with NHS England and the Department.
NHS England commissioned an investigation into the incident by its Internal Audit team on 1 April 2016, working with auditors from the Department and NHS SBS, into the incident. The terms of reference covered the appropriateness of the response to the incident by NHS SBS; the response by NHS England to confirm that similar issues did not exist in other Primary Care Support services; contract management processes to enable a lessons learned exercise and assurance over other services provided by NHS SBS.
The Department commissioned an investigation by its Internal Audit team which considered the Department’s role in the corporate governance of NHS SBS.
The Information Commissioner’s Office (ICO) was informed by NHS England on 18 April 2016 and is presently conducting an investigation into the incident with the full cooperation of NHS England. The ICO determines its own terms of reference, and the timing of any report is a matter for the ICO.
The National Audit Office (NAO) is also undertaking an investigation into how the incident occurred, contract management and the handling of the response. At the time of completing this answer the final terms of reference have not yet been received. The outcome of the NAO’s investigation will be reported to Parliament as appropriate.
Given that this national incident is currently subject to an investigation by both the NAO and the ICO, it is not appropriate to publish related documents until these investigations have concluded.
NHS SBS no longer provides an NHS mail redirection service, and we understand that NHS SBS has taken disciplinary action over the non-delivery of this NHS correspondence.
In order to support GP practices, which have been required to review and assess large numbers of returned documentation arising from this incident, NHS England agreed payments with the British Medical Association’s General Practitioners Committee on behalf of GPs.
These payments are intended to provide recompense for the time required to review and assess the documentation in the context of relevant patient medical records; to communicate with patients about the incident where necessary; and to report to NHS England the outcome of this work and whether there is any potential harm caused because of the delay.
Payments made to GP practices, to the end of February 2017 for this work now total £2,442,750, for which final liability remains subject to discussion.
Payments were made to practices related to the number of items received for review as follows:
Number of Pieces of Correspondence Repatriated
Payment for Assessment and Review of Documentation
Less than 20
A fixed payment of £50
A fixed payment of £100
More than 50
£50 per 10 items
The Department and NHS England have focussed on ensuring that matters of patient safety are being addressed. There is no estimate of the cost of staff time related to the generation of the original correspondence.
The specific costs for the redirection service were not separately identified within the contract and are not available.
There has been no loss of correspondence and, at this point, there has been no confirmed case of a patient being harmed as a result of this incident. Work continues to conduct the necessary assessments by registered GPs and undertake further clinical reviews, where required. As, to date, no harm has been identified, no compensation has been paid to patients.