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a dr writing notes imageFebruary 6 2018

An investigation into the system of handling clinical correspondence between GPs and other parts of the NHS has set out how a further backlog arose. 

The National Audit Office’s investigation has followed on from an initial investigation in 2016 into a backlog of 435,000 items that had not been processed. This included clinical correspondence that had been sent to the wrong GP and had had to be redirected.

This latest investigation stems from a hearing of the parliamentary Committee of Public Account in October 2017. NHS England had told the Committee that it had discovered a new backlog of 162,000 items of clinical correspondence that had not been redirected.

“NHS England stated that a small proportion of GPs had not been complying with guidance and had erroneously been sending clinical correspondence and other material to Capita, the current provider of primary care support services for NHS England. Capita has no contractual responsibility for redirecting clinical correspondence,” said the NAO in its new report.

The investigation has now looked at:

  • responsibilities for redirecting clinical correspondence;
  • the build-up of the backlog of clinical correspondence within Capita; and
  • action taken by NHS England and Capita to investigate, understand and rectify the problem.

Among the findings of the report are:

  • NHS England’s National Incident Team identified and clinically reviewed a backlog of 373,000 items of unprocessed clinical correspondence;
  • NHS England is only paying GPs for reviewing items of clinical correspondence after they have confirmed they have done the work;
  • NHS England has not yet stopped GPs from sending clinical correspondence to Capita in error;
  • NHS England has not finalised its process with Capita for handling any correspondence that Capita receives in error;
  • NHS England has agreed a process for assuring itself that there are no more boxes of unprocessed correspondence in archives.

The report was published in the same week that the share price for Capita fell, following the company issuing a profit warning statement. This was two weeks after the collapse of another company with a significant number of government contracts, Carillion.

Dr Richard Vautrey, Chair of the BMA’s GP Committee, has met with NHS England chief executive Simon Stevens to discuss concerns around Capita which has responsibility for running Primary Care Support England (PCSE). Last week, PCSE issued a statement on outstanding medical records and an FAQ.

Commenting on the fall in Capita’s share value, Dr Vautrey said: “This news is extremely concerning, but not altogether surprising considering the continued warnings the BMA has given over Capita’s shambolic running of backroom services in GP practices throughout the country. Just this month our own research found multiple failings across all areas operated by Capita in surgeries, including the handling of patient data.

“GPs will be rightly worried about the future of these services – which have a real impact on patient care – and the Government must provide assurances of what plans are in place to protect them should Capita suddenly be unable to deliver. With the collapse of Carillion [in January], we saw the problems that can arise when public services are outsourced to a private company, and this must not be allowed to happen again.”

Links:
NAO announcement    
NAO ‘Investigation into clinical correspondence handling in the NHS’. February 2 2018  
Capita ‘Update on Capita's transformation and outlook’ January 31 2018            
PCSE statement on outstanding medical records           
BMA statement           

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