Great Ormond Street Hospital today apologised after discovering that an inadequate IT system left it unable to check whether its patients were being treated in time.
The world-famous children’s hospital has launched an urgent inquiry and is alerting all hospitals across the UK who have referred patients to it for specialist care.
The Care Quality Commission, the NHS watchdog, has delayed publishing a potentially critical report into the hospital while checks are made into whether any patients have suffered harm as a result of delayed treatment.
Between 300 to 400 children have already been found to have waited more than the 18-week legal maximum for their treatment to start. But the figures could run into thousands as the hospital has been collecting “unreliable” data on waiting times since new rules were introduced in 2007.
GOSH said in a statement: “We have recently discovered that we have not had the appropriate IT system and the right processes to track our patients accurately.
“We would like to reassure our patients and their families that throughout this process we are ensuring that all patients that need treatment are treated or have plans to be assessed or seen.
“We are very sorry that our record keeping and processes to date have not matched the high standards that we, and others, expect of ourselves.”
Problems were first identified earlier this year when a new executive team discovered that the use of paper records remained widespread, making it impossible to access all patient information on a central computer.
This meant that hospital managers “didn’t know when the clock had started” on a child’s wait for treatment – or even if the treatment had been completed.
This month the hospital, which has 40,000 inpatients and 230,000 outpatient appointments a year, “paused” its duty to provide 18-week waiting time data to NHS England. A new computer system is being ordered but it may take “a couple of years” to install.
Some GOSH patients may be offered treatment in other NHS children’s hospitals or in private hospitals to clear the backlog. Children affected by the delays are those awaiting non-emergency treatment but who require the high-level care provided at GOSH due to underlying or congenital complications.
CQC inspectors visited GOSH in April and were due to publish a report in August. Hospital bosses fear failing the requirement for the trust to be “well led”, which could result in the embarrassment of it being placed in special measures.
Edward Baker, CQC deputy chief inspector of hospitals, said: “Since our inspection, the trust brought to our attention that there were problems regarding the reliability of their patient information systems. The publication of the CQC report has been delayed while the trust undertakes an assessment of what the impact has been on patients waiting for admission or appointments at the hospital.
“We are continuing to work very closely with the trust and stakeholders, and will be publishing the findings from our inspection as soon as the required reviews and assessments are completed.”
Many GOSH patients have complex care needs and may be seen by up to 10 consultants. Children are normally referred to GOSH via another hospital rather than by their GP, further complicating the record-keeping. About half are referred from hospitals outside the capital.
NHS insiders with knowledge of GOSH claim it suffers from weak central management. Powerful consultants, famed for their clinical excellence, are able to operate in “silos” and sidestep the modern-day NHS’s target-driven culture and demands for seven-day working.
An NHS England London spokeswoman said: “As the lead commissioner of services at Great Ormond Street, we want to ensure that all patients at the hospital have received timely treatment and so we have asked the trust to undertake a full review and share the findings with us through regular updates and meetings we have with them.”
Here is the statement in full issued by Great Ormond Street Hospital to the Evening Standard:
“We strive to ensure that all of our patients and their families receive the best possible care and experience.
“Our FFT results (Friends and Family Test) are consistently among the best in the country with 98% patients and their families recommending GOSH as a place to be treated. Our clinical outcomes put us amongst the best in the world for children’s care.
“However, we have recently discovered that we have not had the appropriate IT system and the right processes to track our patients accurately.
“As a specialist tertiary hospital, the majority of our patients are referred to us from other hospitals and many of these patients have no clear date as to when the ‘clock started’ if they are to be treated under 18 week rules. The issue around adequate tracking and data systems came to light following concerns around the number of patients with these unknown clock starts. This in turn led to a wider review of our information and our systems and processes.
“The review found our processes wanting and we acted swiftly to bring in the technical expertise we need to help us to address this issue.
“While we undertake this work, we have decided to pause the reporting of this data. This is to allow us to conduct a thorough review and assure ourselves that our records are accurate.
“Work is already underway to address the issues with our IT system and we are rolling out new training on how best to record patient data to ensure our processes for managing data correctly are as robust as possible going forward. We are working with our regulator and other NHS national partners in this work.
“The 18 week data does not relate to critically ill, emergency or urgent care. We would like to reassure our patients and their families that throughout this process we are ensuring that all patients that need treatment are treated or have plans to be assessed or seen.
“We are very sorry that our record keeping and processes to date have not matched the high standards that we, and others, expect of ourselves.
“We are continuing to communicate with families on a case by case basis and we are committed to providing the best possible care for patients. We will continue to prioritise and treat patients according to clinical need.”