Daily Insight: Back to basics

Long-standing issues with the IT infrastructure across several hospitals in Greater Manchester came to a head over the last week, with a total failure of key clinical systems.

The problems have affected Royal Oldham, Fairfield General, Rochdale Infirmary and North Manchester General hospitals, where the systems all run from servers which essentially lack the necessary capacity, and are unfit for purpose. There have routinely been smaller scale outages in recent years.

The latest incident began last week and has meant staff are having to use handwritten patient lists and notes in theatres and the emergency departments, while blood and scan results are also being written by hand. Patient histories are largely unavailable.

HSJ spoke to staff who said there are major concerns over patient safety, as the lack of digital systems increases the risk of errors, and also slows down multiple processes.

It is not clear what has directly caused the latest failures, but the trust ruled out a cyber attack. One source said there had been “critical IT memory loss”, which resulted in new instability across the core clinical systems.

The four hospitals were part of Pennine Acute Hospitals Trust, which was taken over by the Northern Care Alliance Foundation Trust. North Manchester General Hospital is run by Manchester University FT.

There are plans to move the NCA hospitals on to an electronic patient record designed by US firm Allscripts, which was recently bought by Harris Computer Corporation, but this is not due to happen until at least the end of 2023. MUFT is due to move to an EPR designed by Epic, another US tech firm.

Dire warning

A senior director of an ambulance trust has made unusually candid comments about a region’s serious and worsening situation with handover delays. 

West Midlands Ambulance Service’s nursing director Mark Docherty was one of the drivers behind raising the trust’s risk rating for delays to 25 in October and now he has predicted an exact date of 17 August when “catastrophic failure” could occur.

He told HSJ “teenagers are dying in the street from things that are completely reversible” and questioned why NHS England and the Care Quality Commission were not “all over the issue”.

It came as documents submitted to the trust’s May board meeting revealed comments by another director suggesting that more than 100 serious incidents at WMAS related to patient deaths where the service has been unable to respond because its ambulances are held outside hospitals. 

Mr Docherty also raised the case of Jamie Rees, who died on new year’s day aged just 18, after an ambulance arrived too late. His mother Naomi Issit told HSJ her “cheeky” son deserved better. 

NHSE responded by saying services are in line for new investment. They added that systems and trusts are encouraged to implement a series of initiatives to tackle handover delays.