NHS legacy IT at fault for mismanaged health screenings

An investigation has been launched after eligible patients weren’t notified about their required screenings

Doctor NHS

Legacy IT and a blunderously constructed database network in the NHS has contributed to the extremely poor management of health screenings in the UK. 

Worryingly, a new report from the National Audit Office (NAO) has revealed that cancer patients are some of the worst affected, with more than 100,000 women not being alerted to the fact that they were due to have breast and cervical cancer screenings last year. 

The NAO found hat the computerised system which is supposed to automatically select women to be invited to screenings suffered a "serious failure" that prevented 122,000 women since 2009 from being informed about their required screening.

The affected women were aged between 68 and 71 and when focussing on the first six months of 2018, 43,220 women had not received letters inviting them for a cervical screening. A further 4,508 women were not sent their results letters. Of these women, even more tragically, 182 needed follow-up treatment.

According to the report, the government declared the NHS database system "not fit for purpose" as long ago as 2011 but IT Pro reported Doctors' distrust in the IT systems as far back as 2008, just before the analysed data set in the new study.

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NHS England announced its intention to replace the system known as the National Health Application and Infrastructure Services (NHAIS) by March 2017 following government pressure but has failed to do so. The project is now 23 months behind schedule.

The delay has caused additional cost and greater risk that screening services cannot reliably identify and invite eligible populations for screening.

One of the reasons why the NHAIS is not considered fit for purpose is because patient data which is used for things like automatic notification of eligibility for cancer screenings is divided over as many as 83 separate databases.

The issue with having data stored across this many databases is that it becomes more difficult to track screening histories when patients travel into different geographic boundaries.

Each screening program also has its own IT system on which they rely and some, such as the cervical programme, are as old as 30 years.

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The Independent Breast Screening Review concluded that the IT on the breast screening programme was "dated and unwieldy" and that 5,000 women were not invited to their final breast screening because of errors caused by using two complicated systems, despite the best efforts of staff.

"Our screening programmes are recognised as among the best in the world and we are committed to making any improvements needed, said a spokesperson form the Department of Health and Social Care.

"We are working closely with NHS England and Public Health England to address the issues this report highlights.

"We have committed an initial 1.8 million to identify and design an immediate replacement for the breast screening IT system. A further 12 million will be available to implement the final version.

"We will also spend 487 million on healthcare technology as part of the NHS Long Term Plan to improve patient care and reduce workload on staff."

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The report follows more news that suggests NHS's IT just isn't up to scratch. An FOI from January 2019 revealed the 'extraordinary' amount of cyber attacks NHS trusts sustained in the past few years.

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Experts weighed in expressing distrust in the statistics, speculating that the NHS could be underreporting the statistics. "It wouldn't be surprising if this number was even double or triple if a thorough investigation was being done," said Joseph Carson, chief security scientist at Thycotic.

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