back to article Database ballsup: NHS under pressure over fresh patient record error

The government is facing another NHS IT scandal, as it scrambles to confirm whether discrepancies between two databases have affected patient care. NHS England confirmed The Register that it was working to establish the impact of thousands of mismatches, which saw patient records present on one database and absent from another …

  1. Anonymous Coward
    Anonymous Coward

    Between my wife and myself

    we probably have 5 or 6 lifetimes experience of the NHS.

    That experience has led us to use our electronic tools to diarize every appointment, follow-up, and remind us to chase for a follow-up (uncompleted tasks are a great way to get nagging reminders).

    On top of that, despite being techheads of the first order, we both insist on getting paper letters for appointments which we take with us to the actual appointment.

    Even then, I've turned up, shown a letter, and been told that the appointment "isn't valid".

    1. Giovani Tapini

      Re: Between my wife and myself

      I recognize your experience. Indeed you will get multiple reminders, all with slightly different details, 3 phone numbers that no longer exist, and one that answers but has no idea about the service detailed on your appointment. If you get past the point of finding out which hospital, outbuilding, random clinic is hosting your appointment, don't be surprised if the lights are off and all the doors are locked.

      And they wonder why appointments are missed. It does not matter how good you are at recording all your contacts and instructions with accuracy and alacrity.

      Its also almost inevitable that if you have two massive overlapping databases there will be discrepancies. This in itself should not be a surprise, the lack of foresight to install mitigations on data quality is, however shocking (changing to Daily Mail tone of voice momentarily). It should be obvious that this will be the case, indeed the longer it is left the larger the drift/mismatch will become.

    2. Doctor Syntax Silver badge

      Re: Between my wife and myself

      "despite being techheads of the first order, we both insist on getting paper letters for appointments which we take with us to the actual appointment."

      Despite? More likely because of.

      We had the experience of turning up for an appointment of my wife's complete with letter and being told it had been moved to the previous day and we'd been notified (Oh no we hadn't) about 3 months previously.

      1. Prst. V.Jeltz Silver badge

        Re: Between my wife and myself

        its news to me theres a national database ,let alone 2 , especially at primary (gp) level , given that are all essentially private busnesses. under local unbrellas under a local nhs trust.

        Ive been lucky enough to visit gp very very rarely , same with hostipul , but every time I go they take a stab at my address and its invariably wrong - its like you have to tell every department individually.

        so I hold little hope they are actaully managed to record any sort of medical history.

        I made enquiries with NHS england recently about how to get a copy of ny records - which they enthusiaticly claim is easy , but didnt get anywhere - and an email asking for help recieved an automated reply and that was it

        1. Adrian Midgley 1

          Re: Between my wife and myself

          There's a hospital database, and a national one, or two, and each department keeps a list of addresses and uses that, except when individuals within it keep tehir own list.

          You'd think they don't trust the central ones.

          And yes, you should be asked each time, and ideally should answer truthfully.

  2. Aladdin Sane

    may not have been invited to ... child immunisation, bowel cancer screening

    So people may well have died because of this incompetence.

    1. JohnMurray

      Re: may not have been invited to ... child immunisation, bowel cancer screening

      Who knows?

      The bowel cancer screening results *letter* tells you you probably don't have it. Also that just because the results did not detect any, it doesn't mean you have none....

      As for child immunisation...parents opting for the "fuck-off I don't want my child immunised" option are increasing every time a newspaper prints a "immunisation leads to autism" story...

  3. }{amis}{
    FAIL

    Sadly not suprised

    Data migration and synchronisation across databases is a well know cluster f@#£k even when you have good documentation of both systems and skilled techs doing the work.

    Given that the odds are on that both of the databases involved were almost certainly poorly documented legasy messes written by people who have long since walked this kind of horror is inevitable.

    1. John Smith 19 Gold badge
      Unhappy

      "Data migration and synchronisation across databases is a well know cluster f@#£k "

      True.

      Top tip.

      Clean the data before you do the migration/copying/whatever.

      Yes, it could be done after the move but (somehow) it never is.

  4. nuked
    Facepalm

    Actually...

    ...an error rate of 0.08% doesn't seem at all bad. I think the issue lies with this statement:

    "Some of these mismatched records date back to 2008"...

    1. Aladdin Sane

      Re: Actually...

      A process sigma of 4.66 is pitiful.

  5. Bitsminer Silver badge

    Only two sources of truth?

    Surely this can't be right. Dig a little deeper and there should be another ten or twenty databases and applications with patient or medical or facility data. NHS is an old bureaucracy.

  6. nfb

    Re: Between my wife and myself

    At our advanced age my wife and I have become regular users of the NHS at our local Teaching hospital. They always provide a bar-coded appointment letter, we turn up, use the reader and take a seat. Wait times vary however the recent change to "see and treat" appointments has been a tremendous improvement.

  7. Anonymous Coward
    Anonymous Coward

    Opt-outs?

    Perhaps one system was honouring opt-outs, and the other wasn't?

    1. Anonymous Coward
      Anonymous Coward

      Re: Opt-outs?

      No, this isn’t exactly news to anyone with access to these data sets. They have never been in alignment with each other, even before the opt outs started.

  8. Anonymous Coward
    Anonymous Coward

    Ooops. Oh, well, what do you expect? Different hospitals use different software for their systems, different GP's use different software to hospitals and other GP's and we are all wondering whats going on.

    Not a clue between IT departments between CCG's and hospital trusts. I have an NHS email, and because I now work in a different CCG area and hospital, they are having a bit of trouble moving it over. Dont ask me why, I dont know (or care). So if something as simple as that gets a bit screwed up, lord knows what the rest of it is like.

    As a bit of a side mission, I used to work in a GP surgery and a patient wanted to register with us rather than their current GP in the same CCG, so I put it on the system, a few whirrs and clicks later, computer said no. So I decided to just register them as a new patient, which worked. For 3 days. Then alot of faff and crap later the CCG said that they cant be registered as new patients. OK, they are registered with another GP, so they went off and did some stuff, and asked for ID, proof of address etc, which I scanned and emailed.

    They get back to me (eventually) and said its all done. Which it wasnt. Computer had strop and said patient not registered. Long story short, they did get registered. 3 weeks later BUT theres the GP2GP thingy which should have transferred the patient data "automagically(TM)" but didnt. I couldnt be bothered to ask why it didnt happen, but an IT droog told me its to do with the registration, reregistration, re-reregistration and whatever else happened to get them registered with the new GP, so all the data had to be manually transferred. Ah, the joys of IT in the NHS (or lack of it)

  9. John Smith 19 Gold badge
    Coat

    "Ah, the joys of IT in the NHS (or lack of it)"

    No there's lots of IT in the NHS.

    It just doesn't work very well together.

    1. Anonymous Coward
      Anonymous Coward

      Re: "Ah, the joys of IT in the NHS (or lack of it)"

      lemme tell you I.T. asset management techniques in this nhs IT department are laughable. They wont put me in charge of it though to implement some basic rules / strategies like "When you install a computer , record the fucking room number. dont guess . dont put 'unknown' " , no that job goes to someone on double the money im on.

      1. Anonymous Coward
        Anonymous Coward

        Re: "Ah, the joys of IT in the NHS (or lack of it)"

        continued .... I've just been listening two managers discussing asset management policy .

        they are concerned ward 3 might change its name to stroke ward.

        USE THE FUCKING AUTOCAD MAPS PROVIDED BY THE ESTATES DEPT WITH ROOM NUMBERS THAT DONT CHANGE .

        MORONS.

        The two of em take 5x my salary between em .

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