Monday, October 06, 2008

The world's biggest computer botch-up: Take a bow NHS

Patients `at risk' from flawed $25BILLION IT system

An NHS computer system intended to revolutionise patient care has so many software flaws that seriously ill or badly injured patients are at risk of being inaccurately diagnosed, according to an internal health service document. An assessment of the system at the first hospital to launch it, the Royal Free Hampstead NHS Trust in north London, details a catalogue of software glitches and design faults. It warns that the problems pose a possible "risk to patients by underestimation of clinical condition".

According to the document, the system, which is being used in the accident and emergency department, is routinely crashing, patient information is intermittently "lost" and some staff are reverting to pen and paper. Extra staff have been drafted in to help cope.

Tony Collins, executive editor of Computer Weekly, said the document, disclosed by an NHS employee, warned that some of the problems could "continue indefinitely". He said: "This is the centrepiece of the Connecting for Health programme [the government's plan to computerise NHS records] and it isn't working properly." Hospital officials said this weekend that continuing problems were being "vigorously" pursued with the contractors while staff were being vigilant to ensure patient safety was not compromised.

The report is the latest setback for the 12 billion pound Connecting for Health programme, which was meant to provide a single nationwide IT system for the NHS containing records for every patient by 2010. While some elements of the programme have been introduced ahead of schedule, the patient record system has been beset with delays and software problems.

Last June the Royal Free became the first trust to launch the most advanced version. To protect patient confidentiality, records can be accessed only with a swipe card and a code. The launch was a key test for Connecting for Health, which has faced questions about the reliability of its systems and whether patient confidentiality could be easily compromised with computerised records. Two months after the launch there were reports of missing data and delays in booking patient appointments.

Now an assessment of the new system at the Royal Free has uncovered a series of problems, which appear to be unlikely to be fixed in the short term. The Royal Free Hampstead NHS Trust said the implementation of the new system was initially better than expected but there were continuing problems that would "take some time" to rectify.

Source






NHS child loses out as surgeon gives liver transplant to private patient from the Gulf

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A senior surgeon broke NHS guidelines by transplanting part of a donated liver into a private overseas patient instead of saving it for someone on Britain's waiting list. Professor Nigel Heaton, head of the transplant unit at King's College Hospital in London, transplanted part of the liver into a boy from one of the Gulf states.

The surgeon was the subject of a formal investigation after other doctors said that a child on the NHS organ waiting list should have been given priority. National guidelines state that, because of the acute shortage of donor organs in Britain, livers must be offered to all other NHS centres before they can be given to a patient from outside the EU. There are about 400 NHS patients on the liver transplant waiting list - 20 per cent of whom will die before a suitable organ can be found.

The incident sparked fury among surgeons at St James's University Hospital in Leeds, which first received the liver from a 40-year-old donor. After instructions from UK Transplant, which co-ordinates NHS transplant services, the Leeds surgeons sent the liver to King's for a `super-urgent' adult NHS patient on the understanding that it was to be used solely for that person. St James's only learned the following day that Prof Heaton had split the liver into two when a member of staff from King's contacted them.

Prof Heaton had used the larger right portion for an adult NHS patient and transplanted the left lobe into a seven-year-old boy who had rejected an earlier liver and was seriously ill. He later died.

A senior medical source said: `This was clearly a violation of procedure. It should have been offered back to every other hospital within the NHS and then throughout Europe before going to a non-NHS recipient. `There is no process for it to go to a non-entitled patient on compassionate grounds. It just doesn't happen.'

David Mayer, chairman of UK Transplant's Liver Advisory Group, said the Leeds doctors had been extremely concerned because they had a sick child, an NHS patient, who could have benefited if they had known the liver was to be split. He added: `If we were to provide livers for the world from the UK, then UK patients would be enormously disadvantaged.'

The procedure of splitting livers has been developed in recent years to counter the shortage of donor organs, particularly for children. Because livers are able to regenerate relatively quickly, two patients, usually an adult and a child, can be treated with one organ. Normally, livers from donors aged over 40 are considered too old to split, so UK Transplant had not expected this to happen in this case.

In a statement, King's said they had applied to have the Gulf state's child considered for priority liver transplantation on compassionate grounds and that there had been no objections. They said that the investigating panel had found that guidelines had been breached and that it had recommended that King's review its practices and ensure all staff were aware of transplant guidelines. A King's hospital spokesman confirmed that Prof Heaton had been paid for the original transplant on the private patient - which had been rejected - but had received no further fee for the second operation.

The surgeon, who lives in a 1million pound detached house in Beckenham, Kent, gave George Best a liver transplant three years before the alcoholic ex-footballer died of multiple organ failure. Earlier this year, this newspaper revealed that King's had agreed with the Greek and Cypriot governments to treat patients from those countries privately using NHS livers, charging around 85,000 pounds per operation.

King's has given livers from UK donors to 22 private patients from Kuwait and the United Arab Emirates in the past five years. The hospital has made more than 4million from performing transplants on overseas patients in that time.

Source

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