Capita contract probed after thousands of clinical letters stuffed in a drawer somewhere

It was not contractually obliged to forward them so...

The UK's National Audit Office is investigating a backlog of 162,000 undelivered items of clinical correspondence on the watch of Capita's £700m Primary Care Services contract.

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NHS: Remember those patient records we didn't deliver? Well, we found another 162,000

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In September 2015, Capita commenced the seven-year contract to provide primary care support services, including the management of GP pay and pensions, medical records, patient registration, and maintenance of its of new GPs.

The NAO is scrutinising the broader contract amid "ongoing issues" with service delivery.

Previously, GPs had forwarded clinical correspondence to the PCS centres, and a proportion erroneously continued to do so after the contract was signed with Capita.

In October 2016, Capita formally reported the backlog to NHS England. "Capita told us that, with hindsight, it believes it could have reported the backlog sooner," said the NAO.

A clinical review to be completed by NHS England at the end of next month estimates it will cost £2.4m to review clinical correspondence for evidence of harm, including £300,000 that it will pay to GPs. No patient harm has been identified yet.

In the absence of any agreed and contracted process for handling correspondence for redirection, all such correspondence arriving at Capita was stored, but not processed.

It follows a separate incident in which 700,000 patient records went undelivered under the NHS Shared Business Services joint venture with Steria last year. Attempts to resolve that gaffe have so far cost £6.6m.

Due to a change in Capita's process for its Primary Care Services business, the firm stopped processing the redirected correspondence some time in spring 2016. In the absence of any agreed and contracted process for handling correspondence for redirection, all such correspondence arriving at Capita was stored, but not processed.

Capita began closing a number of the 36 PCS sites from March 2016. Upon closure, inventories of all remaining records at the site were made and shared with NHS England. The inventories made reference to "clinical notes" but at this point no one identified that these included unprocessed clinical correspondence, said the report. Capita stored the material in its archive.

NHS England has not yet been able to stop GPs from sending clinical correspondence to Capita in error and continues to receive 5,000 to 10,000 items of paperwork from Capita every month.

The body is planning to run an information campaign to ensure that GPs understand the guidance for handling correspondence for patients that are not registered at their practice.

The report said NHS England is also discussing commercial arrangements with Capita for handling any correspondence that it receives in error. ®

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