Poor IT systems have been identified by the Audit Commission as a contributory factor leading to errors in waiting list statistics.
The finding shows the impact that the NHS’s legacy of IT underinvestment is having on waiting lists – the government’s highest profile target for service improvement.
Reports of the commission’s widely publicised bulletin on Waiting List Accuracy focused on the chief executives who have been dismissed for actively manipulating waiting lists.
However, the bulletin finds IT problems were a more widespread cause of inaccuracies. It states, “In over half the sites checked, problems with the information technology systems were identified as a contributory factor potentially leading to reporting errors. These problems ranged from relatively minor to an inability to produce the data required.”
In some cases ageing systems were causing the difficulties – in one case the commission found a 20 year old system – and some no longer received technical support from their IT system supplier.
However, in other trusts new systems were failing to produce the information required. The commission says that in one case a system was unable to re-adjust the dates for patients whose treatment was deferred or suspended and was unable to remove patients treated as an emergency for the same condition as the one for which they were awaiting treatment on the list.
The report continues, “Problems with IT systems were made worse in some trusts that has been formed from mergers and were trying to integrate the information from a number of different systems. Typically this led to trusts running parallel computer and manual systems that increased the likelihood of reporting errors.”
Examples of good practice were identified:
Nuffield Orthopaedic Centre, Oxford has an IT system that automatically sends out letters to all patients at four monthly intervals, checking their information and asking if they still wish to go ahead with their operation. Staff follow up patients who do not respond.
Epsom and St Helier, Surrey generates a weekly set of waiting list reports from the trust’s IT system which ensure that appointments are made for patients approaching their maximum waiting time.
James Paget Healthcare, Suffolk produces reports direct from the main PAS which ensures consistency of information to support internal and external reporting needs.
Wirral Hospital, Merseyside has an open audit trail for changes to the PAS and has a good executive information system for consultants to review their performance and that of colleagues.
The report notes that many trusts are procuring new IT systems and recommends that checks should be made to ensure that the newly-procured systems can cope with the current reporting requirements and can easily be updated as clinical practice and reporting requirements change.