Attack takes down Notts network

A network problem in Nottinghamshire left around 20 GP practices without access to their clinical system or internet and email last week.

The problems began last Monday afternoon and on Tuesday some practices using TPP’s SystmOne were unable to access their hosted system while others using non-hosted systems could not access internet or email.

Nottinghamshire Health Informatics Service said the problem appeared to be a technical system failure originating from one of the practices linked to the Nottinghamshire COIN network.

Chris Locke, chief executive of Nottinghamshire Local Medical Committee, told EHI Primary Care that there were widespread IT problems across the county on Tuesday.

He added: “A number of areas were badly affected with nine out of 11 practices down in Bassetlaw and others unable to access NHSmail or use Choose and Book.”

The Fountain Medical Centre in Newark was among the SystmOne practices affected by the network problems.

Dr Mark Folman, a partner at the practice, told EHI Primary Care: “We turned up for work on Tuesday and we couldn’t access our clinical system at all.”

Dr Folman said the practice reverted to its fall back plan and was able to print out appointments for the day stored on a memory stick while consultations were held using pen and paper.

He added: “There was no access to blood results and previous consultations and patients weren’t able to book ahead, although we had duty doctor helping to triage the calls so that we saw all our booked appointments plus emergencies.”

Dr Folman said at that stage Nottinghamshire Health Informatics Service was unable to say when the problem would be resolved so he travelled across the area to download appointments for the rest of the week from a SystmOne surgery that was still working.

He added: “It came back on at 4.30pm on Tuesday and we then had to retrospectively document the consultations from the morning and process the prescriptions which we stayed late to do. In the end the fall back plan actually worked incredibly well and we were very pleased with it.”

Dr Folman said problems accessing email were continuing but that the practice had been told that problems accessing their clinical system should not happen again.

He added: “Access to our clinical system is the priority and these things do happen but at least we know now that our fall back system worked well.”

A statement issued to EHI Primary Care by Nottinghamshire HIS said the problem was first picked up on Monday near to close of business when three sites were affected and the impact on practices was assessed to be minimal.

The statement added: “The problem worsened Tuesday 16 June and involved approximately 20 practices, but still intermittently. At this point, as the root cause could not be isolated technicians were deployed to practices in order to set bypass routes in place to allow consistent access to clinical systems.

“Technicians worked on resolving the issues throughout Tuesday and around the clock Tuesday night into Wednesday. All sites were made stable by various work arounds by 13:00 on Wednesday 17 June.

“Further investigation by HIS staff and Cisco consultancy appears to point to a denial of service attack (technical system failure) originating from one of the GP practices within the VPN security tunnel. Further work is underway to resolve this.”