Royal Free addresses merger RTT issues

Royal Free London NHS Foundation Trust has had to deal with 18-week referral to treatment data quality issues following its acquisition of Barnet and Chase Farm Hospitals NHS Trust earlier this year.

Royal Free took over Barnet and Chase Farm Hospitals in July, inheriting a problem with the latter’s RTT waiting list times.

In the trust’s July board papers, an RTT programme governance report acknowledges that the issue of RTT data came up during the due diligence and Monitor risk assessment phases before the acquisition.

The report says RTT waiting time targets at Barnet and Chase Farm are not being met, “although by what margin is yet to be established”.

“At [Barnet and Chase Farm] it was from 2013 onwards not known how long how many patients had been waiting, and so from October 2013 that trust ceased reporting its data, intending to resume doing so only when the position was ascertained.

“External help was sought by the trust to achieve that clarity, but the picture turned out to be complicated, hard to disentangle and evidently involving substantial numbers of patients waiting longer than the standard.”

An RTT programme report for the trust board’s September meeting says while data validation efforts are on track, data errors continue to be added to the system, creating further work.

“A level of error is expected but there are concerns regarding the volume of new data errors.”

The report says a full RTT training programme is being designed, while healthcare software company Cymbio has provided two people to conduct data quality training in admissions and central outpatients, “both key sources for potential data error”.

A pilot for a new outpatient outcome form has taken place at Barnet and Chase Farm sites in cardiology to help reduce errors at source, with feedback being collected to inform a trust-wide roll-out.

The report says the trust cannot forecast when it will re-achieve the national waiting time list standards for the combined trust until the operational validation is complete.

In a statement, a Royal Free spokesperson told EHI that Barnet and Chase Farm identified problems with its recording and reporting of 18-week RTT pathways in 2013.

“The root cause of the problem was poor data quality caused by a combination of an inadequate patient tracking list system and operational processes.”

The spokesperson said that since acquiring the trust in July, Royal Free has been “working hard to validate and correct data quality issues associated with active RTT pathways and implement new operational processes and procedures”.

“Information systems are only one element of managing RTT in the trust, and we continue to work to ensure that our systems and processes are as effective as possible.”