NHS system error puts lives at risk as nearly 50,000 women are not sent screening letters

By | November 15, 2018

NHS hit by fresh cancer screening blunder: Lives at risk as nearly 50,000 women are not sent smear test letters, reminders or test results by ‘shambolic’ private firm with a £330million Government contract

  • More than 4,500 women were not sent the results of their screening tests 
  • Whereas more than 40,000 were not sent appointment invitations or reminders 
  • The BMA has called the situation ‘incredibly serious’ and ‘appalling’
  • The union warned patients’ safety and lives could be at risk because of the error 
  • Capita caused the failure but the NHS must take responsibility, experts say

The NHS has been rocked by a fresh cancer screening blunder as almost 50,000 women were not sent letters inviting them for a smear test.

Health leaders today warned ‘lives are at risk’ because of the ‘appalling’ error by the private firm Capita, which has been branded ‘shambolic’ and ‘incompetent’. 

The company – contracted to produce and send invitation letters to women eligible for the screening programme – blamed human error for the failure and said disciplinary measures would be taken. 

The error meant 43,000 letters inviting female patients for a smear test or giving them a reminder were not sent between January and June. A further 4,500 were regarding their cervical cancer screening results.

The British Medical Association, the GPs’ trade union, has written to NHS England about its ‘extreme concern’ that so many women did not get the letters because of the ‘gross’ error by Capita.

‘This is an incredibly serious situation,’ said the association’s Dr Richard Vautrey. He added it was ‘appalling that patients may now be at risk’ of cervical cancer and said hundreds of women are likely to be ‘extremely anxious’ over the news. 

It comes after the NHS was engulfed in a similar scandal in May, which saw 450,000 women miss life-saving breast cancer screening scans because of a ‘colossal’ IT failure.  

Some 48,500 women in England did not receive letters inviting them or reminding them to attend cervical screening tests, which can pick up on early warnings of cancer (stock image)

Some 48,500 women in England did not receive letters inviting them or reminding them to attend cervical screening tests, which can pick up on early warnings of cancer (stock image)

The error has been traced back to the private company Capita and pressure is mounting on the NHS to cut ties with the firm.

Capita apologised for the blunder, saying the correct process ‘was not properly followed’ and implying it may sack the people responsible. 

It is currently unclear how the administrative error occurred. The firm, based in London, has only said the correct process for uploading, organising and checking datafiles was not properly followed. 

The firm added that the individuals responsible did not immediately escalate the issue to senior management upon discovery of the problem.  

The BMA accused the company of being ‘shambolic’ and said NHS England must take the blame for paying it to do the work.

The NHS sends women letters every three years after they turn 25 inviting them for a cervical screening test.

This falls to every five years for women aged 50 to 64. Those over 65 are only offered a test if they have recently had abnormal test results. 

Around five million women in the UK are invited for smear tests every year. Around 850 die each year from cervical cancer in the UK. 

Around one in 20 women who have a smear test have an abnormal result, but only one in 2,000 have cervical cancer, according to The British Society for Colposcopy and Cervical Pathology. 

The tests pick up on abnormal cells on the cervix which, if caught early, can be removed in order to try and prevent cervical cancer.

Around 43,200 women who were due to receive invitation or reminder letters between January and June this year weren’t sent them. And 4,508 women missed letters about the results of their screenings.

Around 180 of which are thought to have shown abnormal findings, meaning those women may have been at risk of cancer.

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Of those women, 90 have already been contacted and the NHS is tracking down the rest over the next 10 days, NHS England says. 

However, sources close to Capita deny the women faced any risk of cervical cancer because they would have been told the results by their GP. 

‘It took me three weeks to find I was okay’ 

Kelly Swingler is one of the thousands of women who didn’t receive their NHS cervical screening results.

The mother-of-two diligently attends cervical smears once every two years and regularly encourages her sister and friends to have them as well.

But when Miss Swingler, from Peterborough, did not receive her results after her most recent test in May, she became concerned.

She said: ‘The results normally come back in three to five days. It took me three weeks to get through to my doctor who said everything was okay.’

Mrs Swingler has had smear tests come back with abnormal results before, so she believes it is essential to keep up to date with screenings.

The 38-year-old businesswoman added: ‘I go every time I am reminded to.

‘Because the results are usually so quick to come back, I did start to get concerned. There are many women that are not going to their screenings. But the ones that do go don’t hear anything – that is something you just don’t need.’

Mrs Swingler said of Capita, the contract company responsible for the blunder: ‘They have a duty of care and responsibility. If that were any other company, if that were my company, we wouldn’t still be in business. They are being paid a lot of money.’ 

 

Smear tests pick up on abnormal cells on the cervix which, if caught early, can be removed in order to try and prevent cervical cancer (stock)

Smear tests pick up on abnormal cells on the cervix which, if caught early, can be removed in order to try and prevent cervical cancer (stock)

WHO ARE CAPITA AND HAVE THEY MADE ERRORS BEFORE?

Capita won a seven-year contract worth £330million in 2015 to run back-office services for the NHS in England, such as sending out invitation letters to people eligible for screening programmes.

The firm, based in London, employees 70,000 people and specialises on administrative services for the private and public sector.

Capita, whose chairman is Sir Ian Powell, had nearly £1billion wiped off its value in January as shares plummeted to a 15-year low.

The fall came after bosses blamed weak sales and said the company had spread itself too thinly.

Reports suggest the giant, listed on the London Stock Exchange, receives nearly half of its income from Government contracts.

Capita was considered responsible for 12 out of 18 serious NHS data blunders between July 2016 and July 2017.

Sacks of medical records were delivered to the wrong surgeries, emails sent to private firms and confidential details published on websites.

At the time the British Medical Association’s Dr Richard Vautrey said: ‘This is yet another serious failure of a service… run by Capita.’

Capita is also responsible for collecting the BBC licence fee from households and running the London Congestion Charge. 

Last month, the Ministry of Defence acknowledged Capita, which has had the contract for Army recruiting since 2012, had ‘underperformed’. 

The disclosure drew an angry response from MPs on the committee who warned the service was ‘withering on the vine’ and called for the contractor to be sacked. 

Dr Vautrey said: ‘This is an incredibly serious situation, and it is frankly appalling that patients may now be at risk because of this gross error on the part of Capita.

‘Some women will now be left extremely anxious because they have not received important correspondence, particularly letters about abnormal smear test results that need urgent follow up. This has been caused solely by Capita’s incompetence.’

The Royal College of General Practitioners (RCGP) has said women shouldn’t panic but the NHS must answer for its failings.

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The body has urged the health service to ‘seriously review’ its contract with Capita, suggesting pressure will grow on NHS bosses to cut ties with the company.

Professor Helen Stokes-Lampard, RCGP chair, said: ‘This error has put patients at risk, and it will undoubtedly cause women more anxiety. 

‘It is vital everything is done as a matter of urgency to rectify the situation, and ensure all affected women are informed – particularly those who have not received their test results.

‘We urge women not to panic and to await further information – we understand that NHS England are already working to contact anyone who has been affected.’

This is not the first time Capita has made an error while working for the NHS this year.

The company won a seven-year contract in 2015 to run a £330million back-office services contract for the NHS, in which it was required to crack down on ‘ghost patients’.

These are patients who don’t exist in reality but are registered at GP surgeries and, since Capita took over, the number of them has risen from three million to 3.6million.  

Health leaders are furious with the company’s failure to meet the high standard expected.  

‘Since it took responsibility for GP back room functions three years ago, Capita‘s running of these services has been nothing short of shambolic,’ added Dr Vautrey.

‘And after repeated warnings from the BMA and government, this is now clear evidence that its failings have put patient safety – and possibly lives – at risk.

Capita, whose chairman is Sir Ian Powell, had nearly £1billion wiped off its value in January as shares plummeted to a 15-year low

Capita, whose chairman is Sir Ian Powell, had nearly £1billion wiped off its value in January as shares plummeted to a 15-year low

THE NHS BREAST CANCER SCREENING SCANDAL DATES BACK TO 2005 

The NHS breast cancer screening scandal that cost up to 270 lives may actually go back to 2005 – four years earlier than first thought, it was revealed in May.

Health Secretary Jeremy Hunt said around 450,000 women aged 68 to 71 had not been invited to their final routine screening due to a computer error dating back to 2009.

But Professor Peter Sasieni, a cancer screening and prevention researcher at King’s College London, said the problems could have started as early as 2005.

Some 450,000 women have not been invited to crucial mammograms as a result of the IT glitches – and as many as 270 women are feared to have died.

If the scandal actually dates back 13 years instead of nine, then 500,000 people may have missed scans and some may have died as a result.

‘It is ultimately NHS England that bears overall responsibility and it must now take this service back in-house. 

‘As the body which commissioned Capita to take on this work, despite clear warning signs that it was not up to the job, NHS England must shoulder the blame for this dreadful situation; you cannot outsource responsibility.’ 

Dr Stokes-Lampard added: ‘This is the second blunder of its kind this year, and we all need answers about why this has happened and assurance that it will not happen again.

‘We will be asking NHS England to urgently and seriously review its contract with Capita – this is the latest in a long line of serious errors made by the company, and it is clear to us that they have not properly understood the scope or complexity of the work they have bid to do to support primary care.’

An NHS England spokesperson said: ‘Every woman’s case is being reviewed, but there is no current evidence that this incident has led to harm to the women involved, and our priority now is to ensure that anyone affected by this incident is contacted, and knows how to get checked if they are due a cervical screen.’

Capita has blamed human error for the failing and are taking ‘disciplinary action’ against the people responsible for covering it up, the company said.

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It said an auditing team has been appointed to investigate the incident and more stringent checks put in place to try and stop it happening again.   

It comes after the NHS was engulfed in a similar scandal in May, which saw 450,000 women denied life-saving breast cancer screening scans because of a 'colossal' IT failure

It comes after the NHS was engulfed in a similar scandal in May, which saw 450,000 women denied life-saving breast cancer screening scans because of a ‘colossal’ IT failure

In a statement, Capita said: ‘We have investigated the precise circumstances around this incident, and it is clear that the correct process for uploading, organising and checking datafiles was not properly followed.

‘When the problem was discovered, it was not immediately escalated to senior leadership, or NHS England, by the individuals responsible. 

‘Capita is investigating the managerial handling of the matter and taking appropriate disciplinary action. 

‘Additionally, a senior executive responsible for this contract has already left Capita. 

‘The risk to women of this incident is low and there is no current evidence of harm, but Capita nevertheless apologises to both the NHS and to the women whose correspondence was delayed.’ 

It comes after the NHS was engulfed in a similar scandal in May, which saw 450,000 women miss life-saving breast cancer screening scans because of a ‘colossal’ IT failure.

The women, aged between 68 and 71, were never sent letters offering them routine breast screening because of an IT error lasting from 2005 to 2018.

And then-Health Secretary, Jeremy Hunt, said up to 270 of them developed breast cancer which shortened their lives.

The chief of Breast Cancer Now, Baroness Delyth Morgan said at the time: ‘It is beyond belief that this major mistake has been sustained for more than a decade.’

The glitch wasn’t even discovered until Oxford University researchers were setting up breast screenings as part of a study and found some women’s were automatically cancelled because of their age.

Mr Hunt first blamed a ‘computer algorithm failure’ but apologised, saying: ‘For many years oversight of our screening programme has not been good enough.’

Women are invited for routine breast screening on the NHS every three years between the ages of 50 and 70.

WHAT IS CERVICAL CANCER? AND HOW DOES OBESITY CAUSE THE DISEASE?

Cervical cancer affects the lining of the lower part of womb.

The most common symptom is unusual bleeding, such as between periods, during sex or after the menopause, but other signs can include:

  • Pain during sex
  • Vaginal discharge that smells unpleasant
  • Pain in the pelvis

Being overweight or obese can double a woman’s risk of cervical cancer, research suggests.

This is due to excessive fat leading to higher levels of the hormone oestrogen, which is associated with the disease.  

Other causes can include:

  • Age – more than half of sufferers are under 45
  • HPV infection – which affects most people at some point in their lives
  • Smoking – responsible for 21 per cent of cases
  • Contraceptive pill – linked to 10 per cent of cases
  • Having children
  • Family history of cervical or other types of cancer, like vagina and kidney

In the UK, the NHS invites women aged between 25 and 64 for cervical screening, known as smear tests, every three-to-four years.

This aims to pick up abnormal cells that could lead to cancer if left untreated and saves at least 2,000 cervical cancer deaths a year in the UK.

These abnormal cells can be destroyed by methods such as laser therapy or freezing treatment. 

Since 2008, girls aged 12-to-13 have been offered an HPV vaccine, which protects against more than 70 per cent of cervical cancers. 

If diagnosed, treatment depends on where the cancer is, if it has spread and the patient’s general health.

Surgery may be required, which usually removes the womb and cervix. Enough can sometimes be left so a woman can still get pregnant. 

In more advanced cases, a combination of chemo, radiotherapy and surgery may be required.

Source: Cancer Research UK 

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