Five hundred patients may have suffered serious harm as a result of the NHS mislaying 500,000 test results and letters over a five-year period, ministers and officials have admitted in parliament.
The review is also understood to be looking at whether correspondence between GPs and hospitals that was mislaid between 2011 and 2016 caused or contributed to the death of any patients, sources added.
Chris Wormald, the permanent secretary at the Department of Health, told MPs on Monday that NHS England was still investigating 537 “live cases” to establish if a patient’s health had been damaged because of the blunder – after the Guardian exposed the scale of the huge loss of patient-sensitive material.
Giving evidence to the public accounts committee, Wormald said that the 537 cases included 173 which, having already been examined for evidence of “potential high risk of harm”, are now being subjected to “further clinical review”.
Jeremy Hunt, the health secretary, was also summoned to the Commons by an urgent question from Labour to explain why NHS Shared Business Services (SBS) had stored more than 500,000 different documents relating to patients’ diagnoses and treatment in a warehouse instead of delivering them to GP surgeries across England, as it was meant to do.
Hunt also faced claims by Jonathan Ashworth, the shadow health secretary, that he had covered up what he called a catastrophic breach of data protection.
“Over half a million patients’ data – including blood tests results, cancer screening results, biopsy results, even correspondence relating to cases of child protection – all undelivered,” Ashworth said. “They were languishing in a warehouse on the secretary of state’s watch.”
In response, Hunt said that no cases of harm had yet been confirmed. “As things stand, if you had listened to my response, you would have heard that there is no evidence so far that any patient safety has been put at risk,” he said.
The health secretary added that he took officials’ advice to say nothing about the incident when he first learned of it on 23 March last year. But, Hunt added, he defied identical advice from civil servants in July and instead chose to acknowledge the non-arrival of so much medical material in a brief statement to MPs in July 2016 and in the health department’s annual report and accounts.
Labour responded by saying that Hunt’s Commons written statement was just 138 words long and mentioned neither the huge amount of correspondence involved or the potential impact on patients.
Hunt also denied that the correspondence had been “lost” during the five years it had been mislaid. In that time it was being held securely – although undelivered – and no breach of patient confidentiality occurred because no one had accessed it, he told MPs. However, he acknowledged that NHS Shared Business Services, handling internal post, had blundered by not getting the documents to GPs as they should have.
Neither ministers nor officials would spell out how serious the potential impact could be on individual patients, and the health department would not officially confirm that assessments were being made if people had died. But Simon Stevens, the chief executive of NHS England, hinted that some people may have been seriously affected.
Stevens replied: “By definition the small number of cases that are left are those we want to chase down. They have had a clinical review initially and now contact is being made with the GP where that is possible to identify.”
Hunt was unable to tell several MPs who asked how many of the documents that went astray related to any of their constituents. Labour is pressing him to publish a full breakdown of where patients affected by the loss of material lived.
However, internal NHS documents seen by the Guardian show that 250,530 (49%) of the 515,437 pieces of correspondence related to patients in the east Midlands. Another 129,992 (25%) involved people in the south of England, especially the south-west; 80,472 (15.6%) related to people in London; and 51,563 (10%) to people in the north of England.
Nottingham City NHS clinical commissioning group saw the most number of documents mislaid in relation to patients whose healthcare it pays for – more than 25,000. More than 22,000 documents went missing relating to people in both Dorset CCG and Northern, Eastern and Western Devon CCG.
Dorset, Essex and Notingham are among the areas with the largest number of cases of potential harm to patients, based on the clinical review already undertaken, the NHS documents show.
Meg Hillier, the chair of the public accounts committee, accused health department officials of overseeing an “unedifying” turn of events, which had resulted in a major “cock-up” that had dragged on for nearly a year.
Hillier raised the prospect that the department, as the co-owner of NHS SBS – which mislaid the material – could have to pay compensation to any patient whose health may ultimately be shown to have suffered as a direct result of the incident.
Wormald said that the department would be looking to fine NHS SBS for the costs involved. “We will be looking at that and that will have to be discussed and agreed once we have finished the most important part of this work which is the tracking down of patients,” he said.
Norman Lamb, the Liberal Democrats’ health spokesman, said: “It beggars belief that a failure on this scale could have happened, putting patients at risk. Since the Francis report [into the Mid Staffs scandal] the whole emphasis has been on openness.
“The coalition government legislated to introduce a ‘duty of candour’ so that clinicians are required by law to be open about any issue where patient safety has been put at risk. Exactly the same principle should have applied here.”