BMA: calls for ‘shambolic’ Capita to lose contract after up to 48,500 missed cancer screening info

The British Medical Association’s (BMA) General Practice division has tweeted its extreme concern about an ‘appalling’ error by private contractor Capita that led to as many as 48,500 women not receiving cervical cancer screening invitations or, in some cases, results – putting women’s lives at risk:

Dr Richard Vautry, chair of the BMA’s GP committee, has written to NHS England with the call. The BMA’s full statement reads:

BMA criticises ‘appalling’ failure to send cervical screening letters to up to 48,000 women
The British Medical Association has written to the chief executive of NHS England expressing its extreme concern after being made aware that up to 48,500 women have not received information regarding cervical cancer screening after a system error.

The BMA understands that the majority of the correspondence relates to appointment invitations or reminder letters, but that some are screening results. This incident is the latest in a series of failings by Capita, the organisation contracted to provide GP back office services.

In its letter to Simon Stevens, the BMA has urged NHS England to strip Capita of the contract and take Primary Care Support England (PCSE) services back in-house. NHS England has assured the BMA that it has written to those affected and informed GP practices. The BMA, is now informing its GP members, alerting them to the situation and preparing practices for the very understandable concerns and queries that patients are going to have. GPs will do all they can to provide these women with support but there must be no suggestion that GPs and their teams bear the brunt of rectifying this unacceptable failing by a private company – something GPs have experienced in the past.

Dr Richard Vautrey, BMA GP committee chair, 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.

“We know that, because of the nature of this procedure, many patients are already reluctant to attend these appointments, and therefore reminder letters are crucial to provide encouragement and reinforce the importance of having a cervical smear test done. Incidents like this, therefore, will hardly inspire confidence in the system and risk even fewer women getting checked.

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

A Capita statement provided to the SKWAWKBOX reads:

Primary Care Support England (PCSE), the contract delivered by Capita on behalf of NHS England, is addressing an issue relating to issuing invitation and reminder letter regarding cervical screening correspondence. Letters are being sent to all women who have experienced a delay in receiving cervical screening correspondence. Additionally, there has been an issue relating to issuing results letters.

All women aged between 25 and 64 are eligible for inclusion in the National Cervical Screening Programme, which involves screening most women for cervical disease every three or five years. As part of the contract with NHS England, PCSE supports the National Cervical Screening Programme by producing and sending invitation, reminder and results letters to eligible women.

For invitation and reminder letters, from January to June this year, approximately 43,200 women due to receive letters were sent an invitation letter or a reminder, but not both.

We are writing to the women who only received one letter to remind them to book an appointment and to apologise for the delay in sending a reminder letter. The scale of the screening programme should be borne in mind: approximately nine million letters are produced and sent each year to women in England.

For results letters, GPs are responsible for care, including contacting women who require further examination. GPs or screening clinics have the primary responsibility to notify women of their test result. PCSE additionally sends letters to women informing them of their screening result and these letters are not part of the referral process. A total of 4508 results letters have been delayed this year. Only a small proportion of these results required further examination, and they should all have been contacted directly by their GP.

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.

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.

We have appointed an independent audit team, led by PwC, to carry out a detailed review into operational systems and processes in PCSE. We have upgraded checks in place at every stage of the process and offered NHS England additional resource as this issue was resolved.

Capita has held the contract since 2015 but does not expect to make a profit on it until the end of 2020.

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