Emergency Question
The next item of business is an emergency question from Neil Findlay on the information technology problems at NHS Greater Glasgow and Clyde.
NHS Greater Glasgow and Clyde (IT)
To ask the Scottish Government whether it will provide an update on the information technology problem at NHS Greater Glasgow and Clyde.
NHS Greater Glasgow and Clyde has informed us that, as a result of a failure in its IT infrastructure yesterday morning, a number of out-patient appointments, in-patient procedures, day surgery cases and chemotherapy appointments have had to be postponed. Despite national health service staff working overnight to resolve the issue, it has continued into today. I stress right away that maternity and emergency services have been maintained throughout.
I understand that the failure is related to network servers that serve a number of the board’s systems and sites. That meant that clinicians were unable to access some services, including some patient records and imaging. In addition, the recognised standby process did not kick in.
There has been minimal impact on day cases and in-patient procedures. Only those procedures that require live access to images and theatres have been affected today. There has been an impact on out-patient appointments where the consultant is seeing a patient for the first time or requires access to electronic patient records. However, early indications are that, up to now, fewer than 10 per cent of out-patient appointments have been affected by the incident, and there has been minimal impact on day cases and in-patient appointments. That said, I express my concern for all those patients whose treatment was affected yesterday and today.
This morning, I spoke to the chair of the board, and the director general for health and social care in the Scottish Government has spoken to the board’s chief executive. I can report that NHS Greater Glasgow and Clyde has now been able to resolve the problem with the server and is incrementally reloading users back on to the system. No data appear to have been lost. Around 50 per cent of users now have access to the system, and the remainder should have access by later this evening. The system is being closely monitored to ensure that it remains robust.
NHS Greater Glasgow and Clyde is contacting all patients who have been affected by the incident to ensure that they receive their treatment as soon as possible and that appointments are rescheduled as quickly as possible. I have asked that the board keep in close contact with my officials to ensure that we are fully apprised of the situation going forward. In addition, my officials will work closely with the board to establish the root cause of the incident and share the lessons with other NHS boards.
Finally, I thank all staff in NHS Greater Glasgow and Clyde for their efforts over the past two days in working to resolve the issue.
Obviously, the situation is very worrying. Many people have had their appointments cancelled. Will the cabinet secretary advise what will happen to patients who have missed appointments and cannot get another one immediately? What reassurance can he give patients who are waiting for treatment over the next few days? It is my understanding that similar systems are used in other health board areas. Will the cabinet secretary instruct an independent review of all IT systems that are being used to ensure that robust contingency plans are in place across Scotland?
On the last point, I have already instructed a robust review right across the NHS in Scotland with all the NHS boards to ensure that the IT systems, including the back-up systems, are robust.
Before I came to the chamber, I was updated on the figures for the people who are affected, as members would expect. Over the past two days until midday today, NHS Greater Glasgow and Clyde has postponed 500 out-patient appointments, 14 planned in-patient procedures, 43 day cases and 48 chemotherapy patient treatments. However, in the same period, 7,400 patients have had their procedures and appointments maintained.
On the first point that Mr Findlay raised, every effort will be made to ensure that those affected by the problem will be treated at the earliest possible opportunity. It will be a matter of urgency to ensure that all those affected by the crashing of the IT system will receive their appointments as soon as possible in the near future.
I have had many requests for supplementaries. I will do my very best to get through them.
The cabinet secretary said that emergency services have not been affected. Can he confirm that and say whether he expects there to be any problems at all with emergency services?
I can guarantee that no one requiring emergency or maternity services has been affected, nor is there any anticipation whatsoever that that would happen even if the problem was not resolved this evening. The essential impact of the IT failure has been to deny access to certain aspects of the IT systems. I can give the member a list of the systems affected if she desires that level of detail. The impact has been on planned appointments and planned procedures, and there has been no impact on emergency or maternity services, I am delighted to say.
Does the cabinet secretary agree that what happened was not a failure of policy or management, but the failure of a system? Will he accept the support of everybody on the Conservative side of the chamber for the work that has been done to resolve the problem as speedily—it turns out—as it has been?
Alex Neil referred to lessons being learned and potentially passed on to other health boards. In resolving the issue, has the health board isolated now what the problem was and does it have any reason to believe that it may be something that other health boards need to know about urgently in case such an incident were to occur elsewhere, or was it more unexpected in nature?
First, I thank Mr Carlaw for the tone of his remarks, which are much appreciated here and which I am sure will be much appreciated by the staff who are working so hard to resolve the issue.
It is too early yet to be absolutely sure why the problem happened and why the back-up system was not more resilient. The two software companies concerned—Microsoft and Charteris—are involved full time with our staff as well as with the staff of NHS Greater Glasgow and Clyde in trying to get to the root cause of the problem.
I am obviously cautious, but it now looks as though we have broken the back of the problem in terms of the system being successfully rebooted and back up. We will know definitively how robust that is by later this evening. However, the top priority is to get to the root of the problem so that we can be absolutely sure that it does not happen again in Glasgow or in any other part of the national health service in Scotland.
I welcome the cabinet secretary’s commitment to ensuring that those who have missed appointments are seen as quickly as possible. Will that be done on the basis of one offer or as many offers as it takes? Clearly, people need to plan and sometimes to rearrange their lives in order to attend hospital appointments. In the event that someone is offered a new appointment quickly, as the cabinet secretary suggested, but is unable to take it up, will they be able to continue to liaise with the health board to get the appointment as soon as possible, rather than be put at the back of the queue?
Under the circumstances, every effort will be made to accommodate patients who have been affected by the impact of the IT system crash. We will be totally flexible in trying to ensure that people get appointments as quickly as possible. Inevitably, that will involve some people working longer hours for a short period, and extension of the hours for appointments to ensure that everybody who has been affected by the problem is treated within a reasonable period. I have had the total assurance of the chair of the board that absolutely every stop will be pulled out to ensure that patients get their postponed treatment or appointment at the earliest possible opportunity, which I hope in every case will be well within a month, or even a week or days.
I, too, recognise that the Government has acted very speedily on the issue, so it is not a matter of criticising any policy.
However, can the cabinet secretary say how many patients he anticipates will now fail to be treated within their treatment time guarantee periods? Can he confirm that all those who have been affected who are awaiting chemotherapy and who have missed appointments will receive their scheduled treatment by the end of the week?
First, on chemotherapy, I should say that the chemotherapy services are working fairly normally today. Yesterday’s chemotherapy appointments were affected, however.
Again, I thank Jim Hume for the tone of his remarks. Until the IT system is up and running, I cannot give him any statistics or information on the numbers who have been affected in terms of the treatment time guarantee. Once I am in a position to do so, I will be more than happy to supply members with that information. I am sure that, when the formal TTG statistics for the period come out, members will be understanding of any breaches in NHS Greater Glasgow and Clyde.
Although I welcome the IT review across all health boards that the cabinet secretary mentioned, no IT system will ever be foolproof. Does he believe that health boards have contingencies in place to ensure that, when computer systems stop working, patient care of the most vulnerable patients, including cancer patients, is not compromised?
Absolutely. There are two contingencies, one of which is the back-up IT system, which for some reason did not, as I said earlier, work in this case. That is particularly worrying and it is one reason why we are placing so much emphasis on getting to the root of the problem—the problem being not only the original malfunction but why the back-up system did not work when it should have done. We are testing that elsewhere.
There are other back-up systems for, for example, chemotherapy, in order to ensure that patients are treated as they would normally be treated. Where necessary, paper exercises have been undertaken to minimise impacts, in particular on chemotherapy and patients who require very serious treatment.
I thank the cabinet secretary for his answers so far. He has covered the incident in a lot of detail.
I ask the cabinet secretary not to underestimate the scale of the incident, although I am sure that he does not. NHS Greater Glasgow and Clyde books 20,000 appointments a week, and a large number of people have missed appointments, although many others have not.
In the interest of not wasting a crisis, I ask the cabinet secretary whether lessons can be learned. I am sure that he has had representations from staff about the introduction of TrakCare and their concerns about it. The redeployment and scaling down of secretarial staff has had an impact, and there have been issues and problems on the ground with the promised hardware.
I am sure that the cabinet secretary will take those issues on board while the full scale of the incident is investigated, and that he will ensure that resources are put in place to resolve the issues that have arisen for many of my constituents and others in NHS Greater Glasgow and Clyde’s area.
Duncan McNeil has made a number of reasonable points. I point out that 10 hospitals across NHS Greater Glasgow and Clyde have been affected, but some of the patients come from further afield, including from Ayrshire and parts of Lanarkshire, and in particular for chemotherapy services, for example.
I emphasise to Duncan McNeil that the problem is not with any particular software but with the server. Although TrakCare has been adversely affected, that was not a result of a problem with TrakCare but a result of the problem with the server. So that Parliament is fully informed, I confirm that the systems that have been adversely affected are TrakCare—as I said, not because of a problem with that system but because of a problem with the server—Portal, Ascribe and PACS, plus other diagnostic systems, laboratory systems, chemotherapy systems and the contact centre.
The cabinet secretary is well aware that NHS Ayrshire and Arran depends on NHS Greater Glasgow and Clyde for provision of services, as do many other adjoining health boards. What effect has the loss of IT capacity had specifically on service provision in NHS Ayrshire and Arran?
Once the IT systems are up and running again, I will ask for an analysis of the home areas of the patients who have been affected, if we can do such an analysis, so that we can find out how many patients from Ayrshire and Arran, Lanarkshire and other health board areas have been affected. Because of the problem itself, I am not in a position to give reliable statistics at the moment, but I will be more than happy to supply members with reliable analysis when it becomes available.
I apologise to the two members who were not called. I need to protect the next item of business.