CrowdStrike crisis highlights concerns about IT backups

The NHS needs to find an improved way of backing up its IT systems following the havoc caused by the CrowdStrike failure last week, a senior GP has said.

Practices kept going with pen and paper last Friday and continued to struggle with a backlog of appointments and other work this week. The CrowdStrike problems affected Microsoft systems around the world, impacting travel services as well as healthcare systems and the EMIS services used by practices.

Dr David Wrigley, Deputy Chair of the BMA’s GP committee for England, said: “Friday was one the toughest single days in recent times for GPs across England… While GPs and their teams worked hard to look after as many as they could, without access to the information they needed much of the work has had to be shifted into the coming week. The BMA’s GP committee will continue our dialogue with both EMIS and NHS England, both to make sure that the coming week can be used to recover as quickly as possible and to urgently work on securing a better system of IT backup so that this disaster is not repeated in future.”

Practices advised on outage compensation

Pressure is growing for practices to receive compensation for the costs incurred during the recent worldwide IT failures. Practices were badly hit by the CrowdStrike failure, which led to appointment systems and EMIS being inaccessible.

The IGPM said practices had to call in extra staff and locum cover to deal with the backlogs of work. It said: “NHS England must find a way to compensate practices for costs incurred. This was beyond practices’ control and they are already struggling financially.”

Dr Katie Bramall-Stainer, Chair of the BMA’s GP committee for England, advised practices to “cost up everything and send invoices to the integrated care board”.

Improve NI contingency planning

GP leaders have said that Northern Ireland’s health service needs extra investment in contingency and recovery plans following the recent IT crisis in which EMIS systems and other Microsoft software failed.

The Department of Health in Northern Ireland said affected practices had implemented continuity plans and gave priority to the most clinically urgent patients. The region’s electronic care record system was back in action by 9.00am on Friday, but the EMIS system was not restored until 9.00pm on Saturday. EMIS was unable to give the ‘all clear’ to practices until Tuesday.

Dr Frances O’Hagan, Chair of the BMA regional GP committee, said: “To ensure such an outage does not have a similar impact in the future… we would call for more investment from the Department of Health in contingency planning and recovery plans.”

Call for rethink on GP training and retention

GPs are pressing for a rethink of NHS workforce projections amid concerns it will not solve the crisis in general practice. Nearly 10,000 doctors have signed a letter, organised by the Royal College of GPs, pressing for a rethink of the plans, unveiled last year and seen, at the time, as the key to solving the problems of the NHS.

The letter warns that the Workforce Plan only proposes a 4% increase in the number of fully qualified GPs compared with a 49% increase in hospital consultants. The letter has been sent to the new Health Secretary, Wes Streeting.

It states: “General practice has been ignored for too long, and our patients are paying the price – and as the front door to the NHS, this has serious repercussions for the rest of the NHS. A well-funded general practice service, staffed with enough GPs, will alleviate pressures across the NHS.”

NHS failing in local prevention aims

According to a National Audit Office report, NHS local bodies have been unable to implement measures to manage demand and transform services. The report notes that practices have delivered a huge increase in appointments in the last five years, while patients are complaining it is harder to get appointments.

The NAO says that the new local integrated care systems have developed partnerships and drawn up plans to prevent ill health. They have, however, “struggled” to manage the daily pressures of restoring NHS services following the pandemic. It warns: “When we consider how the health needs of the population look set to increase, we are concerned that the NHS may be working at the limits of a system which might break before it is again able to provide patients with care that meets standards for timeliness and accessibility.”

Siva Anandaciva, Chief Analyst of The King’s Fund, said: “This report comprehensively shows the desperate state of NHS finances that the new government has inherited. It should act as a warning to politicians of the tough decisions yet to come.”

Safety concerns from online consultations

Practices need to be careful about using online consultation tools amid growing concerns about their safety. According to the Health Services Safety Investigation Body, safety must be a priority when using these new tools. The organisation defines online consultations as being when the patient and clinician are not communicating in real time, but may be using questionnaires or chatbots to collect information. In an extensive investigation, it collected information from patients and staff at 16 practices in England, undertaking four focus groups. Today it calls on NHS England to conduct an evaluation of safety risks.

Patients described feeling frustrated, humiliated and embarrassed by having to give information through these means, while staff reported concerns that they caused disadvantage for some patients and reduced the continuity of care.

The HSSIB says there is evidence of harm through missed or delayed care linked to these tools. One example was a patient who did not get a timely diagnosis of skin cancer because they had to submit answers to questions before getting a consultation.