Robot computer program empties patients from waiting lists at Queen’s and King George Hospitals

Patients who had waited more than six months to be seen by two east London hospitals were quietly removed from the waiting list by a poorly monitored computer program.

Earlier this year, Matthew Trainer – chief executive of Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT), which runs King George’s Hospital in Goodmayes and Queen’s Hospital in Romford – apologized to patients affected by the ‘mistake.

The 1,800 patients were removed from the waiting list without their GP being informed or BHRUT even being aware of it.

According to internal reports obtained via a Freedom of Information request, the error occurred because of the Robotic Process Automation (RPA) program which transfers patients between national NHS waiting lists and hospital lists. local hospitals.

An “automated process” removed patients from the waiting list after 180 days if the trust did not have sufficient capacity to offer them appointments within that time.

Minutes from a task force formed when the error was discovered in May show that at the time there was no “RPA manager” to oversee the bot after the previous person “moved to another role”.

A staff member, whose name has been redacted, said: “There was a lack of leadership and governance in the process. Prior to the implementation of RPA, there was an RPA Steering Group, which no longer exists.

“There was a robustness to the monitoring process which had slackened due to lack of resources over the past few months. RPA will reduce a lot of waste in the system, but will require governance and a lot of resources in the future. »

An unnamed staff member told the task force that “robotics only do what they are programmed to do” and how information is “introduced” into the system needs to be monitored.

The bot’s vendor, software company Blue Prism, also conducted a review of the failure and found a “bot capacity-related caching issue” that causes their “memory” to be exhausted, according to the verbal procedure.

Another problem was a failure to manage the “lag” between the robot and the various NHS waiting lists, which had been updated without notifying the robot.

A staff member suggested that even the recent rebranding of BHRUT’s internal computer system from Medway to Careflow could have had a “major impact” on the robotic system.

A similar incident on the waiting list first happened at BHRUT in April 2019, when more than 200 patients were also automatically withdrawn after 180 days.

To solve this problem, an additional “robotic process” was created, supervised by a person, who put the deleted patients back on the right list.

The minutes also show that NHS Digital has been aware of patients being automatically removed from its national waiting list after 180 days since at least 2017, but has “no plans” to change this rule.

Matthew Trainer, Managing Director of BHRUT, said: “We have put in place measures since the correction of this error to more closely monitor our systems that use robotic process automation, including additional monitoring of personnel.

“Our teams are working hard to see patients who have been delayed, reducing those waiting more than two years from 218 to zero in just two months.”

According to NHS Shared Business Services (NHS SBS), a joint venture with the public sector, RPAs are useful automated programs that can take on “repetitive, time-consuming and mundane tasks”.

NHS SBS says there are now more than 77 robots in the health service, half of which support finance and accounting.

A spokesperson for NHS SBS said it had no connection to the BHRUT incident, as many trusts have their own RPA projects directly with vendors such as Blue Prism.

Blue Prism and NHS England have been approached for comment but had not responded at the time of publication.

Gordon K. Morehouse