NSW Health is investigating the placement in a rubbish bin of copies of medical letters by a sub-contractor to a private medical transcription company, Global Transcription Services (GTS).
GTS has provided contracted transcription services to both private and public health facilities.
Outside transcription services have been a feature in some local health districts and private providers for more than a decade. Royal North Shore Hospital has engaged the company since 2010.
On Tuesday 11th April a member of the public found a large number of follow up letters from specialists to general practitioners in a bin at an Ashfield apartment block.
The same day, police were advised and collected the letters and took them to Ashfield Police Station.
On Wednesday 12th April staff from Royal North Shore Hospital collected the correspondence from the Police, and after examining them referred them to the Ministry of Health on Thursday 13th April as the correspondence related to a number of private and public health facilities
The correspondence related to patients at Royal North Shore Outpatient Clinics, Gosford Hospital Outpatients and Cancer Centre, Dubbo Hospital Cancer Centre and six private providers:
- Chris O’Brien Lifehouse providing services to Dubbo Cancer Clinic
- Northern Cancer Institute, French's Forest and St Leonards
- Sharp Neurology
- Southside Cancer Care Centre
- Strathfield Retina Clinic
- The Woolcock Institute
On Good Friday 14th April senior staff and clinicians in NSW Health undertook an initial review of the public hospital correspondence as the most important consideration was ensuring that patient care had not been compromised. No evidence of a need for immediate clinical intervention or for individual patients to be contacted was found.
The correspondence included letters from specialist doctors to referring general practitioners and treatment progress reports mostly relating to clinic attendances in December 2016. There were 768 public patients involved.
There were also just over 700 pieces of correspondence relating to private patients and these were forwarded to the relevant private providers.
On Tuesday 18th April the letters involving public patients were referred to the relevant treating clinicians for review to ensure continuity of care for the patients concerned.
By Thursday 20th April letters were mailed to the clinical addressees to ensure the patients’ medical records are complete.
Attempts were made to contact the six private providers on Good Friday. Three were contactable and on 14th April scanned letters were sent to Chris O’Brien Lifehouse and Sharp Neurology.
On the re-opening of private providers (Tuesday 18th April) all private providers were contacted and letters were sent the same day.
On Thursday 13th April, immediately on becoming aware of the incident, NSW Health informed Global Transcription Services (GTS) that it should cease printing and postal services for any NSW Health entity.
GTS was unaware of the incident until informed by staff at Royal North Shore Hospital. It advised over Easter that the breach occurred when a sub-contractor was responsible for processing the correspondence while the manager was on leave in January.
On Monday 17th April NSW Health was advised that the sub-contractor had experienced health issues.
As a direct result of the failure by GTS to secure and maintain documents properly, the NSW Minister for Health, Brad Hazzard, has directed that there should be an external review into the processes of transcription services in NSW public health facilities. NSW Health has this week had preliminary discussions with consultants KPMG to conduct the review.
NSW Health has also written to the Acting NSW Privacy Commissioner to advise her of the incident.
Assistance for patients and clinicians
Each of the private providers will make their own arrangements for patients to contact them.
NSW Health’s primary concern has been to investigate and ensure that patient care is not compromised.
NSW Health asks that patients treated in the public facilities with any questions about their care contact one of the dedicated phone numbers:
- Dubbo Cancer Centre – (02) 6809 6200
- Gosford Hospital Outpatients and Cancer Centre – (02) 4320 3920
- Northern Cancer Institute 0419 287 585
- Royal North Shore Hospital Outpatients – (02) 9463 1409
- South Side Cancer Centre 0419 287 585
- Lifehouse – (02) 8514 1999
- Sharp Neurology – (02) 8425 3546
- Strathfield Retina Clinic – (02) 9746 3378
- Woolcock Institute – (02) 9114 0000