'Shambolic' hospital left patients waiting in pain for scans

A hospital was criticised yesterday for allowing its screening department to descend into a "chaotic shambles" that left thousands of patients in pain, waiting for tests that were never done.

The Chase Farm Hospital in Barnet, north London, "failed patients at every level" the Government's NHS watchdog, the Commission for Health Improvement (CHI), said.

A routine inspection of the hospital's radiology department revealed 2,700 requests for ultrasound scans that had been allowed to pile up and were never processed. Some patients had waited up to 19 months for tests on conditions ranging from suspected cancer to gallstones.

A clash of egos among consultants fuelled by disputes over private practice contributed to the chaos by generating an "atmosphere of unease and ill feeling" in the department. Allegations that private work was being done in NHS time are being investigated by the NHS Counter Fraud Service and a decision on a complaint of race discrim-ination is awaited.

An investigation into the hospital's failings, published yesterday, says that 80 per cent of the patients caught up in the backlog have now been screened and almost a quarter had an abnormal result.

Although no patient is known to have suffered harm because of the delays, the report says the condition of 543 patients who went elsewhere for their scans is not known.

A disturbing finding is that the requests for scans were allowed to pile up in the full knowledge of the staff that ran the department, even though a prompt response for a patient with cancer could improve their survival chances. The backlog was frequently discussed at meetings but nothing was done. It became so routine that scans were performed if GPs or patients complained, regardless of their clinical priority.

Peter Homa, chief executive of CHI, said the hospital had tolerated a "high risk" situation that had not been properly managed. "It is a matter of luck that no patient appears to have suffered a serious adverse outcome," he said.

"The clinical condition of all the patients affected must be reviewed to confirm whether anybody was harmed. The rest of the NHS should learn from this unacceptable incident."

There had been a similar backlog of 800 requests for ultrasound scans in 2000 and while that was being cleared the second backlog built up. In May 2002 there was still a backlog and no system in place to ensure it did not happen again, the report says.

The hospital issued a public apology for the delays and its chief executive, Liz Hayer, resigned after the problems were disclosed in February. CHI said yesterday that new management at the Barnet and Chase Farm Hospitals Trust had taken "robust action" to deal with the failings and had cleared the backlog but still needed an action plan.

The trust had also failed to resolve difficulties over the merger of Chase Farm and Barnet hospitals four years earlier, the report said. Even now, the radiology service operated as two separate departments within the trust.

The report says the trust must put patients first when planning and providing care and systems must be put in place so the trust knows if a patient has had an ultrasound.

It adds that a doctor with senior management experience must be appointed to lead the department and get the team working together.