Written Question · S6W-01898 · Session 6
On what date errors were first identified in the data in the Scottish Cervical Call Recall System (SCCRS) in relation to (a) incorrect reco…
The question
To ask the Scottish Government on what date errors were first identified in the data in the Scottish Cervical Call Recall System (SCCRS) in relation to (a) incorrect recording of subtotal hysterectomies and (b) wrongful exclusions from the screening programme.
The answer
As I noted in my statement to Parliament on 24 June, a single NHS Board first discovered in December 2020 that a small number of women who had subtotal hysterectomies had been wrongly excluded.
In 2016, a review was carried out of all individual records on the Scottish Cervical Call-Recall System (SCCRS) which had both a subtotal hysterectomy entry and also an open exclusion on the record. This was prompted by an IT error that had led to ‘no cervix’ exclusions being automatically added to the system when a subtotal hysterectomy was recorded together with recommended management of ‘no follow up’ or ‘no further recall’. This error was swiftly addressed.
In the course of addressing the issue, a number of other cases were identified, where a subtotal hysterectomy had been recorded on SCCRS and a manual exclusion had subsequently been opened. As soon as this was discovered, a process was initiated to identify all records on SCCRS with subtotal hysterectomies and open exclusions.
Following a rigorous review of affected records, it was established that some exclusions had been opened in error. Anyone affected was re-instated to the screening programme, and provided with a full explanation. Recommendations were made for safeguards to be put in place to prevent further instances of inappropriate manual exclusions.
At that time, it was believed that the records review had captured all affected patients, and there was no evidence to suggest further widespread errors in the recording of subtotal hysterectomies or the general application of exclusions.
It should be noted that, in 2006, in preparation for the migration to SCCRS, a data cleansing exercise was carried out. GP practices were provided with a list of women where there were discrepancies between the exclusion status and screening history and asked to resolve these before the transfer to SCCRS was complete.
This data cleansing exercise was standard good practice prior to the migration to SSCRS and did not uncover significant coding or data issues that gave rise to widespread concerns. Once the inconsistencies were resolved, the migration to SCCRS was carried out. A decision was made to migrate total hysterectomy information and all exclusions but not subtotal hysterectomy information, as individuals with subtotal hysterectomies would continue to be screened.
Although the actions taken in response to the issues detected in 2006 and 2016 were reasonable in light of the available evidence, we will consider whether there were opportunities to detect the wider issues now identified, and, if so, what lessons can be learned to strengthen monitoring and auditing going forward.
In 2016, a review was carried out of all individual records on the Scottish Cervical Call-Recall System (SCCRS) which had both a subtotal hysterectomy entry and also an open exclusion on the record. This was prompted by an IT error that had led to ‘no cervix’ exclusions being automatically added to the system when a subtotal hysterectomy was recorded together with recommended management of ‘no follow up’ or ‘no further recall’. This error was swiftly addressed.
In the course of addressing the issue, a number of other cases were identified, where a subtotal hysterectomy had been recorded on SCCRS and a manual exclusion had subsequently been opened. As soon as this was discovered, a process was initiated to identify all records on SCCRS with subtotal hysterectomies and open exclusions.
Following a rigorous review of affected records, it was established that some exclusions had been opened in error. Anyone affected was re-instated to the screening programme, and provided with a full explanation. Recommendations were made for safeguards to be put in place to prevent further instances of inappropriate manual exclusions.
At that time, it was believed that the records review had captured all affected patients, and there was no evidence to suggest further widespread errors in the recording of subtotal hysterectomies or the general application of exclusions.
It should be noted that, in 2006, in preparation for the migration to SCCRS, a data cleansing exercise was carried out. GP practices were provided with a list of women where there were discrepancies between the exclusion status and screening history and asked to resolve these before the transfer to SCCRS was complete.
This data cleansing exercise was standard good practice prior to the migration to SSCRS and did not uncover significant coding or data issues that gave rise to widespread concerns. Once the inconsistencies were resolved, the migration to SCCRS was carried out. A decision was made to migrate total hysterectomy information and all exclusions but not subtotal hysterectomy information, as individuals with subtotal hysterectomies would continue to be screened.
Although the actions taken in response to the issues detected in 2006 and 2016 were reasonable in light of the available evidence, we will consider whether there were opportunities to detect the wider issues now identified, and, if so, what lessons can be learned to strengthen monitoring and auditing going forward.
In the Official Report
No contribution in the Official Report cites S6W-01898 by reference.