NHS England London has released its third data update on the clinical impact of the ransomware cyber attack perpetrated against Synnovis on Monday 3 June.

Over three weeks on from the cyber attack, NHS organisations across London continue to work in partnership to ensure people who require critical and urgent care receive it.

NHS England is also continuing to work with Synnovis and the National Crime Agency to respond to the criminal ransomware attack on Synnovis systems.

In response to the attack, NHS England London declared a regional incident and has been coordinating work across affected services, as well as with neighbouring providers and national partners to manage disruption.

Some services, such as outpatient appointments, are now operating to similar levels to before the incident but there continues to be disruption to other services.

Urgent and emergency services have remained available as usual, and patients should access services in the normal way by dialling 999 in an emergency and otherwise use NHS 111 through the NHS App, online or on the phone.

Patients will be kept informed about any changes to their treatment by the NHS organisation caring for them. This will be through the usual contact routes including texts, phone calls and letters. Staff are working hard to keep all patients informed and the NHS apologises for any disruption.

The data for the third week of the cyber attack (Monday 17 – Sunday 23 June) shows that across the two most affected Trusts, King’s College Hospital NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust, 1,300 outpatient appointments and 205 elective procedures had to be postponed because of the attack.

This means so far 3,396 outpatient appointments and 1,255 elective procedures have been postponed at King’s College Hospital NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust since 3 June when the cyber attack happened.

Dr Chris Streather, Medical Director for NHS London, said: “Over the past week we have started to see some real progress in general practice where the impact of the cyber attack was significant on pathology services across south east London. The mutual aid agreements that have been put in place to meet urgent demand has been introduced at pace across all six boroughs and pathology services are currently able to operate at 45% of the capacity they had prior to the cyber attack.

“This is helping to increase the number of blood tests available in the most critical and urgent cases. It is important that patients with booked appointments continue to attend unless they have been contacted to say otherwise. We apologise again to everyone who has been affected – staff are working hard to rearrange affected appointments and treatments as quickly as possible.

“We do continue to experience disruption to services at King’s College Hospital NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust. I would like to thank all the staff at the trusts who are working tirelessly to provide care and support to patients who have been affected by the incident.”

In a joint statement, Julie Lowe, Deputy Chief Executive at King’s College Hospital NHS Foundation Trust and Dr Simon Steddon, Chief Medical Officer for Guy’s and St Thomas’ NHS Foundation Trust, said: “We are continuing to manage the cyber attack as a critical incident across both trusts, and we have also put measures in place to ensure we limit the disruption to patients resulting from the industrial action this week and next.

“We are having to postpone a number of operations and appointments at present, and we would like to apologise again to those patients affected. Staff are continuing to do an excellent job in very challenging circumstances, for which they deserve enormous credit.”

NHS Blood and Transplant have called out to O Positive and O Negative blood donors to urgently book appointments to donate in one of the 25 town and city centre NHS Blood Donor Centres in England, to boost stocks of O type blood following the cyber incident. You can visit blood.co.uk or call 0300 123 23 23 to book an appointment.

Investigations of this type are complex and can take time. Given the complexity of the investigation, it may be some weeks before it is clear which individuals have been impacted.

As more detail becomes available through Synnovis’ full investigation, the NHS will continue to provide updates and a helpline has been set up to support people impacted (incident helpline: 0345 8778967).

More details on the incident, including a questions and answers section, are available on the NHS England website.

Background

NHS London impact update based on provisional data reported by trusts and organisations involved.

Please note all numbers quoted are drawn from unvalidated management information; these have been provided in the interests of transparency.

Updates will be provided on a weekly basis as the incident continues.

The update covers the week 17 – 23 June 2024. The next update will be issued on Thursday 4 July.

Planned care (day case and inpatient treatments)

Across Guy’s and St Thomas’ and King’s College Hospital NHS Foundation Trusts there have been:

1. 205 elective procedures postponed (A figure of 320 cancellations was originally provided for the week commencing 10^th June, but following further validation, the actual figure was 383.
2. 20 of these were cancer treatments (compared to 29 last week, a figure of 32 was provided for w/c 10^th June previously, but this has been revised following validation)

There is no immediate significant impact on cancer reported metrics. It is too early to understand the impact on 62-day performance and Faster Diagnosis Standard for the affected trusts.

Transplant impacts

1. 15 organs were diverted for use by other Trusts (compared to 46 last week); there was one planned transplant cancellation which will be rebooked.

Maternity

Across Guy’s and St Thomas’ and King’s College Hospital NHS Foundation Trusts:

1. 1 planned C-sections have been postponed/rescheduled in the last week (compared to 1 the week before).

Outpatients

Across Guy’s and St Thomas’ and King’s College Hospital NHS Foundation Trusts:

1. 1,300 hospital outpatient appointments were postponed in the last week (compared to 1,301 last week, a figure of 1,294 was provided for week 10-16 June previously but this has changed following validation)
2. 30 community outpatient appointments have been postponed in the last week (compared to 38 last week)

Urgent and emergency care

All unplanned services, including A&E services, are open as normal.

Optional blood borne virus (HIV, Hep C and Hep B) tests, which are offered to A&E patients as part of a trial, are currently suspended.

Blood tests

South East London pathology services provided this week have increased to approximately 45% of normal capacity – compared to 30% last week.

Primary care

Primary care appointments are going ahead as normal, however blood tests are being prioritised for urgent cases.

Impact on services and tests has varied however GP referrals have been significantly impacted with only urgent referrals being accepted for Blood Sciences (haematology, biochemistry, immunology, virology). Normal services are operating for histology (a diagnosis and study of the tissues which are used to diagnose infections, cancer and other diseases) and cervical smears.

Wider impact

Synnovis provides specialist tests for other hospitals in the country. However, the material service impact remains in south east London. Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust and South London and Maudsley NHS Foundation Trust remain in a critical incident, while Oxleas NHS Foundation Trust, Lewisham and Greenwich NHS Trust, Bromley Healthcare, and primary care services in South East London continue to be significantly impacted and involved in the incident response.