On this page for primary care professionals, you can find the current statement, the emails shared with primary care from NHS SEL ICB and any materials shared with primary care for their use.

Current statement issued 6 June 2024:

“NHS organisations across London continue to work in partnership to manage patient care following the ransomware cyber-attack on Synnovis earlier this week.

Guy’s and St Thomas’ NHS Foundation Trust and King’s College Hospital NHS Foundation Trust remain in a critical incident, while Oxleas NHS Foundation Trust, South London and Maudsley NHS Foundation Trust, Lewisham and Greenwich NHS Trust, Bromley Healthcare, and primary care services in South East London continue to be impacted.

Chris Streather, Medical Director for NHS England London, said:

“NHS staff are working around the clock to minimise disruption to patient care following the ransomware cyber-attack on Synnovis earlier this week.

“Pathology services at the impacted sites are available – albeit at a reduced capacity – with the most urgent cases being prioritised.

“Unfortunately, some non-urgent operations and procedures including transplants continue to be postponed, while nearly all non-urgent blood tests have been postponed in primary care services in South East London.

“We are sorry to all those who have been impacted and staff will work hard to re-arrange appointments and treatments as quickly as possible.

“Urgent and emergency services are available as usual so 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.

“If you have not heard from your healthcare provider, please attend appointments as normal as services including outpatients and community services are mostly running as usual, including cervical screening.”

Message to primary care - 17 June 2024 - 1 message

Today we have collated a reminder of messages for primary care to keep you up to date with the evolving situation.

Mutual aid update – 17 June

Today, Bexley and Bromley practices joined Southwark and Lambeth in receiving mutual aid pathology support. Later this week, we anticipate that a soft launch of mutual aid arrangements will start in Greenwich and Lewisham on Wednesday. We hope that these services will allow all boroughs to request urgent and critical pathology. The guidance we produced around this is here.

Each implementation of a mutual aid arrangement in a borough will also free up some capacity in Synnovis to support critical requests for other boroughs.

These services will improve over time and we can keep you up to date as this develops. These arrangements have been established as quickly as possible. We are also working to minimise changes to existing arrangements as much as possible, but there are likely to be some changes to testing regimes, test catalogues and reference ranges that arise from the change to a new pathology provider. We will provide you with further updates and details of the changes, along with the new contact details for support, queries and communications with the new provider. There may also be some issues with workflows, and we will be supporting you to resolve these as quickly as possible.

If you have any issues arising from the mutual aid arrangements, please contact the help desk to register issues. Please note the following contact details for the ICT Team if needed:

Phone Contact                 0208 176 5400

Email                                 ict@selondonics.nhs.uk
Self Service Portal           https://nhssel.haloitsm.com/portal/home 

We are looking to arrange a webinar with each borough before they go live. You will receive this information from your ICB borough primary care team the working day before your borough’s webinar. We will also provide guidance on actions practices need to take before any mutual aid is implemented. We thank you for your patience as we work with you and our mutual aid providers to resolve any issues.

 

Printing of pathology labels

Synnovis and mutual aid providers have raised issues with the quality of printed labels on samples being submitted. To ensure that no samples need to be returned over the coming weeks, we would ask practices to help by:

  • Only using Brother ink cartridges. 3rd party cartridges often contain lower quality inks which degrade both in the printer and outside.
  • Dust the printer drum. There should be a slider inside the machine to dust the drum. Move this backwards and forward approximately 15 times to dust it. The dust is often caused by lower quality inks.
  • Leave the label for 30 seconds after printing. This reduces any smudging.
  • Checking your DPI/resolution print settings. It should be set to 1200 dpi but many are set at 600. If you have an issue with this, the ICT service desk can help.

 

Primary care webpage

We are looking at revising the structure of the webpage where we are hosting the information for primary care. The idea is to revise this by topic and to only include the latest and most accurate information. The page in the current date structure is available here.

Messages to primary care - 14 June 2024 - 1 message

Dear colleagues,

Today we have collated a few messages for primary care to keep you up to date with the evolving situation. We will not be sharing regular updates over the weekend and these updates will resume on Monday. The messages below cover an update on mutual aid, an updated pack on harms monitoring and guidance on how to keep a record of non-urgent tests for when more capacity becomes available.

Mutual aid update – 14 June

As part of our plan to restore services, we have been working across London with other pathology services. These arrangements will need to be implemented borough by borough. With the implementation of the mutual aid arrangements, Southwark and Lambeth practices will not receive a Saturday service this week as there are no couriers available.

Today, Southwark practices joined Lambeth in receiving mutual aid pathology support. This afternoon, we anticipate that a soft launch of mutual aid arrangements will start in Bexley and Bromley with the service fully starting on Monday 17 June 2024. We hope that these services will allow those boroughs to request urgent and critical pathology. The guidance we produced around this is here.

The plan for other boroughs will be provided shortly (noting that this is subject to further investigation regarding feasibility). Each implementation of a mutual aid arrangement in a borough will also free up some capacity in Synnovis to support critical requests for other boroughs.

These arrangements have been established as quickly as possible. We are also working to minimise changes to existing arrangements as much as possible, but there are likely to be some changes to testing regimes, test catalogues and reference ranges that arise from the change to a new pathology provider. We will provide you with further updates and details of the changes, along with the new contact details for support, queries and communications with the new provider. If there are issues with workflows, we will support you to resolve these as quickly as possible.

We are looking to arrange a webinar with each borough before they go live. You will receive this information from your ICB borough primary care team the working day before your borough’s webinar. We will also provide guidance on actions practices need to take before any mutual aid is implemented. We thank you for your patience as we work with you and our mutual aid providers to resolve any issues.

SEL System Potential Harms Monitoring – updated and simplified pack

We have developed and updated the guidance for raising quality alerts and patient safety issues after constructive feedback from primary care and the LMC. The pack has been updated and on page 3 of the pack, you can find a link to the form where you can raise quality and patient safety issues arising from the Synnovis Cyber attack. Clinicians are not expected to complete other forms in the pack; these are shared for transparency. The guidance is here.

Recording pathology needs for future routine testing for Lambeth and Southwark

Following the transfer of the urgent pathology service to HSL we have been asked to clarify how practices can raise their orders for non-urgent/routine tests and the link with Ardens template.

Non-Urgent Tests

Practices should use the HSL T-quest link to order the routine tests and print off the form. However, we would ask practices to ensure that patients are advised there is no current service available to undertake routine testing and that they should wait to be contacted before booking/attending for phlebotomy.  A record is then made in the Ardens template which indicates the level of urgency (low/medium/high) which can then be used at a later date to risk stratify and recall.

Messages to primary care - 13 June 2024 - 1 message

Today we have collated a few messages for primary care to keep you up to date with the evolving situation. Synnovis also shared an update with primary care this morning and we would encourage you to read this communication too. The messages below cover an update on mutual aid, details on available blood testing sites, a message around medicines and a media reminder.

Mutual aid update – 13 June

As part of our plan to restore services, we have been working across London with other pathology services. Today, Lambeth practices starting receiving mutual aid pathology support.

These arrangements will need to be implemented borough by borough. Tomorrow, we anticipate that these will extend to Southwark. The plan for other boroughs will be provided shortly (noting that this is subject to further investigation regarding feasibility). Each implementation of a mutual aid arrangement in a borough will also free up some capacity in Synnovis to support critical requests for other boroughs.

These arrangements have been established as quickly as possible. We are also working to minimise changes to existing arrangements as much as possible, but there are likely to be some changes to testing regimes, test catalogues and reference ranges that arise from the change to a new pathology provider. We will provide you with further updates and details of the changes, along with the new contact details for support, queries and communications with the new provider.  There may also be some issues with workflows, and we will be supporting you to resolve these as quickly as possible.

We are looking to arrange a webinar with each borough before they go live. You will receive this information from your ICB borough primary care team the working day before your borough’s webinar. We will also provide guidance on actions practices need to take before any mutual aid is implemented. We thank you for your patience as we work with you and our mutual aid providers to resolve any issues.

 

Interim prescribing monitoring guidance in development

To support general practice and community teams with clinical prioritisation of blood testing for patients taking high risk medicines, the ICB medicines optimisation team are working with relevant clinicians and clinical teams across SE London to develop interim prescribing monitoring guidance. These recommendations will be circulated next week as part of the updated prioritisation guidance. We appreciate your patience as we develop the necessary resources to support delivery of patient care.

 

Blood testing sites – update

All phlebotomy appointments for clinics which feed into Synnovis services have been cancelled until the end of June. We have split the arrangements below out by borough.

 

Lambeth and Southwark

Under mutual aid arrangements, for critical and urgent tests, patients in Lambeth and Southwark should go to:

Lambeth

Gracefield Gardens, 2-8 Gracefield Gardens, London, SW16 2ST

From Thursday 13th June: 8:00 – 17:00

Last patient entry: 16:45

Southwark

Tessa Jowell Health Centre, 72H East Dulwich Grove London SE22 8EY

Friday 14th June: 7:30 – 15:30

Last patient entry : 15:15

Bromley

An urgent blood test request pathway exists via the Community Phlebotomy Service run by Bromley GP Alliance (BGPA). Urgent referrals should be made via email to selicb.bgpa.phlebotomy@nhs.net  BGPA will manage the booking and contact the referrer and patient by phone with the appointment date and time.

  • Beckenham Clinic: 14 The Crescent, Beckenham BR3 1DU
  • Orpington Health and Wellbeing Centre: 19 Homefield Rise, Orpington BR6 0FE

Bexley, Greenwich and Lewisham

Patients requiring critical blood tests can visit the following sites from Monday to Friday. Please ensure you have typed ‘urgent’ onto their tQuest form before printing it and handing it to them.

Bexley and Greenwich

  • Queen Elizabeth Hospital (8am to 6pm)
  • Queen Mary’s Hospital (8am to 6pm)
  • Erith and District Hospital (8am to 2pm)

Lewisham

  • Waldron Health Centre (7.30am to 11am)
  • Rushey Green Group Practice (7.30am to 12pm [noon])
  • South Lewisham Health Centre (8.30am to 4.30pm)

 

Media approaches

Thank you to all practices across south east London for your help and support with managing the media messaging on this cyber attack. If your practice is approached directly by a media outlet on the Synnovis cyber attack and ongoing incident, please contact media@selondonics.nhs.uk for advice and support. We can help to manage the response and the query for you.

Message to primary care - 12 June 2024 - 1 message

Today we have collated a few messages for primary care to keep you up to date with the evolving situation. These involve some instructions from Ardens on creating templates, SEL System potential harms monitoring and an update on mutual aid.

 

Ardens flags

We have been working with Ardens on two updates to the EMIS system during this cyber attack incident.  One is a quality flag which will be added automatically every time a patient record is loaded during the period of the critical incident. The second is a template to help practices to record any tests which have been delayed; this will also allow you to record the priority status. This allows practices to keep a log of these and their urgency which at a later date you can search on to contact patients. Here you can find some initial guidance and further information from Ardens on the updates. We are working with Ardens to arrange appropriate training and support for practices and will update you on these as they become available.

These updates will be loaded on to the system tonight, 12 June 2024.

 

Mutual aid arrangements – update

As part of our plan to restore services, we have been working across London with other pathology services. In the first instance, this will allow us to transition to the processing of urgent samples, but this will need to be implemented borough by borough. This implementation will commence on 13 June 2024 in Lambeth, and the plan for other boroughs will be provided shortly (noting that this is subject to further investigation regarding feasibility). Each implementation of a mutual aid arrangement in a borough will also free up some capacity in Synnovis to support critical requests for other boroughs.

These arrangements have been established as quickly as possible. We are also working to minimise changes to existing arrangements as much as possible, but there are likely to be some changes to testing regimes, test catalogues and reference ranges that arise from the change to a new pathology provider. We will provide you with further updates and details of the changes, along with the new contact details for support, queries and communications with the new provider.  There may also be some issues with workflows, and we will be supporting you to resolve these as quickly as possible.

We are looking to arrange a webinar with each borough before they go live. You will receive this information from your ICB borough primary care team the day before your borough’s webinar.

We thank you for your patience as we work with you and our mutual aid providers to resolve any issues.

 

SEL System Potential Harms Monitoring – reminder

In response to the Synnovis Cyber-attack, SEL ICB Incident Management Gold Command require a process for monitoring, identifying and responding to potential patient harm as a result of the ongoing service delivery impact. This process will not replace individual organisations approach to managing harm within their services but aims to give a system overview. Here we have provided a slide deck which sets out further information about this incident monitoring.

Primary Care Clinicians will be expected to follow their current clinical processes for immediate escalation of individual patient clinical concerns.

A SEL System Harm Review will form part of the overall System Level 3 Critical Incident – Incident Review arrangements, which will comprise of two complimentary reviews related to the system level 3 critical incident will be undertaken across the SEL integrated care system led the ICB. A SEL System Harm Review Panel will be established to oversee the harm reviews.

It is anticipated that separate clinically led harm reviews will need to be undertaken at GSTT, KCH, LGT and in primary care.  Harm reviews will need to consider both immediate and potential for longer term harm.

Message to primary care - 11 June 2024 - 1 message

Following the update yesterday evening, we wanted to include a couple of further messages. As a reminder, all previous messages sent to primary care from the ICB are here. We are also hoping to provide an updated toolkit for primary care communications in the next 24 hours.

The Synnovis update provided information around how their laboratories are working at the moment, and how they are working to improve the situation. It also provided detail of how important it is for practices to only submit critical pathology requests currently.

 

Critical tests

To support clinicians in defining critical, urgent and routine tests clinical leads have put together this guidance for primary care. The guidance will continue to evolve and we will keep you up to date as it does. The guidance is available here.

This document also does not supplant clinical judgement based on patients’ background, medical history and clinical presentation. ​It is intended to highlight evidence-based recommendations.

 

Mutual aid arrangements

As we have previously shared, Synnovis only have capacity to support critical requests for pathology from general practice with a maximum of 400 tests a day.

As part of our plan to restore services, we have been working across London with other pathology services. In the first instance, this will allow us to transition to the processing of urgent samples, but this will need to be implemented borough by borough. This is due to capacity, speed of mobilisation, geographical restrictions and the interoperability of other pathology provider systems with our own systems.

This implementation will commence on 13 June 2024 in Lambeth, and the plan for other boroughs will be provided shortly (noting that this is subject to further investigation regarding feasibility). Each implementation of a mutual aid arrangement in a borough will also free up some capacity in Synnovis to support critical requests for other boroughs.

These arrangements have been established as quickly as possible. We are also working to minimise changes to existing arrangements as much as possible, but there are likely to be some changes to testing regimes, test catalogues and reference ranges that arise from the change to a new pathology provider. There may also be some issues with workflows, and we will be supporting you to resolve these as quickly as possible. We thank you for your patience as we work with you and our mutual aid providers to resolve any issues.

 

Printing of pathology labels

Synnovis have raised issues with the quality of printed labels on samples being submitted. To ensure that no samples need to be returned by Synnovis or any organisations providing mutual aid over the coming weeks, we would ask practices to help by:

  • Only using Brother ink cartridges. 3rd party cartridges often contain lower quality inks which degrade both in the printer and outside.
  • Dust the printer drum. There should be a slider inside the machine to dust the drum. Move this backwards and forward approximately 15 times to dust it. The dust is often caused by lower quality inks.
  • Leave the label for 30 seconds after printing. This reduces any smudging.
  • Checking your DPI/resolution print settings. It should be set to 1200 dpi but many are set at 600. If you have an issue with this, the ICT service desk can help.

Message to SEL stakeholders - Tuesday 11 June 2024

NHS organisations across London continue to work in partnership to manage patient care following the ransomware cyber-attack on Synnovis last week.

The majority of routine pathology tests in South East London are now paused. This is impacting health services including Guy’s and St Thomas’ NHS Foundation Trust and King’s College Hospital NHS Foundation Trust. Oxleas NHS Foundation Trust, South London and Maudsley NHS Foundation Trust, Lewisham and Greenwich NHS Trust, Bromley Healthcare, and primary care services across Bexley, Bromley, Lambeth, Lewisham, Greenwich and Southwark continue to be impacted.

Pathology services at the impacted sites are available – albeit at a reduced capacity – with the most urgent cases being prioritised.

Unfortunately, some non-urgent operations and procedures including transplants continue to be postponed.

We are sorry to all those who have been impacted and staff are working hard to rearrange appointments and treatments as quickly as possible.

Urgent and emergency services are available as usual so 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.

If you have not heard from your healthcare provider, please attend appointments as normal as services including outpatients and community services are mostly running as usual.

Background

  • Transplants will be assessed on a case-by-case basis with patient safety being at the heart of our approach.
  • All urgent and emergency services such as A&E, urgent care centres, maternity departments remain open as usual
  • Work is underway to understand the full extent of the attack, as well as the impact upon data. Once further information is known we will report accordingly in line with ICO requirements.
  • NHS England has deployed a cyber incident response team, which is working round the clock to support Synnovis and provide emergency guidance.
  • Synnovis is a pathology partnership between Guy’s and St Thomas’ NHS Foundation Trust and King’s College Hospitals NHS Trust, and SYNLAB, Europe’s largest provider of medical testing and diagnostics.

Please share the public messages below with your contacts:

Healthcare providers in south east London are experiencing disruption to pathology services, particularly phlebotomy (blood tests). The majority of routine pathology tests are now paused.

Unfortunately some procedures and operations are being cancelled. If you have not heard from your healthcare provider, please attend appointments as normal. Most services including outpatients and community services are running as usual.

Blood tests

It is important that you attend your blood test appointment unless you have been contacted with a cancellation. All routine blood tests in south east London are currently paused.

If you’re worried a delay will affect your care, please speak with your healthcare team.

We apologise for any inconvenience and thank you for your understanding.

Messages to primary care - Monday 10 June 2024 - 2 messages

Synnovis cyber attack update – 10 June PM

Further to the message this morning, we have included some more information for practices below. The incident is ongoing and the situation will continue to evolve. We will endeavour to share verified information with you as it becomes available.

Urgent tests – critical blood tests

Synnovis is currently receiving more tests from primary care than the laboratories are able to process. Many of the tests are having to be written into systems manually, this is causing delays in the reporting of results and further limiting the number of samples which can be processed.

It is important that primary care only submit critical tests. Critical tests are defined as requiring an investigation that is critical to inform immediate required treatment which cannot be determined or safely administered without the investigation e.g. within 0-24 hours.

 

Southwark and Lambeth phlebotomy sites close

Please note that the following phlebotomy sites specifically run by Synnovis, in Southwark and Lambeth, are closed until further notice:

  • Gracefield Gardens Health and Social Care Centre
  • Tessa Jowell Health Centre
  • Guy’s Hospital phlebotomy site.

 

Positive FIT tests

Synnovis have confirmed that all positive FIT tests received during the incident will be phoned through to practices.

 

Cyber security – heightened risk

We want to remind practices that as they have been directly affected by this cyber attack that they are at increased risk of being targeted. This could be in the form of further ransom demands, phishing attacks (to try and gain login credentials or sensitive information) or others. Please continue to

be vigilant and report any phishing or spam emails by sending to spamreports@nhs.net or via Outlook the Report Phishing button. Any other issues or concerns, please contact :

Email: ICT@selondonics.nhs.uk, SEL ICT Tel: 020 8176 5400 or use the Self Service Portal: https://nhssel.haloitsm.com/portal/home.

You can find some tips on how to increase cyber/security awareness in your practice here.

 

SEL System Potential Harms Monitoring

In response to the Synnovis Pathology Cyber-attack SEL ICB Incident Management Gold Command require a process for monitoring, identifying and responding to potential patient harm as a result of the ongoing service delivery impact. This process will not replace individual organisations approach to managing harm within their services but aims to give a system overview.

Primary Care Clinicians will be expected to follow their current clinical processes for immediate escalation of individual patient clinical concerns.

A SEL System Harm Review will form part of the overall System Level 3 Critical Incident – Incident Review arrangements, which will comprise of two complimentary reviews related to the system level 3 critical incident will be undertaken across the SEL integrated care system led the ICB. A SEL System Harm Review Panel will be established to oversee the harm reviews.

It is anticipated that separate clinically led harm reviews will need to be undertaken at GSTT, KCH, LGT and in primary care.  Harm reviews will need to consider both immediate and potential for longer term harm.  Here we have provided a slide deck which sets out further information about this incident monitoring.


Subject: Synnovis cyber attack update – Monday 10 June AM

We apologise for the lack of communications on Friday, as we were unable to send before 6pm and we are sharing this updated bulletin so general practice have it first thing Monday morning.

All communications including the communications toolkit for primary care colleagues to use are available here: www.selondonics.org/icb/healthcare-professionals/synnovis-cyber-attack/. Frequently asked questions are in development and will be shared once approved by NHS England.

As you know Synnovis experienced a cyber attack on Monday 3 June resulting in severe service disruption, with a very restricted number of tests being undertaken as most processes must be undertaken manually.  There is currently no digital pathway for relaying test results, however work is in progress to explore workarounds for results to be communicated electronically.

 

Testing services available and scale of impact

The table of affected services has been updated with the latest information as at 8am Monday morning and is shown below. Urgent requests are severely restricted at around 400 a day.  Historically primary care and community services have generated around 10,000 samples a day for testing, which gives you an idea of the scale of the impact.

Blood sciences Haematology Urgent only
  Biochemistry Urgent only
  Immunology Urgent only
  Virology Urgent only
Tissue sciences Histology Normal service
  Cytology (excluding cervical smear) Normal service except for semen analysis which is not available
Cervical smears Normal service
 Microbiology Urine MC&S

Wound swabs

Southwark, Lambeth and Bromley

Significantly reduced service – urgent tests only

NB: No Chemical Urine ACRs

Bexley, Lewisham and Greenwich

Normal services as usual (paper results for now)

Others/caveats  Biochemistry
  FIT (faecal sample) Service available
  Faecal calprotectin (faecal sample) Service available

 

Testing alternative pathways

Synnovis and system partners are currently working with a small number of other NHS services, some with an existing digital interface with practices, to identify if there is potential for them to receive and test the samples and electronically convey the results back to practices in a format that will be useable and avoid significant manual inputting.  These pathways will be tested with a small number of practices first before being rolled out. There may be the need for a borough by borough solution due to the available capacity and connections.

 

Phlebotomy protocol template

We are working with Ardens to create a phlebotomy protocol template and a flag that can be added to patient records to record the consultation was undertaken during a critical incident.

 

Prioritisation guide

Our clinical leads are currently developing a prioritisation guide which is being tested to make sure that it is comprehensive and will support clinical staff in decision making, both in general practice and community services.  We hope to share this with general practice early this week.

 

Harms monitoring and outstanding test results

The ICB quality team has developed a harms monitoring document, currently being reviewed by our clinical reference group. This will be circulated this week as a guide for general practice.

Synnovis have confirmed that the 70,000 results that were outstanding were successfully transferred to practices before the cyber attack.

 

Interface group

At our digital collaboration group it was suggested that a small interface group is virtually formed so that GPs and clinical staff from the acute hospitals, mental health, community, cancer, maternity and paediatrics have an opportunity to discuss issues and develop proposals during this period as the whole system is affected and patient care and safety is the number one priority.  We will be setting this up this week and will feedback to you all on progress.

Please look out for regular communications from us on this important matter.

Messages to primary care - Thursday 6 June 2024 - 2 messages

Synnovis cyber attack – 6 June evening update

Thank you for your patience and understanding while we’ve gathered the information needed to give you a clear picture. Further to the information today, we have included a note on manual data entry of pathology results.

The headlines from today are:

  • all phlebotomy should be paused until the end of June – this decision will be reviewed on 13th June based on the status of the recovery. Guidance on urgent tests will be provided tomorrow. Please do not run any phlebotomy clinics at your practice. This will ensure the laboratory capacity is reserved for processing urgent requests.
  • all cervical screening is available
  • couriers are continuing and should still come to each practice at least once a day.

Below we have:

  • What is available
  • Manual data entry of pathology results
  • Update comms pack for practices

 

What is available

Blood sciences Haematology Urgent only
  Biochemistry Urgent only
  Immunology Urgent only
  Virology Urgent only
Tissue sciences Histology Normal service
  Cytology (excluding cervical smear) Normal service except for semen analysis which is not available
Cervical smears Normal service
 Microbiology Urine MC&S

Wound swabs

Southwark, Lambeth and Bromley

Urgent service only

Bexley, Lewisham and Greenwich

Normal services  (paper results for now)

Others/caveats  Biochemistry
  FIT (faecal sample) Can refer to 2ww without this (more details to be confirmed)
  Faecal calprotectin (faecal sample) Not available

 

Manual data entry of pathology results

It is important that any test results, manually added to patient records during this period, are entered consistently.  It is therefore recommended that you use the following Ardens template: “Blood results (v17.9) (Ardens)”.

Updated comms pack

In this version of the pack we have added the table above to the script and provided a telephone message for practices to have on their telephony solutions. The pack and all materials sent to primary care can be found on our website here.

 

We recognise that this is an ever changing situation and we may not be able to provide an immediate response, and we will endeavour to share information as it becomes available.


Update on Synnovis cyber attack – 6 June AM

Thank you for your patience and understanding while we’ve gathered the information needed to give you a clear picture. We have shared this as soon as possible. Below, we have a table of what is and isn’t available as well as other key messages.

The headlines from this are:

  • all phlebotomy should be paused (guidance on urgent tests will be provided later today). Please do not run any phlebotomy clinics at your practice. This will ensure the laboratory capacity is reserved for processing urgent requests.
  • all cervical screening is available
  • couriers are continuing and should still come to each practice at least once a day.

Below we have:

  • What is available
  • Synnovis customer service
  • Accurx fragments and costs
  • GSTT Occupational Health message to patients

What is available

Blood sciences Haematology Urgent only
  Biochemistry Urgent only
  Immunology Urgent only
  Virology Urgent only
Tissue sciences Histology Normal service
  Cytology (excluding cervical smear) Normal service except for semen analysis which is not available
Cervical smears Normal service
 Microbiology Urine MC&S

Wound swabs

Southwark, Lambeth and Bromley

Urgent service only

Bexley, Lewisham and Greenwich

Normal services  (paper results for now)

Others/caveats  Biochemistry
  FIT (faecal sample) Can refer to 2ww without this (more details to be confirmed)
  Faecal calprotectin (faecal sample) Not available

Synnovis customer service

Synnovis’s services department has been affected by IT problems since the cyberattack and has been unable to address queries received in the last few days. However, they now have some capacity to work through your questions. Customer services staff are able to receive calls and, where possible, will answer or appropriately redirect your enquiries.

Please email your queries to customerservices@synnovis.co.uk or call 0204 513 7300. They will make sure they are considered and answered as far as possible in future rounds of communications. You can find out more about customer services, including opening hours, online here.

Synnovis apologise for the disruption to this service and thank you for your patience and understanding.

Accurx Fragments

We are aware that practices have had to inform and notify patients of the recent Synnovis incident which may have involved utilising Accurx fragments.  Please continue to use this method of contacting patients if appropriate but at the same time record the number used for this purpose during this period for future reference. A local template named Synnovis Incident could be used. Here is the link which shows you how to create the template: https://support.accurx.com/en/articles/6867610-accurx-desktop-how-to-create-your-own-message-templates.

GSTT Occupational Health message to primary care

Here we have copied a message from GSTT to primary care:

“We would like to inform you that Synnovis, the Trust’s provider of pathology services, experienced a major IT incident on Monday 3rd June. This issue is affecting several hospitals and primary care services across London and is having a major impact on the delivery of clinical services. As a result, the Trust has declared a critical site incident and is working closely with Synnovis to urgently resolve this issue.

To support the Trust’s response to this critical incident we are only undertaking blood tests deemed clinically urgent until further notice. As a result we are currently unable to perform any blood tests for immunity screening, Exposure Prone Procedure (EPP) clearance and post-body fluid exposure (BFE) monitoring.

All clinics are being reviewed and appointments cancelled and rebooked where necessary. We therefore anticipate an impact on appointment availability over the coming weeks and ask that you bear with us as we manage a backlog of appointment requests caused by this incident. 

Individuals who have sustained a BFE should still report to the Occupational Health, Safety and Wellbeing Service (or Emergency Department, if out of hours) for urgent assessment. 

I’d like to reassure you that the Trust is working tirelessly and making every effort to restore pathology services as quickly as possible but unfortunately we don’t currently have a date for resolving this incident. However, we will continue to update you regularly over the coming days as we learn more.

Should you have any queries, please do not hesitate to contact us via: ohs_contracts@gstt.nhs.uk.” 

Messages to primary care - Tuesday 4 June and Wednesday 5 June 2024 - 3 messages

Tuesday 4 June PM:

“On Monday 3 June Synnovis was the victim of a ransomware cyber attack.

The attack is having a significant impact on the delivery of services at Guy’s and St Thomas’, King’s College Hospital NHS Foundation Trusts and primary care service users in Bexley, Greenwich, Lewisham, Bromley, Southwark and Lambeth. We apologise for the inconvenience this is causing to patients and their families. The attack is affecting all pathology services, including phlebotomy and cervical screening. We recognise this is having a significant impact in primary care and we are working urgently with Synnovis and hospital Trusts to fully assess the impact of the attack and take appropriate action. We will keep you updated regularly with the latest developments.

We are advised that emergency care continues to be available, so patients should access services in the normal way by dialling 999 in an emergency and otherwise using 111, and patients should continue to attend appointments unless they are told otherwise. We will continue to provide updates for local patients and the public about the impact on services and how they can continue to get the care they need.

We are working together with Synnovis and NHS Trusts to fully understand the impact of the incident with the support of the government’s National Cyber Security Centre and our Cyber Operations team. A process for requesting urgent testing is being developed and further information will be shared tomorrow morning. We are assured that all critical results continue to be phoned through to the relevant GP or clinical lead, as per the Synnovis standard operating procedure.

Practices are asked not to perform their own phlebotomy as there would be no capability to process the sample and return it yet. In the meantime, you can still order blood tests via electronic systems, but Synnovis has asked for patients to delay having non-urgent bloods taken until further notice and asked phlebotomy providers to cancel non-urgent appointments.

We have established a page on the ICB website with a statement on the incident. This page will be updated as the situation develops.”


Wednesday 5 June AM

Update on Synnovis 3 June cyber attack

Following from the update last night, we are looking to send out a twice daily update over the next few days. We are hoping to share more information around urgent testing requests later today as well as an updated statement. In the meantime, we would like to remind practices that all pathology requests provided by Synnovis have been impacted by the cyber ransomware attack.

Using the information available, we have included a communications pack for practices. This includes: a printable poster for waiting rooms, a short script for practice staff to answer queries and a statement to go on practice websites. We expect to update this regularly and to share the updates with you through these emails. You can find the information shared with primary care on new area on the ICB website here.”


Wednesday 5 June PM

Update on Synnovis 3 June cyber attack

Following from the update earlier today, we can share an updated statement issued nationally. In the meantime, we would like to remind practices that practices are unable to make any pathology requests and should wait for further information which we will share as soon as we have it. We hope to be able to share more information tomorrow.

Earlier, using the information available, we have developed a communications pack for practices. This includes: a printable poster for waiting rooms, a short script for practice staff to answer queries and a statement to go on practice websites. We expect to update this regularly and to share the updates with you through these emails. You can find this and the information shared with primary care on a new area for healthcare professionals on the ICB website here. The updated statement is below:

“The ransomware cyber-attack on Synnovis is continuing to cause disruption to services at Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust, and primary care providers in south east London.

All urgent and emergency services remain open as usual and the majority of outpatient services continue to operate as normal.

Unfortunately, some operations and procedures which rely more heavily on pathology services have been postponed, and blood testing is being prioritised for the most urgent cases, meaning patients have had phlebotomy appointments cancelled.

We are sorry to all patients impacted and NHS staff will work hard to re-arrange appointments and treatments as quickly as possible.

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 should continue to attend appointments unless they are told otherwise by the clinic team.

NHS England has deployed a cyber incident response team, which is working round the clock to support Synnovis and provide emergency guidance, as well as coordinating with health services across the capital to minimise disruption to patient care.”

Communications materials to support practices - unavailable - to be updated 20 June 2024

To support primary care colleagues, we are developing an updated set of materials for practices to use. These will be available on Thursday 20 June 2024.

It is likely to include:

  • website content for practice websites
  • a short paragraph to share with partners (eg. care homes) on impact
  • a short script for practice staff
  • a telephony message
  • a poster to display in the practice
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