Systems adapted to avoid disruption to Covid vaccination drive after cyber attack, HSE says 

Close contacts will be told to attend their closest test centre for a walk-in test however rather than be referred for a test. 
Systems adapted to avoid disruption to Covid vaccination drive after cyber attack, HSE says 

The vaccination clinic at Cork City Hall. The HSE has said it has adapted the IT system to minimise delays caused by the cyber attack. Picture: Dan Linehan

The HSE has said it has adapted its systems to minimise delays at Covid-19 vaccination centres tomorrow.

In a statement this evening, a spokesperson for the HSE South said while all appointments at vaccination centres in Cork and Kerry continued today, there were some unavoidable delays at some centres because all HSE email systems are offline following yesterday's cyber attack.

"We have adapted systems in advance of Sunday's appointments and will be working hard to minimise any inconvenience. We apologise if anyone experienced delays on Saturday, and remind people to attend appointments tomorrow and next week as scheduled," a spokesperson said.

Despite the difficulties, Covid-19 testing also continues. However, because referrals are affected, anyone who has symptoms or who has been told by public health that they are a close contact will be told to attend their closest test centre for a walk-in test. 

On Sunday, the Lee Covid test centre at the North Link Business Park will be open from 10.30am to 5pm and the Tralee centre at Ballymullen Barracks will be open from midday to 5pm.

Meanwhile, community healthcare appointments and services in Cork and Kerry continue as scheduled and individuals will be advised if there is any change. 

In a detailed memo to HSE staff, the chief clinical officer said urgent services should be prioritised in the wake of the cyber attack. File picture. 
In a detailed memo to HSE staff, the chief clinical officer said urgent services should be prioritised in the wake of the cyber attack. File picture. 

This includes home support (home help); mental health teams and appointments at health centres and primary care centres. 

Appointments will go ahead as planned on Monday unless people are contacted directly.

Services under threat

The vaccination programme update comes as the cyber attack on the HSE’s IT system could see stocks of critical medicines run out, could affect cancer treatments and could delay critical stroke treatments, the chief clinical officer has warned.

Dr Colm Henry said these are among the many risks which now have to be considered as he set out a wide range of clinical advice and guidance for clinical services in the wake of the massive cyber attack.

Time-critical cure and urgent services priority

In a detailed memo to HSE staff this evening, Dr Henry said services to be prioritised should be urgent, unscheduled and time-critical care including dialysis and radiotherapy.

He said services that require or are likely to require blood transfusion should be minimised and, where they are necessary, planned carefully with transfusion services.

Clinicians have been told that all diagnostics requests must or should be urgent and immediately required, and that requests for examination and samples for lab analysis should be limited to those which are time sensitive and essential.

Chief Clinical Officer Dr Colm Henry said the advise is based on a need to prioritise patient safety. Picture: Leon Farrell / Photocall Ireland
Chief Clinical Officer Dr Colm Henry said the advise is based on a need to prioritise patient safety. Picture: Leon Farrell / Photocall Ireland

And because all lab and radiology reports must be communicated by paper reports or telephone, he said the requests for imaging and laboratory diagnostics should be minimised, and that diagnostic results should be communicated by phone or end-to-end encrypted messaging systems.

He said the advice is underpinned by the need to prioritise patient safety and is focussed on unscheduled, urgent and time-critical care, but that this should be monitored daily so that those services that can deliver scheduled care do so.

He also set out a number of inherent risks which are now in play in the absence of the usual IT systems, including limited access to diagnostics; no access to historical clinical, radiological and laboratory records; an intensely stressful environment for staff making decisions without access to many of the usual supports; and the possibility of transcription errors in the recording of hand-written results.

But he said there are very specific risks in certain circumstances, including blood transfusion, radiology and pharmacy departments.

Potential delays at risk

In relation to blood transfusions, he said the absence of access to cross-matching/transfusion history records creates significant additional risks, including challenges with stock control.

In relation to the stroke treatment, thrombolysis, he said there could be potential delays in the treatment because the decision to thrombolyse a stroke patient is made by a stroke clinician, usually at a distance.

He said the absence of computer links and email systems leaves the mental health service open to being in breach of their statutory requirements, and patients without access to their legal rights, especially those who may require urgent involuntary admission.

The attack has resulted in major disruptions to hospital services but the vaccine rollout continues. File picture. 
The attack has resulted in major disruptions to hospital services but the vaccine rollout continues. File picture. 

And he said pharmacy departments’ capacity for stock control will be impaired and may lead to shortage or outage of critical medicines and challenges with issuing of oncology treatments.

But he said contingency planning is already underway to ensure that radiotherapy sessions are not disrupted.

And while it’s still not known how long it will take the HSE to recover from the attack, Dr Henry said clinicians should be mindful that “scheduled care” could become urgent care or result in an adverse outcome, such as the cancellation of certain types of radiotherapy, if it does not proceed.

The HSE has said that this guidance will be updated every 72-hours while work continues to recover its IT systems.

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