Recipient

Cegedim Healthcare Solutions

First report 12 Oct 2017•Latest report 18 Apr 2024

Recipient record

Reports, concerns and published responses

Other public bodies · Sub-organisation. This page brings together reports naming this recipient and response statements clearly connected to concerns raised in those reports.

Reports: 2
Published responses: 50%
Concerns addressed: 1
Stated actions: 1

Reports over time

Reports naming this recipient by issue year.

Evidence profile

Report topics

Share of this recipient’s reports compared with all other recipients.

50%published responses found

1stated actions described

Topic comparisons are not available in the current evidence snapshot.

Concerns and recipient responses

Statements from Cegedim Healthcare Solutions linked to the concerns in each report. Select any concern, action or position to view the source wording.

18 Apr2024
West Yorkshire Eastern
Concerns raised1
1. Failure of general practice IT systems to validate or challenge potential data input errors at the point of entry
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Respondent positions 1
1. Position
  Age-sensitive BMI functionality has not been developed because it is not currently required under NHS framework agreements.
  Unable to act
AI-generated summary

ALEXANDER LEE REID · Prevention of Future Deaths report

This summary was generated using AI from the published report. Please read the original report for the complete account.

Report summary

Alexander Lee Reid received the Oxford AstraZeneca Covid-19 vaccine after being invited early because an erroneous BMI in his GP records led him to be identified as vulnerable. He died on 29 June 2021, and the inquest concluded that his death was linked to the vaccination, with the medical cause recorded as cerebral venous sinus thrombosis and Covid-19 vaccine-induced immune thrombotic thrombocytopenia. The principal concern was whether general practice IT systems should validate or challenge potentially erroneous data at the point of entry to improve data reliability and patient safety.

Read the report on judiciary.uk
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Cegedim Healthcare Solutions; that does not assign responsibility.
PFD Monitor interpretation
Failure of general practice IT systems to validate or challenge potential data input errors at the point of entry
Wider context from the report
“(2) The inquest heard expert evidence that the combined vaccination monitoring and recall specification designed to identify vulnerable people for the purposes of inviting them to receive their Covid vaccinations early had identified Alex as vulnerable from an incorrect BMI of 68.97 recorded in his GP records on 06/02/2004. The mistake was due to the relevant clinician recording Alex's height as 145cm and his weight as 145kg, giving a BMI of 68.97 for an 11 year old boy whose previously recorded BMI aged 9 had been 14.88. (3) The inquest heard expert evidence that to have built a system that would validate multiple data items in an individual's GP records for the purposes of ensuring that individuals were not incorrectly identified as vulnerable would not have been feasible within the constraints and context of the Covid-19 programme. (4) The inquest heard expert evidence that an easier and more appropriate option would be to embed validation rules in general practice IT systems that would check such information at the time of data entry. (5) If the obviously erroneous BMI had not been recorded or had been challenged at the point of entry by the relevant IT system, Alex would not have been classed as vulnerable, would not have been offered a vaccine before guidance was published that the under 30’s should not receive the Oxford Astra Zeneca vaccine, and would not have died when he did. (6) The consequences of the data input error in this case give rise to a concern that more might be done by way of specification design to allow for the correction of or challenge to potential data input errors at the point of entry, with consequential improvements in the reliability of such data and the safety of patients and reducing the risk of other deaths occurring in similar circumstances in the future. ”
Open source report
Source evidence

How this respondent position was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Age-sensitive BMI functionality has not been developed because it is not currently required under NHS framework agreements.

Verbatim wording from the response
“It should be noted that, such enhanced functionality (to additionally take into account patient age when recording weight or height for calculation of BMI, including for patients who are under 16 years of age) is not currently among the NHS requirements in the Framework agreements and therefore has not been developed in our clinical solutions.”

Source location
Response from Cegedim
Page 2 · response
Published 29 April 2024
Open published response
12 Oct2017
Nottinghamshire
Concerns raised3
1. Failure to ensure continuation of prescription safety controls after trial completion
2. Lack of communication of clinical urgency when prescriptions are downloaded
3. Inaccurate help information about unavailable prescription urgency functionality
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.

No linked response statements
No action or position from this recipient is clearly linked to the concerns in this report.
AI-generated summary

Douglas Hodges · Prevention of Future Deaths report

This summary was generated using AI from the published report. Please read the original report for the complete account.

Report summary

Douglas Hodges died in hospital on 3 April 2017 after developing multiple organ failure and systemic sepsis; antibiotics prescribed by his GP had not been dispensed by the pharmacy. The principal concerns were that community pharmacy systems did not communicate prescription urgency at the point of downloading, and that a prescription could be mislaid or accidentally disposed of without detection, creating a risk of future deaths.

Read the report on judiciary.uk
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Cegedim Healthcare Solutions; that does not assign responsibility.
PFD Monitor interpretation
Failure to ensure continuation of prescription safety controls after trial completion
Wider context from the report
“In relation to Wells Pharmacy : 1. I heard evidence from the patient safety manager of Wells Pharmacy Group, who told us they are trialling a system which includes the following provisions : a. Downloading prescriptions only up to 2.30pm each day, with the aim of labelling all prescriptions downloaded on that day. We were told that urgency and delivery instructions would then be picked up at the labelling stage. b. Pharmacists are required to check at the end of each day whether there are prescriptions which have been sent to print but not yet got to the labelling stage. c. If a patient or representative comes in to collect prescribed medication, only one prescription will be downloaded at a time, to avoid any confusion. d. Local GPs will be made more aware of likely / realistic timescales between prescription and the medication going to patients. 2. I note that this trial will end in November. Whilst it is entirely appropriate to trial any change like this, there is no guarantee that changes will be implemented after the trial. I would like to know what the intention of the pharmacy is after the trial period ends, and how it proposes to reduce this risk in future. ”
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Cegedim Healthcare Solutions; that does not assign responsibility.
PFD Monitor interpretation
Lack of communication of clinical urgency when prescriptions are downloaded
Wider context from the report
“In relation to NHS Digital : 1. As matters stand, in a community pharmacy setting, there is no way of communicating clinical urgency between prescriber and pharmacy staff at the time the prescription is downloaded. A large number of prescriptions are downloaded every day by pharmacies. Urgent and non-urgent prescriptions look the same on the system. It is only at the labelling stage that any clinicians’ comments can be seen. 2. We were told that a different system (Vision) is used in scenarios where a pharmacy is run by a GP practice. This system is often used in rural settings. The Vision system allows for a prescription to be marked with a red exclamation mark at the point of downloading, where a prescription is urgent. 3. Where prescriptions go via the NHS Spine, such a system is not currently possible. 4. We heard evidence about a recent survey conducted by NHS Digital, in which pharmacists made it clear that this was the change they most wanted to see. 5. It is clear that agreed guidelines will need to be considered, in line with any such change, to define what is meant by the term ‘urgent’. 6. Prof Hodges’ case makes the case for this change very clearly, and I consider there is a real risk of future deaths if this is not addressed. ”
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Cegedim Healthcare Solutions; that does not assign responsibility.
PFD Monitor interpretation
Inaccurate help information about unavailable prescription urgency functionality
Wider context from the report
“In relation to Cegedim : 1. During the investigation, an experienced clinical pharmacist who works at the GP practice attended the pharmacy and looked at the system in question. When accessing the ‘help section’ of the software, the information she saw suggested that the red exclamation mark system was available and she questioned why this was not being used. It is not clear why this information is included in the ‘help section’ of software that does not currently support this function. It clearly led to confusion. I ask that Cegedim review this and consider clarifying it. ”
Open source report

Information checked against published PFD reports and official responses · Data reviewed 7 Sep 2026 · About data quality and limitations

Data last updated 7 September 2026

Reports, concerns and published responses

Reports over time

Concerns raised1

Failure of general practice IT systems to validate or challenge potential data input errors at the point of entry

Respondent positions A position is what this recipient says about the concern when it does not describe a specific action.1

Concerns raised3

Failure to ensure continuation of prescription safety controls after trial completion

Lack of communication of clinical urgency when prescriptions are downloaded

Inaccurate help information about unavailable prescription urgency functionality

Respondent positions 1