Holderness Health

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First report 19 May 2025•Latest report 19 May 2025

Reports, concerns and published responses

Reports over time

Reports naming this recipient by issue year.

* 2026 is projected from reports observed to 7 Sep 2026.

Reports
1

Naming this recipient

Published responses
100%

Found for named reports

Concerns addressed
1

Across all linked responses

Stated actions
1

Described in responses

Concerns and recipient responses

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

  1. East Riding and Hull

    AI-generated summary

    John Charles Spencer · 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

    John Charles Spencer became unwell on 17 May 2024 and died on 21 May 2024 after a bowel perforation caused by obstruction within a recurrent right inguinal hernia, resulting in purulent peritonitis. The principal concern was that the GP out-of-hours surgery could not access his relevant GP medical history because different computer systems prevented the exchange of information, potentially affecting the examinations undertaken when patients do not report relevant history.

    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 Holderness Health; that does not assign responsibility.

    PFD Monitor interpretation

    Failure of GP out-of-hours surgeries to access key GP medical history information after patient consent

    Wider context from the report

    “(1) The GP medical history summary, populated by the GP that a patient is registered to, is not always accessible to a GP out of hours surgery. Evidence was given that there are various reasons for this, including the patient not providing consent for the exchange of this information. However, on some occasions, even when a patient has consented, the patient record systems utilised by the GP registered practice and the GP out of hours surgery, insofar as being different computer systems or for whatever other technological reason, prevented the exchange of information into the GP out of hours surgery. In this case, evidence was heard that the GP practice was using the EMIS system and that the urgent treatment centre (GP out of hours surgery) was using SystmOne. That fact caused the GP out of hours surgery to not be able to access Mr Spencer’s GP medical summary. This situation generates a concern that, providing the patient has consented, key medical information may not be conveyed to the GP out of hours surgery which should be accessible to allow the appropriate exchange of medical information to inform what examinations should take place in an out of hours setting. This concern is particularly significant in circumstances where the patient does not say and/or present with the points in the medical history relevant to the GPs determination about what further examinations should occur flowing from the medical history of the patient. ”
    Open source report

    Source evidence

    How this respondent action was interpreted

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

    PFD Monitor interpretation

    Migrate clinical IT from EMIS to TPP SystmOne and enable GP Connect to support consent-based access to medical summaries.

    Verbatim wording from the response

    “Relating to the matters of concern raised in your report, I can confirm that Holderness Health had a planned clinical IT system migration from EMIS to TPP SystmOne on 13th May 2024, with GP Connect enabled.”

    Source location

    Response from Holderness Health
    Page 1 · response
    Published 21 May 2025

    Open published response

    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

    The remote surgery was not a significant or currently active problem and therefore would not generally appear in GP Connect’s limited summary.

    Verbatim wording from the response

    “Relating to the matters of concern raised in your report, I can confirm that Holderness Health had a planned clinical IT system migration from EMIS to TPP SystmOne on 13th May 2024, with GP Connect enabled.”

    Source location

    Response from Holderness Health
    Page 1 · response
    Published 21 May 2025

    Open published response
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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