On Wednesday 4th June 2025, a surgery contacted the Clinical Systems team about an issue with duplicate pathology/radiology reports being received from a local trust. In several cases, individual patient records contained the same report repeated over 1,200 times.

Based on their example, we've prepared the following guidance to help surgeries continue using affected records effectively while duplicates remain, and to advise on managing the backlog. Some practices may already have configurations in place.

This article includes:

1. Tips on Clearing Duplicate Reports
2. Making Affected Records Usuable (while you still have duplicates)

Tips on Clearing Duplicates

In short, you will need to manually remove these duplicate reports by first marking them in error, then deleting the now unfiled reports from the system. Both actions can be completed in bulk from the Pathology / Radiology Inbox screen, but we recommend doing so in batches.

NOTE: SystmOne may display an "event failure" message after approximately five minutes of inactivity. This does not mean the system has stopped processing. When performing bulk actions on large numbers of entries, it’s normal for SystmOne to appear unresponsive. Do not interrupt the process - simply wait for it to complete.

Tips

• Where possible, perform these actions on a PC that will not be used for other purposes
• Sign in with username and password, not with Spine connection (smartcard)*
• Use the Patient filter on the Pathology Inbox to ensure you are only looking at one patient's reports
• Sort by Arrival and subsequently Battery Header columns to check if there are other reports present that you need to avoid (i.e. Other reports for the patient that aren't duplicated)
• If possible there is benefit in performing this work out of normal hours: 
  • If a colleague accesses the record while you are attempting to mark in error; this may fail and you may be met with an error message for each of the reports you tried to action.
  • Our intial testing showed that marking large number of reports in error worked significantly faster outside core hours. e.g. 500 reports marked in error during the day took several hours; doing a similar number late in the evening took approximately 15-20 minutes.

*The marking in error stage accesses the patient record which takes longer with Spine access. We have not confirmed if a bulk report deletion from the Path Inbox performs a Spine retrieve; however, signing in without the Spine ensures it cannot be happening.

Making Affected Records Usable

To improve usability of patient records with excessive duplicate entries - and to ensure your system is prepared if the issue reoccurs - please review the following.

If, after attempting below, you require assistance, please submit a ticket to request support.

Ensure the following settings are in place across your organisation: 

1. Tabbed Journal Filter that excludes pathology/radiology results
2. Patient Home view configured to prioritise key items (e.g. Reminders, Patient Status Alerts, Special Notes) above large volumes of pathology results

Both of these can be managed centrally via Organisation Preferences > Clinical Policy in SystmOne.

Tabbed Journal Filter

Creating or amending a Tabbed Journal filter to exclude pathology/radiology entries will make it easier for staff to navigate affected records without being overwhelmed by duplicate data.

The screenshot below shows the rough stages of creating a new or amending an existing Journal filter to hide path/radiology entries. This assumes your surgery already has already familiarsised itself and followed our guidance on setting default Tabbed Journal filters to hide marked in error items, blank entries, and template/code duplication.

Once the filter is set up: 

• Communicate this to staff so they know how to apply it when viewing affected records.
• Staff can also use this filter on demand, even in unaffected records, to reduce visual clutter.

Patient Home configuration

To stop duplicate Path/Rad To Action items from pushing more important information off-screen:

• Adjust the order of display items so that Reminders, Patient Status Alerts, Special Notes, and similar entries appear above Pathology/Radiology.
• Alternatively, staff can collapse the Path/Rad To Action section in individual records by clicking the – (minus) icon next to it.

You may also choose to untick Expand for Path/Rad To Action in Organisation Preferences; however, be aware this setting will apply to all records, which may hide important Path/Rad items awaiting review in unaffected records.

The screenshot shows Organisation Preferences configured with path/rad lower than other items as well as patient record with Reminders, PSAs & Recalls configured to display before Path/Rad to Action