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A cyber attack on NHS systems spotted nearly two months ago is still "compromising" the quality of care trusts can provide, a health boss said.
Software used for check-ins, notes and the NHS 111 service was affected by the ransomware attack found on 4 August.
The chief executive of Oxford Health Foundation Trust (OH), Nick Broughton, said it has done all it can to maintain services despite the disruption.
Software provider Advanced said disruption could continue for weeks.
The trust said it initiated an internal critical incident in early August with a full emergency response.
"One shouldn't underestimate the impact this has had on our organisation… it is compromising our ability to deliver the quality of care that we would like to.
"We're very conscious of the potential impact on patients and we're monitoring that very closely," Dr Broughton told the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board on Tuesday.
"We have done all we can do to maintain services and maintain the safety of those services."
The trust said replacement systems are in place, but are time consuming and more people have had to be employed as a result, impacting agency spend.
District nurses, who are usually heavily reliant on IT systems to co-ordinate their patient lists, reported missed appointments or people being seen twice during the course of the day.
There is no evidence patient information or confidentiality has been compromised.
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