Paper cuts: the NHS prepares to go digital

With the NHS just four years from supposedly going paperless, Danny Palmer examines how the project is already transforming practices and whether the 2018 deadline is achievable

In an effort to improve services and cut costs, the government has set the ambitious target of switching all NHS paperwork to digital records by 2018.

It would mean NHS staff move on from writing things down to a paperless environment in which they can instantly enter and retrieve information digitally using mobile devices.

A recent freedom of information request by Spectralink revealed that with only four years remaining until the deadline for a paperless NHS, two-thirds of medical professionals still rely on pen and paper for recording information. Despite this apparent lack of progress so far, there are those who are confident of hitting the deadline, such as Northern Devon Healthcare NHS Trust director of IT, Mike Jones.

"All of the IT projects we've got on are geared towards ultimately taking us towards a paperless hospital by 2018," Jones told Computing. "The main programme of work we've got is our electronic health record (EHR) programme.

"This is about moving away from paper health and social care records towards an electronic system that will capture critical records and will allow patients and healthcare professionals to have access to their records."

Jones explained how a variety of projects were enabling staff to work more efficiently, including by allowing doctors to digitally request test results. He described implementation as "going well", thanks in part to a procurement programme supported by a Department of Health (DoH) scheme.

"We've been successful in securing a commitment from the Treasury through the Southern Acute Programme for funding a fully integrated EHR system," said Jones, who added the trust is on target to become paperless within four years.

"It's a five-year journey, so for us 2018 is achievable," he said.

His confidence is not shared by Mark O'Herlihy, EMEA director of healthcare at Perceptive Software, however.

"The timings may be aggressive when it comes to doing it in less than four years because some trusts now are very light on digital as a whole," he told Computing, citing research by Perceptive that suggests those on the frontline of the NHS seriously doubt the paperless deadline will be hit.

"We've got a disparity really between the NHS trust heads and the other key staff, as over half of NHS trusts believe that being completely paperless by 2018 is a realistic goal compared to less than a fifth of healthcare professionals," said O'Herlihy.

According to O'Herlihy, the "core systems" are not in place to deliver a paperless NHS by 2018, and that 2021 would be a more realistic target date.

Although many NHS staff doubt the DoH will achieve its goal, there is widespread support for the idea of a paperless health service. Anne Cooper, clinical informatics adviser (Nursing) for NHS England, told Computing that going paperless will help to improve care by streamlining access to patient data.

"Nursing needs good quality information and good patient care is dependent on having knowledge about what's happened before," she said.

"Paper has been the primary mechanism enabling us to do that but technology has the power to move to a place where we can provide better care through better access to information, but obviously that's a big shift."

While Cooper admitted that nurses are currently split between those who appreciate the new technology and those who are less keen or need time to adapt, the majority understand that going paperless will benefit patients.

"Most of them recognise that having good quality information is about delivering better care and most of them are up for it," she explained, adding that digital's ability to provide continuity as patients move between hospitals and clinics will result in better care.

"The information moves with the patient around the system and we're not dependent on looking for case notes. Technology means we can give better care because the history of the patient moves around with them.

"This is about enabling people to give people better access to information to deliver the best care that we can," said Cooper.
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