A worrying BBC News (2019) headline in December reported that hospitals across England are using 21 separate electronic systems to record patient care. Researchers suggested this was risking patient safety because the IT systems do not ‘talk’ to each other, making cross-referencing difficult and potentially leading to errors. The research team, from Imperial College's Institute of Global Health Innovation, looked at data from 152 hospitals, and found that around one quarter were still using paper records and 10% were using multiple systems within the same hospital.
In 2016 the idea of Global Digital Exemplars (GDEs)—NHS providers delivering improvements in the quality of care through the world-class use of digital technologies and information—was launched. Exemplars would share their learning and experiences, creating blueprints to enable other trusts to follow in their footsteps as quickly and effectively as possible. The programme was created following the need identified in the Five Year Forward View, and the Personalised Health and Care Framework (National Information Board, 2014; NHS England, 2017). The NHS Long Term Plan continued the theme of enabling the use of IT to join up timely access to accurate information, support service change to help improve health for all and provide patients with better access to their records.
‘By 2024, secondary care providers in England … will be fully digitised, including clinical and operational processes across all settings, locations and departments.’
To mark International Nurses' Day in 2019, NHS Digital's acting chief nurse, Karen Swinson, wrote about how small technological and information-sharing advances can make a real difference to nurses and the patients that they care for (NHS Digital, 2019):
‘Often that enthusiasm for the job we love isn't so easily extended towards the technology we have to use. Technology that could make our working lives easier and ultimately leads to even better care for our patients.’
Swinson cited the Child Protection Information Sharing system (CP-IS) as one example of how information sharing across the NHS and social care can have a profound impact on young people's lives. The system was designed to act as a warning system for vulnerable and looked-after children, triggering an alert on a child's health record when they appear at an unscheduled healthcare setting, such as A&E or an urgent treatment centre, which in my own trust has enabled real-time multi-agency working and excellent safeguarding practice.
The Nuffield Trust published a research report looking back over the previous 2 years and the progress of the NHS Digital programme (Castle-Clarke and Hutchings, 2019). The authors interviewed a large sample of NHS staff, with some variation in their views as to the progress. Some staff felt that the GDE programme had enhanced sharing and awareness:
‘I think not only are the aspirations of the programme exciting—everybody has gone into it quite warily initially, but it's developed into something that's a really strong network.’
Others found that those in the role of Chief Nursing Information Officer (CNIO):
‘… don't feel as connected to the wider workforce and to nursing in general. They still feel quite … just within informatics and IT. And, actually, that isn't what we're trying to achieve: it's about bringing the two together.’
Comments also pointed to the relatively low proportion of investment on IT in the NHS, compared with other organisations, or to the length of time that it has taken to deliver some digital projects. The Nuffield Trust report recommendations were grouped under the following areas:
As nurse leaders of all levels, we need to consider our influence and contribution to the development and delivery of our own organisation's digital plans. Although progress seems varied, we must remember the start point that we came from and champion the development of digital practice to deliver the overall benefits to our patients.