Strictly Clinical

Paperless in the United Kingdom: National Health Service goal for 2018

Nurses on the front line of care in the National Health Service (NHS) of the United Kingdom (UK) are acutely aware of the pressures facing the health service. Rising demand for services (particularly emergency services) and a tight financial environment mean we all need to do more with less.

We’re also well aware of the impact these pressures place on our daily jobs and ability to spend valuable time with patients. To maintain a focus on quality, last year NHS England launched the “Compassion in Practice” nursing and midwifery strategy. This brought together the “6 Cs”—care, compassion, competence, communication, courage, and commitment—as the underpinning values of the profession.

Given this pressured environment, why did UK Health Secretary Jeremy Hunt in January set out his priority for the NHS to be paperless by 2018? The answer is simple: Only by embracing technology can the NHS meet the challenges it faces over the next decade and beyond.

While the history of health information technology (HIT) in the NHS is a complicated one, there’s no doubt that technology has the potential to contribute directly to improvements in care. Technology can free up nursing time by digitizing such processes as early warning scores, nurse rounding, device integration, digital pens for the community, and supporting communication between clinicians. What’s more, the simple act of capturing patient information on an electronic rather than paper record means patients’ details and medical history can be made available to clinicians at the point of care easily and accurately. Earlier this year, NHS England detailed a vision for making an integrated digital care record for each patient available across the NHS—one that reinforces the active role nurses must play in embracing technology to capture and share patient information electronically.

The next step will be for nurses across the NHS to use this information to change and improve the way they work, closing the feedback loop on the care process. Based on electronic patient records, the UK government’s care.data initiative will draw together and link individual patient information from across primary, secondary, and acute-care settings, making it available to clinicians, providers, payers, and patients themselves. This will allow analytical insights to be drawn on how all parts of the health system can contribute to improvements in outcomes.

However, the NHS must be careful to avoid information overload. Too often, centralized data reporting requirements that start with the right aims become bureaucratic burdens on nurses’ time. NHS England is working with providers through the NHS Confederation on the “Busting Bureaucracy” campaign to remove duplications and redundant data from the system, making sure it captures only the data most valuable to improving outcomes.


Clearly, getting the most from technology requires investment. The first aspect is financial: The government recently released a dedicated ?100m nursing-technology fund (equivalent to about $160 million U.S. dollars) to help hospitals get the systems they need. This is backed up by a broader ?500m investment in health technology made available to acute trusts over 3 years to 2015-2016.

The second investment is a professional one. Getting value from technology and information requires training, strategic planning, and an appetite to use health data to improve the way we work. It will require nurses, midwives, and health visitors to take on the leadership challenge across all levels of organi¬zations.

Anne Cooper is clinical informatics lead (nursing) for NHS England.

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