For many people bureaucracy is a dirty word. It speaks of needless box-ticking exercises and pointless form filling. While that can be the case, the NHS Confederation’s recent report, Challenging bureaucracy, commissioned by the Secretary of State for Health, points out that bureaucracy, which includes recording, collecting and reporting information, is an essential part of any effective healthcare system. Much of the data derived from such processes is really valuable in helping clinicians to better understand the care they deliver.
Earlier this week, I spoke at an event in parliament which looked at the key role of technology in the NHS. It’s a vital component of getting bureaucracy right in our health service and it’s what I want to focus on today.
Data reporting requirements are increasing, but this isn’t necessarily a bad thing. An increased focus on understanding the quality of care is very important. However, there’s no denying that sometimes data collection can become burdensome, and this is something that Challenging bureaucracy looks to tackle.
Better technology will help reduce some of the burden from this increase in reporting, leaving NHS staff more time to focus on caring for patients. Electronic patient records, for example, mean information can be shared more quickly, and there’s less chance of misplacing or losing information. But one thing our report clearly shows is huge variation in how NHS providers respond to data reporting requirements.
The NHS trusts involved in our review which did not have sophisticated information technology systems (importantly electronic patient records) reported more steps to collect and submit data. Obviously this takes up more time and costs, at a time when the NHS can ill afford to waste resources.
This isn’t to say there aren’t some really good examples in the NHS of technically advanced systems, such as the system in place at Salford Royal NHS Foundation Trust. However, we need to ensure the advanced use of technology in places such as Salford is the norm across the health service, rather than the exception.
How do we do this? NHS providers must take a leading role in improving how they manage information in their own organisations. This approach needs to be systematic, focussed on data that stems from clinical practice and developed in partnership with NHS staff.
But there is limited support for trusts to help build the right capacity and skills. It can be difficult for them to know what good looks like and how to achieve this. There’s no blueprint for success for providers to refer to. So we desperately need to share best practice across the system. Recent work carried out by the Health & Social Care Information Centre makes a good start, but more needs to be done. We need to increase the skills and capability of staff to better empower them to understand the information and how it can be used.
NHS England has created an index to benchmark the digital capabilities of providers. We welcome this approach as it will drive improvements and help providers to understand their capabilities in relation to their peers. In our view, the index should be applied to how providers manage information more broadly.
If we can get these things right we will be well on our way to ensuring all the data the NHS collects makes a meaningful difference to patient care.
Simon Pleydell is an associate director at the NHS Confederation. Find out more about the organisation’s review of bureaucracy in the NHS and download the report Challenging bureaucracy.