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What does ‘paperless’ really mean for the NHS? Unleashing the power of digitisation to improve health outcomes

The concept of a paperless NHS has been around for a long time. The idea was first floated back in 2013 by then Health Secretary, Jeremy Hunt. However, it appears we are still quite a way short of a truly digital health service.

In fact, research carried out in 2019 by OpenText showed that only 12% of NHS trusts were fully digitised. This shows just how ambitious the healthcare service’s plans for a paperless NHS by 2020 really were.

That’s not to say that trusts across the UK aren’t working towards this goal. Brother’s recent research alongside the National Health Executive revealed that 89% of respondents worked in hospitals that are striving towards a ‘paperlite’ policy. Most, if not all, will appreciate the benefits of this – it produces less waste, it is more efficient and more sustainable. However, the term ‘paperless’ and the focus on reducing the usage of paper perhaps minimises the true scope and advantages of digitisation.

Digitisation is not about elimination, but enhancement. It is about improving how the entire health service thinks and operates. In early 2019, the government announced its NHS Long Term plan, which requires all secondary healthcare providers to transition to digital records by 2023. The ultimate aim of this plan is to resolve the lack of interoperability in UK healthcare and improve patient care and health outcomes. There is also a strong security aspect to this. Research shows that almost 10,000 patient records at UK public hospitals were mislaid, lost or stolen in the space of a year.1 As well as the very real concerns about patient safety and data fraud, this also brings into question the quality of patient care available.

Unleashing the potential of data

While there are many downsides to paper forms and records, they come with one incredibly valuable benefit – they are full of information. The main promise involved with digitisation is being able to release and utilise this. Once this has been done, it can be used for clinical care, operational decision making and health management.

However, the long-term solution is not just about digitising paper records. It is about fundamentally changing the way people act and think. While technology has touched and improved nearly every aspect of our lives, healthcare delivery still has a very traditional mindset. Ultimately, digital transformation should empower healthcare organisations to evolve working practices, improving patient care while also reducing costs.

Through the creation of a ‘one patient, one record’ environment, NHS clinicians can easily access the necessary information – regardless of where it is and in what form – to more effectively commission and monitor services that reflect the needs of patients. Ultimately, accurate and timely patient data is at the heart of delivering quality care and will ensure all front-line care staff can access this information where and when it is needed, boosting their productivity and enabling them to help more patients, more quickly.2

Tracey Lethbridge, Head of UK Public Sector, OpenText

This will also require better training around data analysis and skills. The more NHS staff can glean from patient data, the better service they can provide. On the macro level too, a better understanding of data can help with crisis forecasting and issues like bed shortages.

How COVID-19 has changed the conversation

We’ve all seen the news stories about the effect of COVID-19 on the NHS: the bed shortages, the lack of PPE for staff, the long, punishing shifts. But one thing that hasn’t really been reported is the technological transformation that has happened at the same time. The NHS, famous for being slow to change, has been quick to pivot to new ways of working to allow care to continue. As Richard Stubbs from NHS Reset points out, “some areas of our services [have been] transformed more in the last three months than in the last decade.”3

This has been, in part, thanks to quick thinking and actions at the local level. GP practices, without a lot of input from government, had to find new ways to do things to protect both patients and staff. Telephone appointments, video consultations and online triage ensured patients could access healthcare without being exposed to unnecessary risk. There are some areas that need further consideration. Like most workplaces, the NHS has seen a surge in the number of people working from home. This presents challenges around secure access of patient files and the ability for different teams and services to collaborate. Fortunately, the technology to do this safely and seamlessly does already exist, and can be implemented without much disruption. As with the digitisation of paper records, the most pertinent requirement is a shift in attitude and habits for staff.

A change in mindset

Going paperless is a laudable goal, especially for an organisation the size of the NHS. And it is already having a significant impact in some areas of healthcare. Around 31 million patients are now using electronic prescriptions4, saving a huge amount of time and resources in GP surgeries and pharmacies.

But as we’ve seen, digitisation is about much more than eliminating the use of paper. It is a transformation of working practices that can improve efficiency, reduce costs, and make powerful use of the vast amount of data available to healthcare organisations. With the right partner, the technology to do this can be implemented and integrated fairly seamlessly. The challenge is to create a shift in mindset. To move away from the traditional way of doing things to a digital-first approach. Not just when it comes to paper records, but at almost every touchpoint for staff and patients. This is an opportunity to revolutionise processes and improve care outcomes.

There is one slight note of caution to be addressed. Equality of access has always been a core principle of the NHS. It’s important that this is maintained. That means considering how the elderly and vulnerable, the less computer literate, and those in rural areas with poor broadband infrastructure access care. In situations like this, there will always be a need for face-to-face interaction and traditional communication. However, digitisation can still play a role in providing better care, whether that’s through analysing patient data, allowing different agencies to collaborate, or mapping out potential problem hotspots. This is an exciting opportunity – one that should be grasped with both hands.

Want to learn more about digitisation in healthcare?

We are running a webinar alongside experts from the National Health Executive to examine the potential of digitisation in health settings. Sign up for free now at our website.


1. Lynne Minion: ‘Call for handwritten medical notes to be abandoned, with claims 10,000 NHS patient records were lost or stolen in a year’

2. Health Europa: ‘One in ten NHS Trusts are fully digitised, despite plans for a paperless NHS’

3. Richard Stubbs: ‘NHS Reset: Why the challenge to reset is a cultural one’

4. Dr Shaun O’Hanlon: ‘How data and digital services can fight COVID-19’

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