Efficiency review calls on NHS to equip all community nurses with digital technology

Antiquated IT systems are stifling nurses’ productivity, says review

Antiquated IT systems are stifling nurses' productivity, says review

Picture: Alamy

NHS community providers would increase the productivity of their clinical staff if they harnessed the potential of digital and mobile technology, an independent review found.

The recommendation is one of 16 in a productivity review of mental health and community health services in England by Lord Carter. It follows the 2016 review of acute hospitals, also led by the Labour peer, which suggested changes that might save the NHS £5 billion a year.

Lord Carter says the use of technology in the health service lags behind 'even other public sector services'.

A recent survey of more than 500 community nurses by the Queen's Nursing Institute (QNI) found almost one in three respondents (29%) still use mainly paper-based systems. That survey also showed there are at least 67 different IT systems being used in community healthcare.

Where electronic case management systems do exist in community and mental health services, they are cumbersome and time-consuming to use, Lord Carter found.

‘The inability to provide a single view of the patient across organisations is lamentable. This lack of investment in adequate systems is indefensible in 2018’

Lord Carter

He wrote: 'The inability to provide a single view of the patient across organisations to date is lamentable. This lack of investment in adequate systems is indefensible in 2018, and means valuable staff time is wasted and patients do not receive the best care.

'While many trusts have, or are implementing mobile-working, e-rostering systems and dynamic scheduling, much more needs to be done to ensure these are being used effectively and driving the productivity and efficiency gains that are possible.

'I am confident that if the recommendations in this report are implemented, up to £1 billion of efficiency and productivity savings per year can be achieved by 2021.'

Recommendations include:

  • Community providers should modernise their care delivery models, in particular through better use of digital and mobile working.
  • NHS Improvement should work with all mental health and community trust boards to help improve the engagement, retention and well-being of their staff.
  • All community and mental health trusts should use an effective e-rostering system and set up formal processes to tackle areas of rostering practice that require improvement.

RCN professional lead for mental health Catherine Gamble said it was admirable that Lord Carter had taken the time to ask nurses on the front line about inefficiencies they encounter.

‘Trusts need to issue nursing staff with iPads so staff aren't chained to archaic desktop PCs’

Catherine Gamble, RCN

Ms Gamble said: 'Sadly, the problems they identified for him will be familiar to mental health nurses everywhere – inadequate IT systems, inflexible e-rostering, and bureaucratic operational procedures that cut down the time they can spend with patients.   

'In particular, trusts need to exploit digital technology opportunities, for example, issuing nursing staff with iPads so that they can record conversations, adapt care plans and evidence change through mood apps while with patients and families, rather being chained to archaic desktop PCs. 

'Mental health nurses' interventions make a huge difference to service users’ outcomes – the best way to improve productivity at mental health trusts will be to free up more staff time to spend with them.'

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