Paper Free NHS Kevin Percival ED Senior Staff Nurse Symphony System Manager Frimley Park Hospital NHS Foundation Trust

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Could the National Programme have been a success? • Yes • Why didn’t it? • Thought – is the vision to be paperless just the national progamme delivered in a different way? • Locally driven now.

A Paper free NHS What do we mean? Why? What are the risks and benefits? For Nurses and Patients

What Examples have we got to go paper free? • Banking System • Airline Flight’s • Internet Shopping • Parcel Delivery Companies • Lottery on-line • STOP – ONE CLEAR REASON THEY ARE NOT EXAMPLES

Choice Do Patient’s have a choice to use the NHS or Not?

What Examples have we got to go paper free? • Banking System – we choice which bank to use • Airline Flight’s – we have a choice of which airline to use and to pay extra to have a boarding card • Internet Shopping – you can choose to go to the shops • Parcel Delivery Companies – don’t order parcels, get them yourself • Lottery Online – Go to the shops and pick up a ticket • The NHS – Choose not to get sick – unrealistic!

Typical NHS Office Quite possibly

Paper free – What does it really mean • Paperless • Paper-lite • Using less Paper • EDM • Electronic Referral System’s

Why? Is it worth the Pain?

Because the Secretary of State for Health Tells us we have to? http://www.practicebusiness.co.uk/news/1770/jeremy-hunt%3A-nhs-paperless-by-2018/– Accessed 01/06/2013

Some make you believe There will not be an NHS unless we go Paperless http://www.publicservice.co.uk/news_story.asp?id=22395 – Accessed 01/06/2013

What the patients say? Why do I need to tell you my medication again, you have it all on your computer there.

Scenario • If you went into your bank to take some money out and they said that because you had not been to the branch before you had to tell them everything about yourself before they would give you any money. • Would you be happy with this? • No • So why do we treat patients in the NHS like it?

Risks and Benefits To the Patients and Nurses?

Barriers to being paperless What some people think it means to them

What is important to Patients?

What is important to Nurses and Health Care Professionals

What did we learn from the Mid Staffordshire Public Enquiry How can Informatics and a paper free NHS try to prevent this from happening again?

What did we learn from the Mid Staffordshire Public Enquiry • If something is in a paper record and never read than that is where it will stay • If something is in a electronic system it can be flagged and read by those that need to see it • It can be used to analyse the care provided • It can be used to help make a difference so the same mistake does not happen twice

Vital Signs – Patient Safety Agenda • An example from my own trust • There is audit evidence that only about 70% of observations are actually done and/or recorded when done paper based • When electronic systems are introduced recording increases to nearly 100%. • Partly, this is due to the fact that it is obvious where the gaps are and, perhaps more importantly, who is responsible. • Steps in tasks can be made compulsory and there is no ‘corner-cutting’ or skipping items http://www.buildingbetterhealthcare.co.uk/technical/article_page/Comment_How _healthcare_IT_can_help_address_the_findings_of_the_Francis_Report/86940 Accessed 2/6/13

Its worth remembering…. If patient information is captured it can be investigated, analysed and presented in meaningful way to those that need that information this therefore provided the ability to remember and learn from mistakes as well as provide a real-time picture of how things are, were and to prevent mistakes from happening again

The Information Journey Data Information Knowledge

Conclusion A Paper free NHS is not about taking all the paper out of the NHS, it is about making sure the information we hold on society is the most useful and meaningful form to benefit not only the patient but the population as a whole.

Any Questions Kevin Percival Telephone: 01252 649235 E-mail Kevin.Percival@fph-tr.nhs.uk Kevin.Percival@nhs.net Twitter @kevin_percival