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Hunt set to unveil anti-bureaucracy drive for NHS staff

Health secretary Jeremy Hunt was today expected to set out plans to cut “cumbersome bureaucracy” in the health service by a third.

NHS staff claim red tape gets in the way of providing the care to patients, Mr Hunt is expected to tell the Reform conference on changes to the NHS.

He will detail some cases where lengthy administrative tasks obstruct medics from their primary job of care giving, including the case of a nurse who had to fill in a 22-page form to get a patient with a gunshot wound admitted to a trauma ward.

Nurses spend more than a million hours every week on paperwork, according to the Royal College of Nursing.

Mr Hunt will announce that he has commissioned the NHS Confederation to work with other bodies to see how endless piles of paper work could be reduced.

He is expected to say: “As we make these changes, we must avoid thinking that care and compassion can be commanded from on high either by regulators or politicians. Endless boxes to tick, cumbersome bureaucracy and burdensome regulations are the problem - they cannot be the solution.

“Good healthcare is in the moment - the minute-by-minute interaction between a person in need and a person there to help.

“It is because people believe in the values of the NHS that they spend their working lives in it. So this is about unlocking those values that lie inside the outstanding doctors and nurses who deliver care week-in and week-out and stopping the dead hand of top-down targets crushing the goodness out of them.”

Mike Farrar, chief executive of the NHS Confederation, added: “Patients must always come first if the NHS is to deliver the best and safest care possible. That is the simple defining principle at the heart of the recent Francis Report into events at Mid Staffordshire NHS Foundation Trust.

“We need to deliver this principle, and we need help to make sure the system is set up in the right way to allow us to do it.

“It is in no one’s interest that staff and management have to deal with red-tape that pulls them away from patient care.

“We need to make sure that the whole system - including hospitals, commissioners and regulators - revolves around the patient. We need the government and policy makers to be alive to the dangers of burdening staff and organisations with overly-bureaucratic systems and processes.”

 

 

 

 

Readers' comments (20)

  • michael stone

    How is this going to be achieved - the NHS is obsessed with 'process', and the recording of compliance with process presumably accounts for a lot of this paperwork.

    This one is tricky !

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  • Small, individual, electronic devices for use at the patient's bedside that sends their data to a central point where it's continually updated would be a good start.....I can already hear the chorus of 'no you cant do that' because..... of the expense, health and safety, infection control, privacy, safeguarding etc. But why not?

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  • Brid Hehir | 12-Feb-2013 2:19 pm

    Small, individual, electronic devices for use at the patient's bedside that sends their data to a central point where it's continually updated would be a good start.

    We already have them , they're called IPads, but please stop talking sense, it isn't allowed in the NHS.

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  • Brid Hehir | 12-Feb-2013 2:19 pm

    Good idea Brid.

    I think that a serious look at what we currently record and then shredding most of it, (because it really is unnecessary and is nothing to do with patient wellbeing), would be a good place to start. That would, of course, necessitate the dismantling of the NHS target driven culture...........oh dear, what a shame that would be...!

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  • I read somewhere a few weeks back that the government had pledged, I think it was £76 million, for nurses to decide how it could be spent on modern tech. to allow them to spend more of their time at the bedside.

    It may be unfounded as I have no experience of using tablets at the bedside apart from attending a presentation of new software for tablets at a European nursing congress several years ago being trialled on one district hospital. Although there must have been significant advances since then the potential barriers I foresee may be the cost to the NHS, risk of theft and most importantly data input and handling errors, causing harm to patients, and system failures. Already the problems of data input, processing and retrieval can be seen in other services where obviously it is only as good as the data handling by the computer operator although the errors are often passed to the computer itself!
    How often do we hear 'oh, sorry, it was a computer error' - far more serious when it concerns patients and their treatment and care!

    I think once there is a reduction in the influence of the baby boomer generation due to retire and all of the staff are the 'net' generation onwards there will be radical changes in how information is recorded and stored, but who knows whether or not this will be for the better?

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  • Ill believe it when I see it. Expect to see more paperwork in the wake of the Francis Report.

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  • Sounds really positive but the accountability the public, regulators and government demand mean increasing amounts of paperwork and electronic records. We'd be better off calculating how time each bit of paperwork, particularly risk assessments, pathways and care plans take to complete and making them as streamlined and user friendly as possible. Always is asking is this worth the time it is taking.

    Also if he really wants to cut red tape to benefit the NHS, do it with social care referrals and funding. If we could get every medically fit social patient discharged within days rather than weeks pressure would be greatly reduced.

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  • Health secretary Jeremy Hunt - politicians created this bureaucracy, now they are saying we have to make changes to "how endless piles of paper work could be reduced". Seeing is very much believing, and frankly, I don't.

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  • clipboard nurses to be replaced by iPad nurses?

    excellent for the efficient and elegant managerial image, tottering around in high heels, handbags, a iPad looks far more sleek and chic than the soon to be outmoded clipboard! I wonder what they will fill their desks with when they no longer have mounds of paperwork. It will certainly put an end to their binning of incidence forms!

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  • I have always been bogged down by paperwork. It really does take you away from youre patients. Even patients pass comments. When taking a patient on to our caseload, you could wallpaper a room with the amount of paperwork that has to be completed. Previous comments regarding incorrect data being put onto computers, what about poor handwriting? Duplication of paperwork, what you write in your notes in the patients home has to be written again in base notes. I can understand why this needs to be done for communication purposes but there must be an easier way.

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  • Anonymous | 13-Feb-2013 9:07 am

    from the sceptic Anonymous | 12-Feb-2013 3:56 pm

    I agree with your arguments as well. maybe as you point out handwriting and transcribing errors are also a problem, not to mention all the time taken away from patients and also the potential of being in a rush and not listening well and taking accurate information on board. Stress, pressure of work and haste can also lead to greater risk of errors, especially where figures are involved, and this applies to both systems.

    The question then arises does IT which system is the most accurate and least error free.

    people will need good, fast and accurate typing skills which older nurses may not have although this should not be a serious problem as the population of nurses not brought up with IT skills decreases.

    presumably IT will continue to develop to improve performance, speed, accuracy and ease of use and will obviously be used increasingly in the future.

    At present tablets which use handwriting technology don't always some people's handwriting accurately so maybe these will be developed as well.

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  • Anonymous | 13-Feb-2013 9:24 am

    Anonymous | 13-Feb-2013 9:07 am

    from the sceptic Anonymous | 12-Feb-2013 3:56 pm

    I would just like to add to my comment above that of course human hands will never replace IT which is much of the problem, but I guess this is now what we have to accept. More machines, less skilled employees/nurses to do the job, ? lower costs and maybe less of a headache for employers as machines don't answer back!

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  • from me above again, I should have written IT will never replace human hands!!!!!!!!!!!! ugh, sorry.

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  • Audit Trail of Complaints/Concerns to bring to book those who victimise or ignore them.
    A little bit more paper, but it would concentrate managers attention on solutions.

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  • I wouldn't trust what any Tory says about the National Health Service. For one, they don't believe in it and, two, they are slowly but surely fragmenting and privatising it. For goodness sake focus on these issues before the detail blurs the reality.

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  • Sounds really positive but the accountability the public, regulators and government demand mean increasing amounts of paperwork and electronic records. We'd be better off calculating how time each bit of paperwork, particularly risk assessments, pathways and care plans take to complete and making them as streamlined and user friendly as possible. Always is asking is this worth the time it is taking.

    Also if he really wants to cut red tape to benefit the NHS, do it with social care referrals and funding. If we could get every medically fit social patient discharged within days rather than weeks pressure would be greatly reduced.

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  • Catchy headline. The paperwork (+ electronic documentation) is there for recording patient care, treatment + results. More of it has grown as a result of litigation + bureaucracy. Lawyers love paperwork, noting how many pages + recommendations in a recent report. We have to do it as its part of the care. We prefer to concentrate of direct patient care, but gone are the days of trust and where everyone can do no wrong. It's there in part for patients + staff protection.

    Look at how many policies + procedures there are in your local organization. Streamlining these would be no small task, probably another team of administrators with more managers to coordinate.

    Ipads, tablets etc isn't just for younger staff, there loads of very technophilic older staff too. Telemetry + wireless transmissions of patients observations, medication, e-documentation + ordering of tests are already available. Security of data + physical equipment is an issue, but good IT security procedures should help, including encryption, disabling equipment / auto-logoff period if used outside certain range, tracking, limited software, accessing with biometric, smartcard + passwords protection, with a big heavy chain attached + waterproof + drop-proof case would help from infection control + accidents.
    Can I remotely look after my ward patients from home/abroad, using the virtual ward software and send in virtual assistants as and where needed, or when flags are tripped. Relatives can visit patients anytime too ;).

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  • a remote link from Hawaii would be great :o)

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  • The danger is that trusts will trun alot of this into electroninc forms and are Electronic records the way ahead. The trust I work in has an electroninc observation system that takes longer to fill in than writing them on a chart. It looses observations and when needed the system is slow to access records if it access's them at all. And the server has the habit of crashing usually when you need it most.
    Somethings are actually more eficient on paper.
    But how much paperwork are we filling in for other professions like dietitians and social workers maybe its time other professions began to pull their weight instead of swanning onto wards expecting nurses to do all the boring stuff and swan off again.

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  • Interesting the results of Hinchinbrooke were dramatic change has taken place by removing paperwork and cutting out middle managers

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