NHS issues guidance on use of instant messaging apps

NHS England has issued new guidelines for clinicians around the use of instant messaging apps during emergencies.

The guidance sets out how and in which circumstances doctors, nurses and other healthcare staff can use messaging apps within acute care settings.

It also includes outlines privacy rules and procedures for sharing patient information.

Andrew Miles, consultant general surgeon and Royal College of Surgeons Council Member, said: “Patient safety is enhanced when NHS staff can quickly communicate confidential patient information between teams, such as by instant messaging.

“Doctors have a responsibility to abide by all relevant rules on patient confidentiality and a professional responsibility to ensure they do not breach that confidentiality when using instant messaging tools.

“This important guidance will keep our patients safer by empowering clinical teams to use the latest and best available technology.”

The guidelines come after an FOI request by Hospify revealed that less than two-thirds of NHS trusts have a policy on the use of messaging apps.

Neville Dastur, consultant vascular surgeon and co-founder of Hospify, said: “Medicine is about the everyday urgent crisis as well as large scale, unforeseen incidents. We welcome guidance that explains how staff can use instant messaging safely in their day-to-day work and in crisis situations.

“These types of large scale incidents require a fast response to co-ordinate teams quickly and provide the best possible care at a stressful time. This guidance gives staff the confidence to know that they can use instant messaging as part of their work and be ready for the next emergency.”

Messaging apps have proven instrumental in helping emergency responders communicate during large-scale incidents, including the Grenfell Tower disaster and the terrorist attacks in London and Manchester in 2017.

WhatsApp also proved a key communication tool during last year’s WannaCry incident, allowing NHS staff to communicate after being locked out of computer systems.

There have subsequently been calls to introduce a WhatsApp-like messaging service into the NHS.

The new guidance was published jointly by NHS England, NHS Digital, Public Health England, and the Department of Health and Social Care.

It does not endorse any instant messaging tool in particular, but rather sets out what standards need to be met by health staff using instant messaging during emergencies to co-ordinate patient care.

This includes only using apps and other messaging tools that meet the NHS encryption standard, keeping clinical records separate and deleting any notes after they have transcribed and attributed in the medical record.

It also offers practical guidance such as disabling lock-screen notifications and discouraging staff from sharing devices.

Dr Helgi Johannsson, consultant in anaesthesia at Imperial College Healthcare NHS Trust, set up a major incident instant messaging group to help coordinate his hospital’s response to Grenfell Tower.

Dr Johannsson, who was involved in reviewing the new NHS guidance, said: “Fully encrypted instant messaging services can be a particularly useful communication tool in delivering care to people during a major incident.

“From the Westminster attack we learnt it was important not to overload the emergency care co-ordinators with offers of help, so with Grenfell we used instant messaging to help coordinate which staff should come in, who was needed where and plan the service for later on that day which vastly improved the care we were able to provide.

“These sensible guidelines will make the care of our patients safer through better communication by NHS staff.”

‘Not a substitute for the medical record’

Dawn Monaghan, director of the Information Governance Alliance, noted that while messaging apps could improve patient care, they were “no substitute for the medical record”.

“It is important any advice received on those channels is added to the medical record, with the original messages deleted,” Monaghan added.

“This guidance has been designed with clinicians to help NHS organisations and their staff take a proportionate approach, considering both the potential risks to privacy and the potential improvements in patient safety.

“I’m hopeful this new guidance will prove a valuable resource to assist NHS organisations in implementing policies that will help their staff decide when it is appropriate to use instant messaging tools and when it isn’t.”