Paperless NHS means paperless referrals

The NHS Commissioning Board’s planning guidance, issued today, has confirmed that a “paperless NHS” means paperless referrals by 2015.

In October, the NHS Commissioning Board’s national director of patients and information, Tim Kelsey, told the Healthcare Efficiency Through Technology Expo that the government’s mandate to the NHS CB would include a commitment to a paperless NHS by 2015.

He said he wanted to “eradicate paper from the NHS” and that there would be no more “referral letters or lost records because we won’t have paper anymore in the health service.”

His statement created a lot of enthusiasm and debate, with many questioning how realistic Kelsey’s goal was.

However, at the Digital by Default conference this month, Kelsey explained that his reference to a “paperless NHS by 2015” meant paperless referrals; and not an entirely paperless health service.

Today’s planning guidance confirms this. It says: “We shall support a move to paperless referrals in the NHS by March 2015 so that patients and carers can easily book appointments in primary and secondary care.”

This will be achieved through the re-launch of the Choose and Book electronic booking service, which the Department of Health is in the process of re-procuring, even though use peaked at about 50% of referrals and has been falling.

Today’s guidance – ‘Everyone counts: planning for patients 2013-14’ – contains a number of commitments intended to provide more information for commissioners and patients, predicated on the use of more modern IT systems.

The document revisits the government’s pledge to give patients electronic access to their records, and apparently extends it.

It not only says there will be a “guarantee” that every patient will have online access to their primary care medical record by spring 2015, but that there will be a consultation on how to open up other records.

“We will consult, by June 2013, on plans for the provision of patient access to interoperable records across the pathway of care.”

When it comes to new information sources for patients, the guidance’s most striking commitment is to publish outcome data for most patients in England, which is now being widely debated.

The guidance also says that all NHS funded patients “will have the opportunity to leave feedback on any service by 2015.”

And it says that the new ‘friends and family’ test will be introduced for A&E and maternity services in April and October next year respectively.

This is despite concerns that the test – which asks patients on a six point scale whether they would recommend the place they were treated to loved ones – will be well understood and provide valid, comparable data.

This is the CB’s first planning guidance, and replaces the Operating Framework for the NHS in England that was published by the Department of Health each December.

NHS North and the North West Health Informatics Leadership Network recently held a conference on the benefits of opening up access to records for patients. Read Jon Hoeksma’s report of the event in Insight.