With the government’s new 10-Year Health Plan set to bring sweeping digital reforms to healthcare, the NHS is on the cusp of a radical transformation.
A core aspect of this transformation is the shift towards fully electronic record keeping. This promises to improve patient care, streamline processes, and modernise how data is managed. However, as with any large-scale change, this transition brings with it both significant benefits and notable challenges.
Record keeping in the NHS
Currently, NHS record keeping is a mix of paper and digital systems (sometimes within the same hospital), leading to inefficiencies and delays in patient care. In many instances, patient records are also scattered across different healthcare institutions which use incompatible systems thereby creating fragmentation. This then limits care coordination and causes bottlenecks in accessing critical information.
Healthcare is becoming increasingly complex, with growing patient numbers and rising demands, and so the need for a more integrated, accessible system is clear. The NHS’s digital reform promises to address these inefficiencies by moving toward a fully digital platform, with electronic health records (EHR) at its core, but this will take a significant effort both in time and resources to get things from where they are now to where they need to be.
The NHS’s 10-year plan outlines a vision of a digital-first service, where healthcare providers can instantly access, update, and share patient data, often through the NHS app. This reform is intended to improve everything from care coordination and patient outcomes to operational efficiency. It also seeks to position the NHS to better leverage emerging technologies, such as artificial intelligence (AI) and machine learning, to enhance diagnosis and treatment.
Legal and regulatory implications
A key aspect of this digital transformation is the need to navigate complex legal frameworks. Healthcare professionals will need training to ensure they are equipped to handle sensitive health data within the bounds of data protection laws, such as the General Data Protection Regulation (GDPR). This includes ensuring patient consent for data use, maintaining data security, and being aware of their legal responsibilities in cases of data breaches or mishandling.
Those responsible for the 10-year vision may not have yet considered some of the risks healthcare staff will encounter daily when everything is recorded electronically and in a place the patient, and others, can see.
Who gets access to the records of a child who is Gillick competent and able to consent to their treatment?
What will happen with the records of patients who are seeing psychologists? Until now psychological records have often been stored separately due to the intensely private and sensitive nature of psychological therapy.
What do professionals do about patients who are subject to coercive and controlling behaviour, if the only place they can write down their concerns is in a place that both the patient, and the people abusing them, can see it?
The list goes on and it will doubtless continue to develop in ways we cannot anticipate.
Advantages of digital record keeping
- Improved accessibility and efficiency: One of the most significant benefits of digital reform is the ability for healthcare providers to access patient records in real-time, regardless of their location. This improved accessibility means healthcare teams can make informed decisions faster, without waiting for paper records to be transferred between departments.
- Reduction of errors: Digital systems help reduce the likelihood of manual errors, such as incorrect dosage entries or missed medical history details. Automated systems with built-in alerts can notify healthcare professionals of potential drug interactions or contradictions in treatment plans, thus improving patient safety.
- Enhanced data sharing: Digital records enable easier sharing of patient information between different healthcare (and perhaps social care) providers. This leads to better coordination between primary care, hospitals, and community services. For example, when patients are discharged from the hospital, their records can be quickly shared with local care teams to ensure smooth transitions and continuity of care.
- Data analytics and research: The reform also opens new opportunities for big data analytics. By aggregating health data from millions of patients, the NHS can identify patterns, predict outbreaks, and improve public health strategies. It will also support medical research, speeding up advancements in treatments and interventions.
- Sustainability and cost savings: Moving away from paper records reduces costs associated with storage, printing, and transportation. In the long run, the NHS can expect significant savings from reduced administrative overhead and better use of resources.
Disadvantages of digital record keeping
- Data privacy and security risks: While digital systems offer improved accessibility, they also come with heightened risks. Healthcare data is a prime target for cyberattacks, and the NHS has already faced ransomware incidents in the past. Ensuring the protection of sensitive patient data against breaches will require significant investment in cybersecurity infrastructure.
- High implementation costs: The transition to a fully digital record keeping system will come with high upfront costs, including new software, hardware, and training programs. Smaller healthcare providers, and healthcare providers with buildings which make digital connectivity a challenge, may find it difficult to meet these financial demands, potentially creating disparities in the speed of implementation across different regions.
- Interoperability challenges: Even within the NHS, different departments, hospitals and regions use systems which are currently incompatible. Ensuring that all these systems can communicate and share data seamlessly will be a major challenge. If interoperability is not achieved, the full benefits of digital reform could be limited.
- Technical failures and downtime: Like any technology, digital record systems are not immune to technical failures. System crashes, power outages, or software bugs could disrupt access to critical patient data, negatively impacting care delivery. The NHS will need robust backup systems to mitigate these risks.
- Staff adaptation and training: The workforce will need comprehensive training to use the new digital tools effectively. Older staff, or those less familiar with technology, may struggle with the transition, potentially leading to frustration and inefficiencies in the short term. Training programs must not only cover the technical aspects but also the legal responsibilities and ethical issues related to digital data management.
Upskilling challenge
The NHS’s move toward digital record keeping represents a critical step in modernising the healthcare system. While it promises to make care more efficient, improve data sharing, and reduce errors, it also introduces new challenges in terms of data security, high implementation costs, and the need for robust legal frameworks.
There will be considerable regulatory challenges, so the need to provide legal training for healthcare professionals will become even more critical. As the NHS shifts toward a more integrated and digital future, the healthcare workforce must be well-prepared to navigate this complex landscape. A deep understanding of digital governance will be essential to manage risk, ensure compliance, and uphold ethical standards in patient care.
Author: Max Duddles is a solicitor and Bond Solon trainer