The NHS is facing two tightly interconnected crises, both feeding off and exacerbating one another.
The longer-standing of the two is the clinical staff burnout crisis: according to the latest NHS workforce survey, 44 per cent of staff reported feeling unwell as a result of work-related stress in the last 12 months, and this follows a rising trend from just 37 per cent two years ago. For perspective, of a workforce of 1.2 million, that’s 530,000 people under such extreme pressure they feel physically or emotionally sick. And, as a Health and Social Care Committee reported in June, burnout doesn’t just ruin the lives of those suffering; it puts patients and every part of the NHS at risk too.
At the same time, the elective care backlog has just reached an unprecedented high, with patients all over the country facing lengthy waiting times for desperately needed treatment.
NHS administrators face an impossible dilemma: how can post-pandemic recovery and catch-up plans be actioned when staff are already overworked and overstretched?
Seizing lessons learnt from COVID-19 practice
NHS England carried out a huge feedback exercise after the first wave of COVID-19, and, unsurprisingly, staff were most positive about how the pandemic-era working arrangements had dramatically shifted to allow for more streamlined collaboration and team working.
Barriers keeping colleagues apart were torn down in the name of speed and efficiency, begging the question, why were they erected in the first place?
But today, staff have warned the collaboration and flexible working achieved during COVID risk are being lost as old norms are reestablished. In the same feedback exercises, commonly cited areas for improvement were “continuing the cross team/departmental collaboration experience” and “greater collaboration with external organisations to help support staff and services.”
How should NHS and partner organisations use this feedback?
In order to understand where collaboration between teams can be improved, we need to look at how clinical resources are used across the healthcare system. One of the obvious problems is that primary and secondary care are siloed and the current referral process is deeply flawed, increasing the backlog of patients awaiting an appointment and worsening doctors’ workload.
When primary care clinicians assess a patient who may need treatment from secondary care services, it’s still standard practice to rely on letters, email chains and phoning hospital switchboards to set a treatment pathway in action.
The entire process is bureaucratic, analogue and frustrating. It wastes precious time and resources for all involved. And, because GPs are not able to communicate easily with colleagues to access timely advice and guidance, patients are not being sent to the right places and assessments are being needlessly duplicated.
This woefully inefficient and outdated system undermines the hard work of NHS staff and results in unnecessary hospital visits.
Enabling better collaboration
Maintaining and extending communication and collaboration in the NHS is the key to reforming the broken referrals system, and subsequently to reducing pressure on healthcare staff and services.
To achieve this, we need to put in place the right digital tools and platforms that allow for instant advice and guidance message exchange, for secure image sharing, for automatic patient record updating and clinical system integration.
This is exactly what we built Cinapsis SmartReferrals to do. We talked to NHS staff, we talked to patients, and we refined our services and functionality until it made their lives as easy as possible. Our interoperable platform makes knowledge sharing possible between disparate NHS services and providers, whilst making data security and patient safety a top priority.
“Communication tools and new systems have to link up to NHS central systems and databases. There’s no point having the patient information if it’s not easy to find and use. The analytics in Cinapsis are so good that we can now trace individual patients through the system - all the data is joined together.”
- Dr Malcolm Gerald, Clinical Lead for Cinapsis Project, Gloucestershire ICS
In one NHS Trust, using Cinapsis has resulted in 83% fewer unnecessary visits to the Emergency Department and 70% fewer outpatient appointments, which have been managed in the community with specialist advice and guidance instead.
Dr William Porter, Consultant Dermatologist, Gloucestershire Hospitals NHS Foundation Trust said:
“Cinapsis halves the time it takes to access Advice and Guidance - it’s far, far easier to use, it’s modern, it’s user-friendly, it’s clear. All the case and patient details are on one page, meaning that you can do more with it, and see many more patients.”
Building the NHS of the future with digital tools
The pandemic has laid bare the reality that NHS collaboration is woefully behind where it ought to be. We have learned that in order to change this, communication systems and processes need to change. As we tackle the mounting backlog of care resulting from the pandemic, we must seize the opportunity provided by digitisation to minimise unnecessary referrals, waiting times and treatment delays.
Not only will this ease the pressure on NHS services and staff, it will reduce the anxiety experienced by patients facing unbearable delays in the receipt of diagnosis and potential treatment. Streamlined communication between primary and secondary care allows for quicker decision-making and more efficient referrals, culminating in a reduction in the number of patients who require hospital care.
If we want to give our doctors and nurses the time and headspace to best look after their patients and themselves, better connecting primary and secondary care through innovative, responsive and secure technology is where we need to start.