Having lately spent far more time than I care to in and around NHS facilities it is hard avoid noticing how much energy / resources are wasted when information is badly managed. I am no systems analyst, but even without an abacus for a mind the potential benefits of sorting out information in the NHS seem clear in three areas:
In some trusts, budgetary adjustments have reduced willingness to create / maintain good patient communications. Visits to dreary GP surgeries are not elevated by leaflet / poster displays that climb the walls like mutant strains of rising damp. Clip art and Comic Sans feature heavily in DIY print productions in which clarity and communication have taken a back seat. Patients should have the right to clear information in support of their treatment.
Physically navigating the NHS, its hospitals, clinics and other facilities can be complex. Some of the larger hospitals have decently planned sign systems and an air of calm efficiency as a result, but many smaller or regional ones do not, and those that are building / reorganizing often fail to consider users by properly re-routing them. How many late / missed appointments are caused by being in the wrong place at the wrong time? Exceptional facilities like the Kentish Town Integrated Care Centre seem to be from another world entirely. Owing its existence to an opportunity of history, the persistent vision of an individual and a gifted design team, such a paragon is unlikely to ever be anything like the norm, in this universe at least.
Patient notes remain the most problematic area. The continuing failure of the £12bn+ NHS online project is so far only considered a monument to wastefulness. Why would it succeed when reliable management of patients’ physical notes still cannot be achieved? When notes are “lost” (mislaid, misfiled, mis-archived offsite), procedures are cancelled, slots go wasted and teams of expensively-trained clinicians / surgeons are stood down – to say nothing of the inconvenience, stress and poorer outcome for the patient. How many have passed on with the dread phrase “we’re waiting for his notes” ringing in their ears?
Economies, efficiencies and improvements from information management can and are being made in many other areas of public life. Rail and other public transport for example – though hardly improving in quality – is more bearable now that your favourite phone app can at least tell you in advance just how screwed up your day is going to be.
[The management wishes to apologise for the following paragraphs, which may contain traces of politics]
Public information is the responsibility of government, yet it is by now clear that the current UK government has no clear vision or true policies for the NHS and many other areas, but will at the drop of a (top) hat happily tinker with budgets / strategies, unleashing waves of upheaval and uncosted change that serve only to weaken institutions further. Dave & chums have benefitted from a winning strategy: blame recent history for anything that does not work now; avoid the sting of criticism by standing for Nothing In Particular (how do you argue with someone who doesn’t believe in anything?).
No-one, right or left-leaning, has all the answers for the NHS, but instead of focusing on state vs. private funding as the battleground, why not try shifting the focus? Creating effective information management requires awareness and deep commitment, but could have many direct and indirect benefits, not least financial. This requires local focus (NHS Design Managers do exist, but are are even rarer than NHS dentists) but also needs to be driven by responsibility at a national level. So come on Dave –what about an Info Tsar? – a minister with a mission to improve communications effectiveness across the country, seeking out information blockages, vacuums, and mismanagement in public institutions.
Unfortunately there may never have been a worse time to hope for one. The rightward end of politics has never been fond of ‘information’, and our government seems awfully keen on either restricting it or leaving it to the market (or Murdoch – and how well that turned out). This after all is the government that just axed the Central Office of Information and sends out letters from No. 10 signed by someone who does not exist.
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