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‘Paperless 2020’ ambition possible but improbable, experts say

The ambition of harnessing the information revolution and making the NHS ‘paperless by 2020’, while a laudable aim, is improbable as an outcome, according to a panel of experts at e-Health Week.

During the lively debate, chaired by Keith McNeil, NHS chief clinical information officer, Dr Afzal Chaudhry, chief medical information officer at Cambridge University Hospitals FT, who has led his organisation’s eHospital work, told delegates the opportunity is a very simple one, which “is transforming patient care with the effective use of information technology”.

“The challenges is that there is so much pressure on service in hospitals and other primary organisations that finding the bandwidth to do this needs to be properly backed, otherwise it is impossible to do,” he argued.

Paul Walsh, chief operating officer of The HCI Group, added that there is a massive opportunity for the system to learn from some of the experiences of pioneers like Cambridge and Salford, “but some organisations really are struggling”.

“In terms of the challenges, for some organisations, it will be a timeline challenge. Whilst 2020 is three years away, even if you are live with an EPR now, achieving paperless or heavily paperlight is a challenge,” explained Walsh.

“There are lots of change management, content redesign and cultural changes. And then there is the elephant in the room: there is a significant financial challenge in the NHS and some of this work takes time and patience.”

Last year, the Wachter Review stated that the target of ‘paperless by 2020’ should be discarded as “unrealistic”. It said: “The goal is not paperless – it is improvement, facilitated by having information where it’s needed, when it’s needed.”

Saduf Ali-Drakesmith, visualisation specialist at Kofax, told the audience at e-Health Week that the financial squeeze shouldn’t be underestimated, but also getting staff engaged was also a challenge.

“Is it possible to do this? Yes,” she said. “Paperless is possible, but will it happen by 2020? Probably not.”

Anne Cooper, chief nurse at NHS Digital, added that while things have moved on, there still needs to be work to make the system paperlight – not just for the professionals, but also with patients.

Everybody is at a different stage, every trust is different, there is no magic bullet that is going to fix this quickly, argued Ryan Reed, digital transformation director at Xerox Health.

“In terms of opportunity, there are a huge number of trusts who have done different things and delivered paperless – in whatever form – whether it is paperless communication, records or everything. It is about sharing that knowledge and working together,” he said.

Jonathan McKee, governance manager at Tavistock and Portman NHS FT, and a co-chair of the London IG Forum, recently told NHE that “it is all a matter of will” with regards to the paperless agenda.

“It started off as 2018, then 2020 and then 2023; why not 2025? Why bother at all?” he said. “If this this is the direction of travel, then it is the direction of travel – we can do it in our own good time.

“If it is imperative that we do it by a certain date then we should stick to the first date. There is no point in having a moving deadline for something that isn’t business critical or a patient safety issue.”

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