Posted: March 26th, 2021

The National Hospital Service (NHS)

The National Hospital Service (NHS)

The National Hospital Service (NHS)
The National Health Service (NHS) is the umbrella phrase for publicly-funded healthcare systems within the UK. The NHS was established in 1948 as one of the key social reforms after the Second World War (Phillips, 2019). The NHS was established on the founding principles that healthcare services should be comprehensive, free, and universal during delivery (Phillips, 2019, p. 2). The NHS’s responsibility and scope are to provide information, IT systems, and data for clinicians and analysts within society and healthcare. Through various partnerships across social and healthcare systems, the NHS IT systems ensure an efficient and secure flow of information within the organization. The NHS’s IT systems and services rely on technology to help healthcare professionals communicate more effectively and allow people to access the healthcare they need quickly easily. While the government and health ministry strive to ensure that the system remains fully operational and efficient at all times, some of the recent experiences, such as the Wannacry hack of 2017, have shown the need to secure the system. This paper explores various aspects of the NHS concerning its IT systems.
NHS Profile
The current NHS Information Management and Technology systems’ historical background suggests that it was established in 1992 (Waterson, 2014, p. 150). The primary aim of coming up with the NHS IT systems was to enhance the use of technology within the first century by introducing integrated electronic records systems, computerized prescription and referral systems, and other underpinning network infrastructures. Digitizing patient’s records allowed the NHS to save costs on paying for storage spaces, and time as NHS staff does not have to spend a lot of time recalling or securing any stored data (Waterson, 2014 p. 152). Instead, the NHS resources and time saved can now be utilized better.
Although the IT services promise to offer numerous benefits to the NHS, they have experienced several challenges: acquiring technology and information rights, which is important to its overall sustainability. These IT services deficiencies are likely to contribute to stress and additional staff workloads, which is likely to compromise the overall patient safety and frustrations at increasing attention given to innovation like artificial intelligence (Waterson, 2014 p. 153). These issues lead to delays while hindering the effective delivery of healthcare services.
The NHS IT systems’ declared plans and strategies continuously improve within the next decade, which can be realized through the UK government’s five-year funding programs in 2018 (Nelson & Berkowitz, 2020 p. 4). This plan outlines the significance of leveraging technology to enhance the effectiveness of the NHS. Moreover, it also sets out critical priorities necessary to support the NHS’s digital transformation while also providing the change in how the NHS takes care of the community. For most primary care settings within the NHS, a key transformation element is the continuation, expansion, and enhancement of the GP systems through the NHS digital platforms that offer IT systems for effective service delivery (O’Dowd, and Cross, 2007 p. 1290). Finally, adopting this approach will ensure that future NHS IT systems are readily available when necessary, and digital records must be stored safely.
Consultancy Reports
Introduction to the IT Service Domain
According to Waterson (2014), Good information technology infrastructure often leads to increased productivity and more time for the patients, while staff experience better morale. According to the NHS vision, IT infrastructure remains a priority, and continual improvement should be central to future contracting. However, the NHS is far from realizing these priorities, as reflected in a 2018 report. Before considering the full potential of the digital transformation of the NHS, there is a need to upgrade the current basic hardware to meet the nationally recommended standards. The existing IT hardware currently appears to be failing on numerous care settings, with no clear way to correct it. Clinicians and doctors should also not be forced by poor IT infrastructure. It takes some time to care for patients to fix malfunctioning systems or solve any other problems emerging from system errors. For example, in some instances, a breakdown in the current NHS infrastructure has often led to delay of patient letters from both primary and secondary care, which leads to the creation of significantly more workloads for the staff while also risking the overall patient’s safety (Waterson, 2014 p. 156).
Most doctors believe that they should give the right medical prescription at any patient’s community pharmacy. Access to this electronic prescription service within hospitals is likely to allow for the realization of this objective. It gives doctors the capacity to continue giving prescriptions to ongoing specialists’ medications instead of patients requiring receiving them through posts or revisiting hospitals for repeat prescriptions (Menger et al., 2019 p. 41). This helps eliminate delays and enhance the delivery of healthcare services. Moreover, such an approach is likely to result in cost and time-saving benefits from improvements like interoperable systems, reductions in the overall number of incompatible programs with the existing system, or digitalization of patient records (Waterson, 2014 p. 156). Adopting these measures should have positive implications on the overall patient’s safety through enhanced quality of care.
The Current State of Affairs Concerning the Brief in the NHS
Among the current impediment to quality patient care delivery at the NHS is the lack of adequate referral communication types of equipment and interoperability for multiway communication between clinicians, doctors, and other workers. This condition damages patient experiences while also affects how clinicians treat their patients. NHS digital recognizes that consistent and efficient IT systems imply that patients don’t have to repeat their care needs or medical story regularly to different people. Unfortunately, in most cases, Waterson (2014) explains that this s not often the case because, with different systems within care and health services where a single care setting is involved, it leads to ineffective communication between different players.
To overcome these challenges, clinicians should have the capacity to see their patient’s records, results, and observations from any location and in real-time. Such an approach would help with emergencies, especially where the summary care record (SCR) is readily available, with the ability to add information to any file remotely, saving a lot of collective effort and time across the NHS (Phillips, 2019 p. 12). An example of this approach’s likely future outlook would be the primary care pathology messaging, where the Message Exchange for Social Care and Health (MESH) is used to transfer messages (Phillips, 2019 p. 16). Mesh tends to be the primary messaging Service applied in social and healthcare, allowing care and health organizations to undertake effective and secure communication. Under these messages, data quality can be supported. The NHS digital is already providing a national message assurance service that is fully automated and provides laboratory implementation testing, among other services. Clinicians and doctors hold this type of document exchange highly, and it should be replicated throughout the NHS. Moreover, secondary-care outpatient letters are inserted automatically into the electronic patient’s record within a patient’s GP practice information technology system, including relevant observations, results, and entries (Phillips, 2019, p. 22).
Evaluation and Recommendations for Change
With healthcare needs changing and systems evolving, the NHS infrastructure needs to be flexible enough to quickly embed and accommodate new software and hardware. It will allow the staff to benefit from this new technology, improving overall productivity, and saving time. As such, among the recommended measures that should be taken to meet these changes includes enabling computers, printers, and tablets for remote working for regular upgrades without regular breakdowns. Another consideration should be integrating fully functioning Wi-Fi with the early adoption of 5G technology and other related technologies being crucial in data transfer between clinicians, doctors, and other care providers (Phillips, 2019 p. 23). These measures should be made standard across the NHS, and they should include care homes.
Another key recommendation should be to establish an effective and local IT support as a best practice for care settings, comprised of in house support, with a constituent approach feature that covers federated care models and larger providers. For most primary care settings within the NHS, a key transformation element is the continuation, expansion, and enhancement of the GP systems through the NHS digital platforms that offer IT systems for effective service delivery. Adopting this strategy will ensure that this GP system can easily access the new information technology initiatives that are already effective (Phillips, 2019 p. 25). Moreover, it is also important that NHS providers access the electronic patient’s records because it allows for prescribed medication such as controlled drugs to be administered effectively.
Finally, through implementing effective IT systems within the NHS, referral processes, particularly e-Referral Service, become digitized and simplified because there is reduced bureaucracy arising from integrated systems. This functionality can only be realized through efficient and quick messaging systems between staff members across care settings (Phillips, 2019 p. 26). In particular, the system has to construct should be able to construct the majority of its referrals from secondary to primary care electronically because it helps free up a lot of valuable clinician time.
Improvement to the IT System and IT Service Management Implications
The NHS is committed to digitizing its operational and clinical processes throughout its secondary care settings within the UK, including community, mental, and acute healthcare settings before 2024 (Waterson, 2014 p. 158). To realize this goal, it crucial that digitization of all the NHS primary settings is done. Most IT systems throughout the NHS should also be in a position to communicate with each other. As such, secondary and primary care settings must be digitized simultaneously to facilitate interoperability within the system. Additionally, patient data quality is another key important element. Various audits implemented to enhance healthcare pathways become less effective, particularly when individuals cannot access consistent information and contradictory information throughout multiple interfaces or sources (Waterson, 2014 p. 157).
IT Service Management Implications
To realize the objective of an interoperable NHS IT system, allowing for exchanging a patient’s information safely and quickly between different healthcare settings, all the relevant data must be stored or available within a suitable format. Many GP systems through the NHS digital platforms still maintain paper records that should be a priority that ensures that such records are safely and swiftly digitized (Waterson, 2014 p. 158). Moreover, secondary care providers can their paper records off-site, making it even more challenging to share or access healthcare data leading to accessibility and cost implications.
Digitized patient records ensure that the NHS will not incur additional costs paying for storage, and the staff will not have to spend a lot of time securing and storing data (Waterson, 2014 p. 157). The money and time saved during this process should be put to effective use. Such a process requires a high level of dedicated funding and national coordination to make sure that it happens quite safely and quickly. More space and time saving from digitization should also repay an initial upfront investment in the long term.
Finally, to ensure that data is readily available when necessary, it’s crucial that digital records have to be lost, especially when the GP practices are closed or patients leave GP practices without registering at another one. Under such circumstances, Waterson (2014) explains that healthcare records will have to be transferred or held securely until a patient registers using a new practice. Such an outcome can be realized cost-effectively and rapidly by requiring that systems supply to operate single nominee holding platforms with an organization data service.
Overall, as shown, the NHS is tasked with ensuring that health related data is collected and managed efficiently to improve its value. The current IT systems are used to process the information and ensure that it is made accessible to all users served by the NHS. As security threats continue to become more sophisticated, the need to improve the current infrastructure has become highly paramount. The integration of various IT systems used by the NHS will improve communication and hence service delivery.

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Menger, V., Spruit, M., de Bruin, J., Kelder, T. and Scheepers, F., 2019. Supporting Reuse of EHR Data in Healthcare Organizations: The CARED Research Infrastructure Framework. In HEALTHINF (pp. 41-50).
Nelson, A.H. and Berkowitz, E., 2020. Supporting A Developmental Approach for Shared Data Infrastructure. International Journal of Population Data Science, 5(5).
O’Dowd, A. and Cross, M., 2007. Richard Granger resigns as chief executive of Connecting for Health. BMJ: British Medical Journal, 334(7607), p.1290.
Phillips, F. S. 2019. United Kingdom’s National Health Service (NHS). Encyclopedia of Health Services Research. doi:10.4135/9781412971942.n393
Waterson, P., 2014. Health information technology and sociotechnical systems: A progress report on recent developments within the UK National Health Service (NHS). Applied ergonomics, 45(2), pp.150-161.


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