Britain’s healthcare sector is facing a number of significant challenges, with long waiting times for treatment being the most pressing issue. In January, NHS England published data that the overall waiting list stood at 7.6 million but highlighted that the waiting list had fallen by 95,000 between October and November 2023. However, the British Medical Association reported that the median wait time prior to the pandemic was 8.3 weeks. This has now risen to 15 weeks, indicating that progress still needs to be made. One factor contributing significantly to this is the presence of numerous outdated systems and applications, resulting in the creation of multiple data siloes. These siloes impede the accessibility of crucial information due to duplication, data inconsistency and, in some cases, inaccessibility for those who need it for timely decision-making.
In November 2023, NHS England issued a guidance letter to healthcare trusts that suggested that digitalisation funds would need to be redirected to help offset the costs of planned industrial action. The letter said that only the trusts with the least digitisation would still receive investments to develop digital systems. This shift in funding allocation prompts concerns about the continuity, digitalisation, and overall enhancement of healthcare services and intensifies the call for efficiency improvements within the healthcare sector. NHS England reported in November 2023 that a total of 189 NHS trusts have introduced electronic patient records, meaning 90% of trusts have undertaken new digital systems. However, this rapid adoption and the emergence of shared care records alongside legacy systems pose challenges in ensuring unified information flow and a singular view which can complicate efforts to gain patient trust.
Ensuring patient data security is paramount, requiring robust information governance and compliance measures to instil confidence in the protection of healthcare. The urgency of information flow during critical healthcare moments further complicates the governance and access to personal data.
Recognising the pivotal role of data in healthcare processes and decision-making is crucial. Establishing whether patient data triggers activity or influences specific workflows is essential for effective data management and access strategies. Regular reviews of the reasons for collecting and storing patient data ensure alignment with desired behaviours, pathways, stakeholders, and outcomes as well as winning patient trust.
Role-based access (RBAC) is a key protection and enablement measure that is prevalent in primary and secondary care through the NHS. By assigning pre-defined roles, RBAC ensures that clinicians are authorised to only access information that is relevant to their role and the care they are providing, fostering trust for patients. However, implementation requires a balance to avoid excessive restrictions hindering job performance and should extend across all layers of care provision.
According to the Information Commissioner’s Office, health accounted for 19% of reported data security incidents in 2023, underscoring the need for enhanced protection measures. Health and social care see a high staff turnover rate, with the NHS Foundation trust reporting a turnover rate of between 10% – 12% for nurses as a result of work-related stress. Staff changes in any industry necessitate systems that can efficiently manage access for both departing and incoming staff to ensure data integrity and continuity of care.
Introduced to the NHS in 2004, smartcards represented a significant technological step forward, serving as a critical tool for healthcare workers. These cards enable workers to authenticate themselves to gain access to sensitive clinical and personal patient information. Despite this innovation ensuring that those who needed access to vital information could gain it promptly and reliably, there remains a need for broader and more comprehensive solutions. Crucially, attention must be paid to scenarios like “break glass access” during medical emergencies which enables health professionals the access to patient medical records without explicit consent. This scenario demands centralised, accurate, and controlled information in a standardised format with a considerable audit trail.
Over half of the UK population has embraced the value of digital healthcare platforms. Over 33 million people, three quarters of adults in England, are already signed up to the NHS App. Almost half of those signed up to the NHS App, use it regularly, with 25.8 million logins in November 2023 – the equivalent of 10 every second. Public appetite for digital reform is significant, led by the desire for easy access. The success stories within the healthcare sector demonstrate how efficiency can be gained from using centralised processes to improve patient care, reduce errors and streamline operations.
However, replicating these successes across the healthcare system is challenging, due to the lack of standardisation in systems and practices across regions and even between individual hospitals. For there to be oversight of a patient’s healthcare record at every level there needs to be a framework of secure governance, digitalisation, and strict access controls in place. This framework is essential, not only for patient privacy and data security, but also for providing the efficient delivery of healthcare services. The journey towards the seamless integration of digitalisation within healthcare systems will require systematically addressing challenges and prioritising patient-centric secure and efficient digital solutions to support this ambitious transformation.
By David Corbin, Head of Healthcare Products, EMEA, Iron Mountain
