Joost Bruggeman, a former doctor and surgeon and co-founder of Siilo, discusses why an outright ban of pagers is wrong and evocative of deep-rooted problems within the NHS
If only Matt Hancock had reached out to the NHS frontline more extensively, he might have realised the importance of the technology he is hoping to ban. You see, the pager is a stalwart of global healthcare for one reason – it really does serve a purpose.
I remember being handed my first pager as a surgeon. Above all else, it signified that I was working in real frontline care, where I could support colleagues and patients wherever and whenever they needed me. And so, having learned first-hand the importance of pagers in healthcare, it came as little surprise to see the negative reaction elicited by Hancock’s announcement of the ban.
The pager is outdated, no doubt. But there are many reasons why pagers are still used by health and care professionals today – they have longer battery lives than mobile phones and, even without Wi-Fi or mobile signal, the pager works by running on dedicated radio-frequency networks, which are more reliable and proven to better penetrate thick hospital walls.
However, none of this is to say that the pager is flawless. Quite the opposite. There are a number of circumstances in which health and care professionals should consider replacing pagers with ‘WhatsApp-style’ alternatives, especially non-urgent care situations – as is point of the government ban.
But here too lies the problem. According to the Department for Health and Social Care, NHS trusts will be allowed to keep some pagers for ‘emergency’ situations, such as when ‘wifi fails or when other forms of communication are unavailable’. However, the governments understanding of what warrants an ‘emergency’ differs greatly to that of the people on the frontline.
Even when a hospital infrastructure is robust enough to support fast and reliable Wi-Fi – which could take years – there may still be a need for pagers in clinical emergencies and matters of life and death.
Indeed, thinking back to my time as a surgeon – despite becoming increasingly reliant on my mobile to communicate low-risk alerts, share detailed patient information and overcome the inefficient barriers within clinical teams or across organisational boundaries – all the while, I still relied on my pager.
And that got me thinking, WhatsApp-style messaging solutions were never intended to replace pagers – they were intended to replace WhatsApp. And for good reason: it’s simply a matter of time before a major WhatsApp confidentiality break – at least, a public one – and this is something we should be trying, desperately to avoid.
WhatsApp is insecure, limited in functionality and unfit for purpose, but its use is pervasive; a recent study by BMJ innovations revealed that 97% of healthcare professionals routinely use unofficial and – often – insecure web-based messaging apps to share private medical data and patient information without consent, despite the fact 68% of the aforementioned expressed concerns over sharing information in this way.
But despite their concerns, healthcare professionals continue to use WhatsApp because it makes their jobs easier. With time so precious on hospital wards and with healthcare professionals under more pressure than ever before – amidst the problems faced by an ageing population and the critical nature of the NHS staffing crisis – are they really going to stop to consider whether or not their phone is GDPR compliant or whether it adheres to the latest Information Governance Toolkit? No. They’re going to use an instant messaging service that is efficient and useful in practice.
But times are changing. And for the sake of the empowerment of their clinical workforce and their own GDPR compliance, it is now up to health and care professionals to find a system that replicates the efficiency and functionality of WhatsApp, and that doesn’t put patient confidentiality on the line.
If we look to countries like the Netherlands and Germany, secure healthcare messaging solutions are already in use amongst more than 140,000 health and care professionals, alongside a limited number of emergency pagers, and driven by grassroots demand. And this is an approach that the UK should consider more seriously. More often than not, we don’t need to ban things innovate – we just need to show people better alternatives.
And so, while Matt Hancock’s announcement is right in so many ways, it is his approach that has upset so many. Not only is there no funding and a limited strategy, but the blanket ban of pagers serves as yet another example of the disjoint between policymakers and those actually providing patient-care – evocative of a deeper-rooted problem seeded within the NHS.
The author is Joost Bruggeman, a former doctor and surgeon and co-founder of Siilo, a Netherlands-based start-up that’s one of the fastest growing European healthcare communication platform providers (a Forbes Top 5 Start-Up to Watch)
