By Elliott Engers

“By improving existing technical capabilities and embracing digital solutions, we are improving the digital infrastructure needed for further development in the future.”

— Elliott Engers
CEO, Infinity Health

In 2013, the UK Government set out a goal that would see a paperless NHS by 2018. Not only was a migration away from paper towards digital tools going to save the British taxpayer over £1.8 billion, it was also going to maximise efficiency and promote better outcomes for all involved.

In the almost decade following the government’s paperless pledge, the project has been met with delay after delay. A 2017 Digital Health Intelligence report argued that the target would not be met until 2027 at the earliest - nine years later than planned. More recently, we spoke to NHSX’s Head of Innovation, Yinka Makinde as part of our insights series in June, and she acknowledged that even the revised target of a paperless NHS by 2024 is still ambitious.

As the healthcare landscape begins to recover from the havoc wreaked by the pandemic, we need to move towards a digital future. Whilst in some areas digitisation has picked up the pace, there are still real barriers to becoming paper free.

Barriers to change

Undoubtedly, an important barrier to implementing substantial change in the NHS is the risk aversion that steers the decision making process. From the crucial mitigation of patient safety risks, to how many prescription bags a local pharmacy needs to order per year, to the fear of learning how to use a new tool, risk aversion can stall progress and choke innovation.

A full move to digital healthcare would mean a step away from an age-old and valued medical resource: paper. Whether it’s paper to-do-lists, paper handover notes, or a paper copy of a patient’s vitals, health and social care professionals have consistently relied on paper to record information, manage their days, and share critical data. Throughout the past year, which took our National Health Service to the brink, paper remained a reliable exchange of information even when the metaphorical lights were going out.

However, in the 2020s (and before…), we have the capability to take the best of paper and digitise it - making it more reliable, safer, standardised, and ultimately time-saving, so staff can spend more time focusing on what’s really important.

However, ditching paper for digital solutions not only requires training and a level of digital literacy, but it also raises questions around information governance and access to adequate technological capacity. And of course, managing risks in cases where digital might fail.

Paper is too risky

We know there are some real benefits to using paper. Paper never runs out of battery, or loses a connection to the internet. Paper provides a flexible blank canvas and requires very little training. But it’s important not to lose sight of the inherent risks paper introduces.

Paper often gets damaged and lost. It’s used inconsistently. It’s not shared instantly and it’s not backed up. Paper is inherently insecure and in the days where ISO 27001 certification is an actuality and NHS has strict standards regarding data and security, information governance should not be holding us back.

With a digital task management platform like Infinity, paper isn’t the strong contender it once was. Health and care staff have all the information they need at their fingertips, meaning that they can manage task lists efficiently and work seamlessly with the rest of their team, and beyond. This is something that will become particularly important as Integrated Care Systems (ICSs) spread and establish themselves (read our Clinical Director Dr Jo Garland’s thoughts on what ICSs need to do to be successful here).

One of the clinicians we work with once told me about their frustrations of having to look tasks up in a paper book, constantly calling colleagues for updates, and following a paper trail to find out what had happened on the previous shift. Using Infinity, they could access everything they needed from anywhere, so when in a patient’s home they could see exactly what had happened before their visit. This, they told me, reduced their need to make phone calls both to and from the hospital base and has negated the need for paper-based processes.

By improving existing technical capabilities and embracing digital solutions, we are improving the digital infrastructure needed for further development in the future. We shouldn’t discount the benefits of paper as meaningless or inconsequential when it has served the health service for over 70 years, but in a modern healthcare system, paper cannot continue to be a key part of a clinician’s toolkit. It is a frustrating bottleneck, preventing our frontline staff from delivering safe and efficient care for patients.

About the Author

Elliott Engers co-founded Infinity Health in 2014 following a conversation with an NHS doctor who was battling with the paper task lists and handwritten notes commonly used in hospitals to manage daily tasks. Elliott saw that this was a technical challenge a startup could really contribute to. He set out to make task management safer and more efficient whilst improving clinicians’ experience of their crucial, high-pressure roles; Infinity Health was born.