The NHS is getting serious about technology. There are a number of tech Initiatives already underway – and more about to hit. What do GP practices really need, and how ready are they to embrace tech, and all the benefits it can bring? What’s getting in their way? We decided to find out.
In conjunction with our partner, business technology solutions’ provider Brother UK, Practice Business consulted practice managers, and other healthcare providers, to identify what the real barriers to change in general practice are because, if the sector can understand these, it can find solutions to overcome them. In this, the third in a series of six reports, we look at some of the key things you told us about challenges, pressures and the burden of admin
Brother UK and Practice Business, in partnership, investigated the barriers to the effective implementation of technology in general practice. We reviewed and analysed the existing literature on the subject and built on this by conducting a reader survey of 135 practice managers and other healthcare practitioners, alongside a number of in-depth interviews.
Assessing the general practice perspective
We found that patient demand is, unsurprisingly, one of the key challenges general practice faces, and that this is having a predictable effect in terms of workload pressures; it is also a key driver in the adoption of technology. Our research makes clear that technology is widely viewed as a means of alleviating practice pressures – realising operational efficiency, improving patient access to healthcare and enhancing the overall patient experience. Furthermore, while there remain some uncertainties about technology, and its adoption in general practice, GPs and their teams are digitally innovating – albeit cautiously.
The greatest challenges
When asked what were the greatest challenges faced by GP practices, patient demand (87.72%) was most frequently cited, followed by administrative burden (66.67%) and recruitment and retention issues (61.40%). One practice manager added that a lack of funding is a contributing factor: ‘Funding impacts on recruitment; the pay we offer is too low in our area, and we need more staff, but cannot afford more.’
This is in line with existing sector research. The King’s Fund’s Understanding pressures in general practice (2016), for example, also highlights that demand is increasing in practices, that this is reflected in a heavier workload which is more complex and intense, and that, as a result, it is more difficult to recruit and retain sufficient GPs for full-time, patient-facing work.
Nearly all respondents (96.61%) said that there has been an increase in workload – again, reflective of the specific challenges identified above. The top reason cited was increasing demand on healthcare services (94.2%) – which could be construed as the result of difficulties recruiting and retaining staff, as well as that of managing a growing administrative burden.
Technology, especially hardware, which is not fit-for-purpose was revealed to be another major contributor to increasing workloads (47.46%) demonstrating that, as demand on services increases, it is important that the right IT is in place to support GP practices and practice staff. When asked if the technology already in place at their practice was effective, 59.32% said it was only ‘somewhat effective’ – allowing much room for improvement.
So, while technology can support the delivery of healthcare, it must be the right technology, appropriately tested and absolutely fit-for-purpose. In Digital change in health and social care the authors make a case for the careful and considered implementation of technology – identifying the need to independently test any technology before it is implemented to avoid gross waste of limited NHS resources.
Finally, in the wake of May 25, data protection and GDPR compliance was noted as a significant contributor to increasing workloads (42.37%) and as something that needed to be considered more carefully by 66.10%.
Administration, ‘paperless’ NHS and digital-first systems
We asked readers what areas they would need to consider more carefully in the face of the digital transformation being relentlessly driven forward in the NHS today. That the majority of respondents identified administrative processes (74.58%) suggests a rethinking on the part of practice staff. Administrative processes are certainly a key area in which digital transformation is gaining ground; there are multiple opportunities to streamline processes, share information, connect systems, collect, manage and store patient data and to realise efficiencies. Respondents appear to have embraced these possibilities, can see that they are starting to make a difference, and so this is where their focus lies.
Even as we continue to encounter hopeful references to a ‘paperless’ NHS, 49.15% of respondents said that 20 to 50% of their documentation is on paper. Admin still consumes vast tracts of time; 37.29% of respondents said that they spend six hours or more on administrative duties and 27.12% reported spending more than four hours, but fewer than six hours, on admin.
With these figures in mind, if the aim is to improve efficiency and reduce the burden of admin in GP practices, we must consider the paper-created workload and the ways in which practice leaders are managing this. Feedback from survey respondents suggested that printers and printer management is an area to be considered. In addition to digitising paper documents, using scan technology and solutions such as managed print services and Brother Print Services for Health offer a seamless answer to an over-burdened NHS.
According to 62.71% of respondents, additional human resources would help reduce time spent on admin – their top suggestion. On the technology front, 59.32% said that better software which connects multiple touch points – within the practice and beyond – would be beneficial, and the streamlining of digitisation of data – patient records, etc. – would ease the admin burden for 52.54%. A high number of respondents, 71.19%, said that they would need to give careful consideration to the implementation of connected systems.
Data protection and GDPR compliance was also high on the list of considerations, with 66.10% of respondents flagging this issue, while 55.93% felt that upgraded technology (hardware), which is more efficient and fit-for-purpose, would help. A further point made by respondents was the adoption of solutions that automated day-to-day tasks – in this case, the ordering of inks and toners. The auto-replenishment of inks and toners, standard aspects of managed print services, can certainly deliver savings in terms of both money and time.
The perceived need for technology
What’s driving the perceived need for tech? Respondents pointed to rising demand on health services in terms of increasing numbers of patients with more complex needs and changing patient expectations as they, increasingly, look for greater convenience and online access to services (76.27%).
Other factors contributing to the need for tech solutions to current problems were identified as the push for NHS-wide digital transformation (69.49%), the requirement for administrative efficiencies and streamlined processes (67.80%), new, digital-first systems such as online patient record access, appointment booking and electronic prescription services (EPS) (66.10%) and the desire to successfully implement new models of connected care (66.10%).
Here, again, the need to employ technology to realise efficiencies and lighten workloads takes centre stage. However, a focus on the evolution of health services is also revealed, an acknowledgement that NHS-wide digital transformation, connected care and new models of care require evolved technology to support them. Practices accept that they need technology that is fit for contemporary healthcare needs – serving an increasingly digitally sophisticated society. General practice appears to be willing to embrace a digital infrastructure provided they can be assured that this will be both effective and sustainable in the future.
Technology that is fit for the future must, by definition, be flexible and scalable; given the constraints on budgets, where practices already have hardware installed, they will need to consider carefully how this can be upgraded and what system adaptations may be required.
You can read the full report HERE
Up next: Part 4 – RESEARCH FINDINGS #2