NHS to issue barcodes for hospital patients under plans to go paper free

NHS Paper Free Plans

NHS England has outlined plans to "bring the NHS into the 21st century" via changes to the way patient records are managed and accessed by both NHS staff and, for the first time, patients

In November last year, NHS England set out how it intends to use technology to more effectively manage data in its Personalised Health and Care 2020: a Framework for Action paper and NHS England has now said it is committed to moving all patient records over to a digital format by 2020.

Tim Kelsey, NHS England’s National Director for Patients and Information is expected to reveal full details of the plans later this week when he addresses 5,000 NHS leaders at the NHS Innovation Expo Conference in Manchester.

As part of his address, Mr Kelsey is expected to say: "Health and social care services in England must end the unnecessary reliance on paper in the treatment of patients. It’s key to making services safer, more effective and more efficient.

"Every day, care is held up and patients are kept waiting while an army of people transport and store huge quantities of paper round our healthcare system. This approach is past its sell by date. We need to consign to the dustbin of history the industry in referral letters, the outdated use of fax machines and the trolleys groaning with patients’ notes. As well as saving precious resources, technology can dramatically reduce errors. Urgent action is a moral imperative where paper is the currency of clinical practice."

According to NHS England, electronic prescribing systems halve medication errors compared with the issuing of traditional paper prescriptions, but only 14% of NHS Trusts currently use them.

Patient 'scanning'

The proposals also include a planned change to the traditional patient wristband, which will eventually be rolled out to include digitally-accessible information such as name, date of birth and consultant name and could, says NHS England, decrease the potential for human error as electronic scanning of  the barcode replaces manual checks.

Hospitals have been issuing electronically printed wristbands for some years, and while a vast improvement over the traditional handwritten and at times illegible paper-insert labels of days gone by, the current type of printed wristbands are still subject to visual checks by staff.

Under the plans, medical equipment, medicines and samples are also likely to be routinely barcoded across all settings in England, which will, if scanned at the appropriate junctures, allow items to be traced throughout the health service.

Barcoded wristbands have been issued to newborn babies in some hospitals for a number of years which has allowed hospital staff to access more information about the baby, including name, NHS number, date of birth, sex and mother's name.

The former National Patient Safety Agency (NPSA), an arms length branch of the Department of Health, had been calling for standardisation of wristbands throughout the NHS since 2007, when it reported more than 2,900 incidences of patients receiving the wrong care as a result of the use of inconsistently produced or incorrectly processed wristbands between February 2006 and January 2007. The NPSA was abolished on 1 June 2012, when its key functions were passed to NHS England.

NHS app

The latest proposals also include the introduction of an NHS smartphone app, which would enable patients to book appointments, order repeat prescriptions and view their medical records all within the app, leading to some security concerns.

However, NHS England says the changes will improve patient safety because wherever NHS services are accessed, staff will be able to swiftly form a clear picture of the best treatment route for each individual patient, with the ability to view past and present medications as well as relevant clinical history from diagnostic tests and case histories to personal preferences, allowing them to treat, prescribe and refer where necessary.

Digital rollout

The NHS has been taking steps towards operating digital healthcare services for some time with 97% of GP practices already operating a service whereby patients can book appointments, order repeat prescriptions and access a summary of their medical records online, with 3 million people already signed up for this service. Patients are also able to book their own hospital consultation appointments online via the e-referrals service at a time and date that is convenient.

NHS England says it is also moving forward with its bid to investigate the potential of converting the entire NHS estate into a Wi-Fi zone.

For doctors and nurses within the hospital setting, Wi-Fi is said to be a key enabler of online clinical systems including remote monitoring of patients via handheld portable devices, a system which is said to "dramatically reduce errors and increase efficiency".

Mr Kelsey is expected to say: "Whether it is patient frustration about not being remembered or professional concern about managing care in the face of unknown risks, the effectiveness and safety of NHS services will be strengthened from being delivered paper free at the point of care.

"Without fully digitised patient data that can be shared across healthcare settings, the NHS cannot modernise in the way that is required."

Paper records

NHS England says the annual cost of keeping and maintaining paper records for some Trusts is currently between £500,000 and £1 million, money which, it says, could be better spent elsewhere.

Paper Records

It has not yet been announced how much the transfer of records over to the digital format is expected to cost.

The NHS has previously faced criticism about its ability to implement large-scale IT projects, but Mr Kelsey will say the health service must "get over the idea" that it can't do information technology and look to "do more to help the public and clinicians take advantage of the game-changing opportunities on offer to improve outcomes for patients."

From 1 November 2015, clinical commissioning groups (CCGs) and other health service providers will be required to complete a self-assessment procedure in order to benchmark their digital services. The results will form a ‘digital maturity index’, giving a basis for comparison with regards to progress and also forming part of the Quality Care Commission's (QCC) inspection regime.


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