OPINION: Analysing NHS System Integration & IT Services
Written by Julian Osborne, IMS MAXIMS (a provider of electronic patient records to the NHS and private sector)
The company has faced a turbulent time over the last twelve months and there were indications of future trouble. Yet the signing of new deals with high profile NHS organisations made it look, at least on the surface, that 2e2 would pull through.
The biggest concern for those trusts using the company’s services, many who relied solely on them to support their entire IT infrastructure, will undoubtedly be around business continuity. How will they continue to provide the same level of service themselves? How can they ensure that their IT applications, many of them now critical for the trust’s operations and more importantly to provide patient care, are not disrupted?
These are all valid and important questions that need answering but I wonder whether they would be asked if the NHS hadn’t chosen to outsource to a commercial company and instead it looked to other local trusts for support.
Several years ago, numerous NHS trusts desperately needed an external IT services provider to support their organisation, often they did not have the head count, capability nor the expertise in-house to ensure that they could implement, run and host the increasing systems that they needed.
Turn the clock forward to 2013 and I question whether, in today’s evolving and slightly more commercially focused NHS, trusts could pull on each other to do this themselves. Opportunities exist if trusts communicated in such a way where local NHS organisations understood each other's requirements, worked in partnership, shared IT services, drew on resources when required, and perhaps most importantly, provided back-up systems for each other and hosted each other’s data.
This doesn’t even need to happen with a trust’s next-door neighbour, services could be mirrored locally and even regionally, reducing duplication, cutting costs and potentially providing far greater stability ensuring that patient data is readily available and in turn accessible at the point of care.
On top of that it would help NHS organisations, many of which may now be reluctant to outsource to such IT providers, to de-risk the situation. Although recent months have seen trusts put into administration, it is highly unlikely that NHS organisations will experience the same type of issues as 2e2.
Traditionally, technology professionals used to join the NHS, gain experience and then head off to the private sector (often only to be re-employed as a commercial entity). This is happening less and less as talent appears to be far more greatly embedded in the NHS. Now the NHS needs to empower its champions to be more commercially minded and ambitious.
There are a number of organisations already pushing boundaries in this area, for example St Helen’s and Knowsley Hospitals NHS Foundation Trust is already working with IMS MAXIMS to host data from other healthcare organisations, not only within the NHS but also the private sector.
The trust is ready and willing to work with other like-minded organisations, public or private and better understand how it can cross-sell its IT systems and services into the NHS and private market.
Of course, there is a time and a place where organisations, such as 2e2 are of crucial importance to NHS organisations in need of their support and expertise; but my question is that in a risk averse NHS, is it simply less risky and more beneficial all around to invest in leveraging the knowledge and IT of our fellow NHS organisations?
NHS staff face severe impact on mental health due to COVID
The decision to drop COVID-19 restrictions in England this month alarmed doctors in the National Health Service (NHS) while hospitalisations are on the rise. At the same time, hospitals have started cancelling operations again adding to the existing backlog of operations, which estimates say could take a year to clear.
Dr James Gilleen of the University of Roehampton and his Covida Project team are warning of the ongoing risks to the mental health of NHS staff, many of whom are traumatised from the first wave of infections. “As the UK continues to see COVID-19 infection numbers rise at a similarly alarming rate as those seen during the country’s second wave, it’s combined with a renewed strain on the NHS and its staff" he said.
The Covida Project is a digital tool created to assess the psychological impact of the COVID-19 pandemic on frontline workers including NHS staff, the police and carers.
“Healthcare workers are already exhausted and burnt-out; they are traumatised from their experiences of working during the pandemic. During the first wave in May 2020, a study from the Covida Project found an unprecedented quadrupling of the number of NHS staff with high levels of anxiety, depression and post-traumatic stress disorder (PTSD) compared to before Covid-19" Gilleen said.
"Having the most severe levels of these symptoms was statistically linked to four key factors - insufficient access or pressure to reuse Personal Protective Equipment (PPE), insufficient workplace preparation, insufficient training and communications, and a higher workload. Staff aren’t just anxious, depressed and traumatised from being over-worked – it is from feeling unsafe and at risk."
The Covida Project found that almost a third of healthcare workers reported moderate to severe levels of anxiety and depression. The number reporting very high symptoms was four times higher than before the pandemic.
Gilleen adds, “With COVID-19 restrictions now fully removed in England, NHS staff face the daunting triple-threat of rising Covid-19 hospitalisations, huge backlogs of medical operations to clear, and the added expectation of large increases in winter flu, which is already being seen even now in summer.
"These difficulties are present at a time when the NHS is already under-resourced, impacted by sickness and/or staff being ‘pinged’ to self-isolate through the government’s track and trace app, and staff continuing to fear the daily risk of infecting family and friends.
"Together these are considerable psychological burdens and create a perfect storm for the mental health and well-being of NHS staff."
Gilleen says there may be worse to come, especially if new, more transmissible variants develop. "Previous research after other pandemics such as SARS has shown that residual mental health symptoms like PTSD can continue for years, so the impact of repeated waves over the long-term will be potentially catastrophic for the mental health of NHS staff.
He has some clear recommendations to protect the wellbeing of frontline healthcare workers. “To protect the mental health of NHS staff they must feel they are less at risk or in danger, have access to the required level of PPE, not be continuously over-worked, with better staffing, more opportunities for rest and space to share their stress.
"Despite this and similar findings from other studies, still not enough is being done to protect NHS staff mental health and wellbeing and we fear it will continue to suffer in the months to come. With this comes the real risk that large numbers of staff will burn out or even quit the NHS.”