Comment: Merging services in the NHS

Dr Saif Abed, medical director at Imprivata reveals why ‘disruptive technology’ is not always a good thing

Dr Saif Abed, medical director for UK & EMEA at Imprivata, discusses the recently-announced plans to merge back office and pathology services within the NHS to save money. It talks about how to merge systems, and that the focus should always be on maintaining patient safety and clinical workflows

Last week it was announced that NHS trusts had been given one month by NHS Improvement to produce plans for merging back-office and pathology services with neighbouring trusts.

This is part of a plan to address this year’s provider sector deficit, which is on course for £550m, a level which is seen as increasingly difficult to manage.

NHS Improvement and associated organisations are looking to reduce this deficit to £250m through a combination of three measures. These are to control paybill growth in certain providers; implement large-cale back-ffice consolidations; and he merger or transfer of unsustainable elective services.

The pace of change is increasing and the requirement for change is imperative due to the financial circumstances that the NHS is now facing. Technology can help trusts to harness change so long as it is well thought out and managed

England’s 44 sustainable and transformation plan patches have also been given until the end of July to identify any planned care services in their areas that are heavily reliant on locum staff, with a view to transferring or merging them to other providers.

Merging services within the NHS is nothing new, and has been generating challenges for many years. However, the pace of change is increasing and the requirement for change is imperative due to the financial circumstances that the NHS is now facing. Technology can help trusts to harness change so long as it is well thought out and managed.

In my time at Imprivata we have experienced the consolidation of services in the NHS and its impact at scale. When merging services, particularly those that involve clinical applications and systems, the most-portant consideration is the effect on patient safety, clinical risk and clinical workflow. At Imprivata we have consciously invested in involving clinicians in our work to ensure that we understand workflow changes and ensure that our technology supports the transitions that come with merging services and departments.

One of the major issues when merging services s the differing systems that each service is currently using, and how they will work together. Existing systems need to be benchmarked in order to provide a baseline for the current situation, paying particular attention to how workers use the systems.

Contrary to what we see in the media, and many vendors’ marketing collateral, ‘disruptive’ technology is not always helpful when it comes to planning and implementing efficient workflows. At all costs, you should aim for as little disruption as possible. The merger of systems needs to be de-risked wherever possible, and to ensure that the delivery of the new service itself is smooth, safe for patients and effective.

Harnessing the experience of third parties that understand the ramifications of merging services, and how to attain a successful outcome, will enable trusts to continue to provide uninterrupted safe patient care

In time, it is desirable to migrate everyone to one universal system. However, this is usually a significant undertaking and, in the meantime, services must continue with patient safety maintained. Trusts also need to be mindful of how they will manage security and access to clinical information while providing transparency and consistency minimising clinical and information governance risk.

Above all, harnessing the experience of third parties that understand the ramifications of merging services, and how to attain a successful outcome, will enable trusts to continue to provide uninterrupted safe patient care.

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