Comment: Why aren’t merged trusts prioritising technology?

Tas Hind, technology director at Essentia, explains how merged NHS trusts can pool technology resources for the long-term benefit of services

With a growing number of NHS trust mergers underway, how they will integrate technology systems has become a hot topic. Unfortunately, technology often comes far down the list in terms of merger priorities. Here, Tas Hind, the new technology director at Essentia, explains what the barriers are and how to best overcome them

Tas Hind

Over the past year, an increasing number of NHS trusts have declared their intentions to merge, compounding the challenges facing the health service.

Some of these, for instance in Manchester and Liverpool, are on a very-large scale.

Often technology gets put onto the backburner and all the other changes take priority. What trusts should be doing is considering them in conjunction with technology from the start

This integration puts a huge amount of pressure on staff, not only to keep the lights on, but also to keep services running.

With new mergers hitting the headlines every month, you would have thought that the integration of their technology systems would be a hot topic. And yet, oddly, technology is often treated as a back-office function, rather than where it should be – at the forefront of driving change.

Is this because there are too many budgetary pressures on top of day-to-day priorities? Is it because one trust dominates the other and there is too much infighting? Is it because some systems are automated in one trust but paper-based in the other? Or is it because there isn’t any information technology representation on the trusts’ boards to influence decision making?

Undoubtedly all of these issues have their part to play.

But trusts are missing a valuable opportunity. Technology can prove to be a significant catalyst for change.

If the integration and consolidation of systems is considered between the merging organisations sooner rather than later, it can lead to real benefits.

Often technology gets put onto the backburner and all the other changes take priority. What trusts should be doing is considering them in conjunction with technology from the start.

With new mergers hitting the headlines every month, you would have thought that the integration of their technology systems would be a hot topic

Imagine a scenario where an emergency care pathway is reconfigured. In this example, one trust takes the lead to treat the patient and captures the information electronically. It then transfers the patient to the other merged trust department that is either running on a different system or a mixed economy of paper and systems. This will only result in inefficient processes and poor patient experience and outcomes.

A much-better solution would be to run the pathway electronically across the two or more organisations and maintain the continuity of care. Organisations that put integration of information technology as part of the merger as number one on their list achieve greater benefits in a shorter time.

To take another example, you might have two trusts that have merged and are on two different Electronic Patient Record (EPR) systems. Clearly, they need to make a strategic decision on which one will be adopted by both organisations. This will be driven by the services that will be delivered by the respective merged trusts as well as the longevity of the system, how widely it is already used, and the perceptions of end users. In addition, temporary measures may need to be taken to share data between the two or more organisations until a longer-term decision can be made.

Furthermore, one trust may have a best-of-breed system that is paperless, whereas the other one has an EPR system but is not paperless. In this situation, a decision needs to be made about whether the trust should adopt the popular ‘e-noting’ type solution while a decision is made to adopt a more-strategic system across the merged trusts.

A good example of where technology was made a priority was when the Princess Royal University Hospital merged with King’s College Hospital.

At the time, the chief information officer for King’s made it their number one priority to get both organisations on iPM, their admin system, and iCM, their clinical system. Without that priority, the merger would have probably failed and the performance and reputation of both organisations would have been impacted.

Trusts are missing a valuable opportunity. Technology can prove to be a significant catalyst for change

All trusts merging need to put information technology at the top of their priority list.

Look at it strategically. Consider the long-term options and implementation roadmap; exploit the immediate opportunities where technology can add real value; and assist with the transition into merged and integrated organisations that improve patient experience, quality of care, and clinical outcomes.

Companies