The NHS has undergone significant changes in its communication practices since the Covid-19 pandemic, driven by advancements in technology and increasing demand pressures. The 2024 Spring Budget recognised technology as ‘central’ to achieving the goals outlined in the NHS Long Term Workforce Plan (2023), allocating £3.4 billion for NHS technology and transformation.
A recent study by The Health Foundation highlighted the widespread adoption of digital tools among NHS clinicians. 86% use electronic health records and utilise videoconferencing for colleague communication. Additionally, 73% employ digital messaging tools to interact with colleagues. As we approach the end of 2024, the use of digital health technology is set to only increase, driven by AI breakthroughs and improved operational efficiency.
However, communication challenges persist. An October study of patients and NHS staff revealed that over half had experienced poor communication from the health service in the past five years. More than a quarter of respondents reported having to chase up referrals themselves, while 16% felt inadequately updated during waiting periods.
This blog post will explore the various communication forms currently prevalent within the NHS, their potential benefits, and the risks associated with their implementation and use.
The state of NHS communications report
The state of NHS communications report, published in March of this year, is named ‘one of the most comprehensive reports ever undertaken’.
One respondent in the report said that new forms of communication have ‘improved the team connectivity and has meant we have been able to do things that we previously couldn’t. For example, we can now verbally brief 800 members of staff virtually every month when previously we would only have around 50 people in face-to-face briefings.”
However, the report also highlighted weaknesses in the NHS. It demonstrates that there’s a need for better management of communication, and for continued investment. This includes embracing AI and other new technologies, as well as better maximising all available communication channels.
With this said, let’s explore the forms of communication increasingly made use of in the NHS and potential concerns to be aware of.
Forms of communication in the NHS
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Video consultation
The use of video, skype and virtual consultation became mainstream in the UK in 2020 as a result of the COVID outbreak. Since the pandemic, we have seen hugely widespread implementation of video consultations across both primary and secondary care. 99% of GP practices now offer video consultations and this means that many more people can receive safe and effective care without having to travel to a hospital or GP practice.
Often a physical appointment is simply unnecessary and using an alternative means of communication is time saving for all parties. Also, using alternative communication can be more environmentally friendly.
However, not all conditions are amenable to telephone or other forms of communication. There are times when a physical examination must take place and there is currently no way this can happen virtually; we already see instances where GPs fail to make a diagnosis based on a virtual discussion with a patient.
It’s also important to consider that not everyone has access to the latest technology. Many elderly patients do not have access to the internet, so practices having virtual consultations as their primary form of appointment can be limiting. According to research from Lloyds Bank, approximately 25% of the UK is likely to struggle with online services.
Some disabilities also make using such technology problematic so there would need to be alternative means of communication, such as face-to-face appointments, to avoid making healthcare inaccessible to patients.
2. AI
One current area of concern in NHS communications is the opportunities and risks posed by the increasing use of artificial intelligence.
On one hand, these tools can significantly streamline workflows by automating time-consuming processes. For example, AI systems can assist in drafting routine correspondence, or rapidly process large amounts of data. This frees up staff’s valuable time to be better used elsewhere.
However, the adoption of AI in NHS communications also raises important concerns. There’s a risk of over-reliance on automated systems, potentially leading to a loss of the human touch that is crucial in healthcare communication. AI-generated content may lack the nuance, empathy, and contextual understanding that skilled human communicators bring to their work. This could result in tone-deaf messaging.
And, more importantly, there are ethical considerations surrounding data privacy and security. AI systems require large amounts of data to function effectively, which may include sensitive patient information. Ensuring the proper handling and protection of this data is crucial to avoid privacy breaches.
We are also increasingly seeing the use of AI to provide medical advice and diagnoses. While they are not intended to replace human healthcare professionals, and offer great potential for improving patient care, if these tools are used without proper oversight by NHS professionals, there is a risk of errors that could lead to serious harm.
3. PEPs
As technology continues to advance, and demand increases for remote access to appointments, we are seeing a rise in the use of patient engagement portals. These are online platforms providing patients with access to their personal health and medication records, appointment scheduling, and messaging with healthcare clinicians.
As of 2023 NHS statistics, 84 trusts have a patient portal with 19 in active procurement. This is a positive innovation, in that now patients can take a more active role in their healthcare, and professionals have time freed up for patient care that would previously have been spent on administrative tasks.
However, there are also potential issues to be aware of. If patient data is not handled securely, there is again a risk of data breaches, as well as the risk that patient data be misused for marketing or other purposes, violating privacy laws. Furthermore, if patients do not have access to technology or internet connectivity, they would be excluded from the benefits of patient engagement portals.
4. Email
Since the Department of Health’s announcements in 2018 and 2019 that use of fax machines and pagers in the NHS would be phased out, email has become a primary method of communication in the health service. This was a positive shift – pagers and fax are undoubtedly outdated, inefficient, and far from an eco-friendly choice. However, replacement with email communication doesn’t come without its risks.
Email is certainly a far more reliable method of communication. Use of read receipts are a way of confirming an email has been received and understood/actioned. And from a practical perspective, this is useful for doctors making referrals and ‘knowing’ they have been received, reducing the amount of time that doctors and their secretaries spend chasing referrals. Encrypted email and use of ‘Drop Box’ or similar, also allows for safer delivery of information.
However, this touches upon an important point. There are risks of data breaches under GDPR when using emails. If emails are to be the primary method of communication, there need to be safeguards to protect against data breaches, and there are numerous potential causes of a data breach:
- Entering an incorrect email address;
- Hitting ‘send all’
- CC’ing in people, rather than BCC’ing people (a good example is the HIV clinic email in 2016)
- ‘Fake’ email accounts being set up and used to obtain sensitive data
- There is also an ever-growing risk of viruses and malware.
The WannaCry hack in 2017 was one of the most significant cyber-attacks globally in recent years. The ransomware spread to 603 GP surgeries and the impact was widespread, resulting in cancelled operations, cancelled appointments, and millions of pounds of costs.
Even with the evolution and progression of technology, the threat of cyberattacks continues. In fact, as technology evolves, so do the tactics used by cybercriminals. A more recent example is the Synnovis cyber attack in June of 2024, where a pathology laboratory which processes blood tests was the victim of a cyber attack. This resulted in delays in patients receiving diagnoses, and breaches in sensitive patient data.
Communication in the NHS, where do we go from here?
As mentioned in the introduction to this blog, the 2024 Spring Budget set aside a very welcome investment in NHS technology. However, it’s important to note that, historically, the NHS has a tendency to raid capital budgets for operational expenses. To ensure the intended impact, funding for digital technology must be protected from being diverted to cover day-to-day costs.
For the funding to yield the desired productivity gains, leaders must empower staff with the necessary support, time, and resources to embrace digital transformation. Officials need to be mindful of the potential pitfalls and ensure the appropriate infrastructure is in place to enable a smooth transition to any new technology.
For instance, one of the main obstacles preventing a technological upgrade is financial. With increased patient demand for services and more expensive treatment, cash-strapped hospitals now need to find the money to update their technology. The money available to health services only stretches so far, and it would not be acceptable to the public for patient care to be compromised by the need to update communication systems.