New research from patient groups and healthcare experts warns that patient safety is being compromised by poor administration within the NHS.
Letters arriving after appointments, not being kept updated about waiting times for treatment and chasing test results are not only frustrating, but they also risk some patients not receiving the care or diagnosis they need on time.
New research from The King’s Fund, National Voices and Healthwatch England shows that poor administration within the NHS is widespread and is worse for some people including those with long-term health conditions and people who are struggling financially.
“Poor admin drives up perceptions of an NHS that wastes money and staff time and puts people off seeking care. Admin matters and it’s time that admin, and the staff that deliver it, are recognised for the value they bring,” says Julia Cream, policy fellow at The King’s Fund and co-author of the report.
Poor NHS admin
New public polling conducted by Ipsos for the report reveals the scale of poor NHS admin.
While just over (52%) of the public felt that the NHS is good at communicating with patients about issues like appointments and test results, a quarter (25%) said it was poor, and those who had actually interacted with health services in the last year reported widespread issues.
Of those who had used the NHS in the past 12 months, either for themselves or someone they care for, almost three-quarters (64%) said that they had experienced at least one issue with NHS admin or poor communication.
“The government is trying to bring down waiting lists and improve access but these efforts will fail if the NHS cannot communicate effectively with people about when their appointment is or who they need to contact,” added Cream.
Not equally felt
Further findings reveal that carers, patients with long-term health conditions, people from ethnic minority backgrounds and those struggling financially were all significantly more likely to experience issues with NHS admin and communication.
The study found that 75% of patients with one or more long-term health conditions had experienced an issue with NHS admin in the last year, compared to 57% of those with no long-term health conditions.
“The results of ineffective and inefficient admin are not felt equally across our society and affect those already experiencing health inequalities more acutely. For people with multiple long-term conditions, the burden of managing admin is multiplied for each interaction with the system,” said Jacob Lant, chief executive of National Voices.
As well as making some patients less likely to seek care in the future, the research shows that poor admin drives a perception of NHS waste. Of those who have experienced at least one problem over the past year with NHS Admin, 61% said that it made them think money was being wasted, 56% said their time was being wasted and 55% felt that NHS staff time was being wasted.
Patients and carers told researchers how poor admin has led to stress, anxiety and deteriorating mental health. Many patients described being unable to cancel or reschedule appointments. One person described how they were automatically discharged from a service when they did not attend an appointment they had been unable to cancel. Another patient received a text confirming their appointment for 99 January. Researchers also heard from a patient who is deaf and described how they are still called on the telephone despite asking for all communication to be via text or email.
Improve patient communication
“Admin issues within the NHS and their impacts on people have been in the shadows for too long. We’ve heard countless stories of people whose NHS letters arrived after the appointment day or were sent to the wrong address while some had their referrals lost in the system,” said Louise Ansari, chief executive of Healthwatch England,
The King’s Fund, National Voices and Healthwatch England say they want the government and the NHS to focus on improving patient communication and admin, with the health service required to regularly report on patient experience of admin processes. They are also calling for admin to be prioritised in the upcoming government 10 Year Health Plan expected later this year.
The three organisations recommend that NHS leaders and policymakers ensure there is adequate training and development for NHS admin staff and that patients are part of the design, delivery and testing of new admin approaches.
