Health Service Focus

02.03.20

Axe the fax: Bringing about the end of the outdated hospital machinery

Richard Kerr BSc, MBBS, MS, FRCS is a Council Member of the Royal College of Surgeons and was Chair of the Commission on the Future of Surgery

This article was first published in the NHE Jan/Feb 2020 edition

It is less than two years since the Royal College of Surgeons of England submitted freedom of information requests to NHS Trusts on their use of fax machines. This 1980s technology, long since abandoned by almost everyone else, turned out to be the backbone of NHS communications, with 9,000 machines still in active use nationwide.

 The government response has been both swift and decisive. Matt Hancock as Health Secretary, announced an embargo on further fax machine purchases, and set a deadline of March this year for the equipment to be junked altogether. We are now approaching that deadline, and we watch with baited breath to see if that target will be met.

 Apart from being glacially slow and totally inefficient, this mode of exchanging information is also clearly insecure. In all our everyday lives we routinely password protect all sensitive documents sent by email. Yet this old technology is exposing sensitive personal, patient data         to interception either at the point of transmission or while piles of paper sit uncollected on fax “in-trays”.

Among healthcare systems around the world, the NHS is often described as the most centralised. The “command and control” nature of the system does present challenges, but it also provides an opportunity to move beyond the Secretary of State’s decree on faxes toward a positive, joined-up approach to data collection and sharing.

Modern integrated systems should be implemented across the service, protecting individuals’ data but also allowing the NHS to track patterns across the population as a whole. Genomic medicine should be to 21st century healthcare what vaccines were to the 20th century: a paradigm shift towards prevention rather than cure.

Personalised early and preventative care remains the major aim. The access and analysis of such datasets will enable that, but the public has to know their data is safe and secure at all times. The UK has the opportunity to be the world leader in this field, drawing on a unified (but anonymised) vast dataset about the prevalence of disease among particular groups, and how those groups respond to different treatments.

In this environment, the fax machine is no more suitable as core hospital equipment than candlelight in operating theatres. If the health secretary succeeds in their abolition, he will have done us all a great service.

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