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GS1 as a patient safety initiative

Professor Terence Stephenson, chair of the General Medical Council and Nuffield Professor of Child Health at UCL’s Institute of Child Health, discusses the benefits of GS1 barcodes in improving patient safety.

When I presented at the GS1 UK Healthcare Conference in April, I was not the first to remark that barcoding doesn’t initially seem the most gripping of topics to talk about; Lord Prior, parliamentary under-secretary of state for NHS Productivity, opened his presentation earlier that day with a similar comment. But, if you broaden it out to the benefits it has for clinical practice, as both Lord Prior and I did in our presentations, it’s not hard to see the benefits that technology, and GS1 barcodes as a key part of this, can have for the practice of medicine. 

If we start with patient safety, just a sample of some of the statistics can give an indication of what we’re dealing with: 

• Of the top 20 risk factors for all deaths, for example, adverse in-hospital healthcare events come eleventh. That’s above alcohol, drugs, violence and road traffic accidents
• Every week, two wrong-site surgeries and two operations occur with kit wrongly left inside a patient 

Every interaction we make in the NHS is open to error and it’s estimated that these errors cost one billion NHS bed days a year. This is worth doing something about. 

I first became interested in barcoding as a patient safety initiative back in 1997 when one of my patients, a newborn baby, was abducted from hospital and it was a few weeks before she was found. That incident was a catalyst for a move towards having everyone tagged and it’s an example of the implications an electronic tag with a GS1 barcode has for patient safety. 

Barcodes aren’t just for patients. They’re also about avoiding waste and allowing money to be shifted to patient care. Procurement is a key area where they can help do this. While I was chair of the Academy of Medical Royal Colleges, we estimated that there could be £2-4bn savings per year from a universal product code that would allow cost comparison between trusts. We also predicted that an additional £2bn could be saved by reducing variation across trusts, i.e. bringing the worst up to the best. That £2bn represents the huge variability that currently exists in our health service – if we are able to identify and stop investing in inefficient practices, we can reinvest in things that actually work. 

Track and trace 

Another example of where barcodes will make a difference is in the ability to track and trace. Following the PIP breast implant scandal, many of the 50,000 women who had these implants weren’t aware which implants they had and there was no quick way of communicating it to them. When I led a review into medical devices for the Medicines and Healthcare products Regulatory Agency (MHRA), one of the most important recommendations I made was that every single thing implanted into a patient should have a unique device identifier. That’s almost certainly going to have to involve a barcode. We already have a unique patient identifier in the NHS, the NHS number, which every person receives at birth, we just don’t use it. If we’re able to link it to the unique device identifier, we’ve got a match that we can track and trace to a patient, and that at the same time gives us the one click reporting that busy doctors and nurses so desperately need. 

Challenges 

There are many opportunities in clinical medicine where we can use technology to enhance patient safety. The above are just a few instances, but one of our biggest challenges is to get clinical leadership on board. Doctors like technology but they also like autonomy – and standardisation seems to them to go against this. Demonstrating the clinical benefits to them will be key, and the first step will be for the six Department of Health GS1 demonstrator sites to prove them. Once the clinical community sees these benefits, we can be sure that they’ll lead the way for the wider adoption of GS1 barcoding standards across all acute trusts in England.

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