A new drive to empower frontline health and care staff has been announced by Health Secretary Matt Hancock, aimed at reducing unnecessary bureaucracy which slowed or limited staff’s capabilities.
After a call for examples of bureaucratic inefficiencies yielded responses from more than 600 frontline staff, a total of eight key priorities areas for action have been identified and announced.
These short to medium term priorities are:
- Data and information will be shared, asked for and used intelligently
- System and professional regulation will be proportionate and intelligent
- Day-to-day staff processes will be simple, helpful and effective
- The government will legislate to make procurement rules more flexible
- GPs will have more time to focus on clinical work and improving patient care
- Medical appraisals will be streamlined and their impact increased
- There will be greater digitisation of services
- A supportive culture is needed at a national and local level
It is expected that stripping back this excess bureaucracy will mean hardworking staff can spend less time on paperwork and more time focusing on patient care.
More than 1,000 examples of excess bureaucracy within frontline health and care staff’s day-to-day jobs was identified, such as improving the ways data was collected and shared. Alongside the 600 staff who responded to the investigative calls, a wide range of other health and care stakeholders, including professional bodies, commissioners, academics and providers, contributed to the conversations.
In response, the Health Secretary laid out a new, comprehensive strategy to streamline processes and reduce bureaucracy.
Some of the key aspects of the strategy included:
- rethinking medical staff appraisals by putting an end to lengthy paperwork and ensuring a more meaningful assessment of professional development and progress. The new process currently being evaluated would mean quicker, more useful appraisals lasting just 30 minutes, down from 3 to 5 hours
- modernising outdated and prescriptive professional regulation. This includes reforming the legislation which sees specialist doctors, including GPs, from outside the UK who want to work in the NHS, submitting up to 1,000 pages of evidence to support an application. This will enable the General Medical Council to adopt different, more flexible routes to registration while still assuring the same high standards of knowledge, experience and skills
- reducing duplicative or repetitive data requests which can take up a huge amount of frontline staff’s time. NHSX and Department of Health and Social Care will launch a data strategy in the coming months to harness the power of data for better patient outcomes and to build on the approach to effective data sharing across the system seen during the Covid-19 response
Announcing the strategy at NHS Confederation’s NHS Reset Conference, Mr Hancock said: “Of course, rules and regulations have their place. They can be the cornerstone of safe and high-quality care. But when left unchecked, rules and regulations can outgrow their original purpose – and they can stifle innovation and damage morale.
“Learning from the first peak, in July we set up a call for evidence on reducing bureaucracy in the health and social care systems. And I mean the system as a whole. We engaged with staff on the front line and spoke with dozens of stakeholder groups.
“The contributions we received have been so vital in lifting that x-ray up to the light, and illuminating those daily irritations that make people’s lives harder. Like onerous clearance processes, complicated appraisals, and slow discharges.
“And of course, the changes we need to make don’t always have to be big. In the pandemic, we’ve seen that little things can make a big difference, for instance letting doctors and nurses communicate with patients securely over WhatsApp or providing single logins across multiple different computers.
“I’m determined that we seize this moment and build on the very best of what we have seen over these past 9 months.”
While a lot of the bureaucratic processes in healthcare are essential to maintain a safe, well-functioning health and care system, and the UK spends only around 2% of healthcare expenditure on administration – a third less than the OECD average – it is reported that approximately a third of a community-based clinician’s time is spent on administration and patient co-ordination, rather than with patients.
Over half of doctors also report that at least one hour of their work each day involved administrative tasks which could be carried out by non-clinical staff.
