The NHS annually spends £6.6 million on underperforming communication tools which drive clinical staff to seek alternatives. Steve Carvell considers the threat this deficiency creates and discusses how modern technology can overcome the associated clinical and commercial challenges.

Pager units sit at the heart of NHS communication strategy. From arranging porters to co-ordinating emergency trauma teams, paging is a core element of healthcare services. However, should these devices be so heavily relied upon in 2017 given the breadth of modern alternatives available?

In a new study into current pager usage, findings have highlighted that there are still circa 130,000 units in circulation across the NHS. This makes the National Healthcare Service the largest user of pagers in the world.

The recurring deficit this pager estate generates is close to £3 million in licensing costs alone. And this figure is excluding indirect losses. Workflow inefficiencies and ongoing network infrastructure maintenance each cause further operational costs, each adding to the ongoing strain of managing an ageing pager network.

The results of this report also indicate a positive trend. Higher income trusts with a strong CDMI (Clinical Digital Maturity Index) rating are significantly less dependent on pager devices. Communication strategies at these Trusts are much more varied, with alternative smartphone solutions and hybrid devices being utilised for critical messaging.

Shadow Communication

The presence of unsanctioned shadow IT is increasing amongst front-line staff, with commercial messaging apps being used without permission instead of Trust issued pagers. The use of WhatsApp between doctors and nursing teams seeking an effective communication channel has been widely reported as front-line staff look for alternatives.

Unauthorised practices like this significantly increase the risk and likelihood of patient data entering the public domain. Mistakes do happen and devices are easily misplaced – patient confidentiality could easily be breached without malicious intent.

In fact, the Information Commissioners Office (ICO) reported 239 data security incidents in the NHS between June to October in 2016. Of these incidents, 65 instances – over 25% – involved unencrypted devices that were misplaced or stolen.

The official NHS England stance on this topic is clear. “Whatever the other merits of WhatsApp, it should never be used for the sending of information in the professional healthcare environment.” Despite this stance, WhatsApp became an invaluable tool during the cyber-attack in May 2017 with many communications going through the platform. During the crisis, up to 500 patients a day were diagnosed from X-ray images sent on the app.

Opportunity for Innovation

Consequently, care staff face a dilemma. They can either gamble with their career, risk a breach in patient confidentiality and continue using effective unsanctioned channels, or return to a clearly inefficient method of communication.

The pager has become somewhat of an iconic symbol in healthcare since its launch. Since then, the reputation pagers have gathered is largely positive. Their reliability in delivering urgent alerts and messages without fail often cited as one example. As pagers operate on dedicated networks and radio frequencies this reliability is reasonably assured. However, the question of efficiency still remains; is this the best way to meet communication needs in a modern healthcare service?

Internal cultures and attitudes have reached somewhat of a stalemate, where paging is accepted, regardless of its merit. However, we may be on the cusp of a shift in that perception.

As Vodafone prepare to imminently withdraw from the pager market, impacted Trusts have a natural opportunity to review communication strategy. To successfully adopt pager replacement technology broader policy changes are necessary, in addition to the creation of new workflow processes to replace those specifically created to support pager technology.

If this battle for hearts and minds can be won, and a communication channel provided offering the flexibility of WhatsApp with the resilience of pagers, then the NHS can redesign frontline communication workflows, improving staff efficiency whilst making a significant financial saving.

Find out more and read the full report – Paging in the NHS: The Cost of Ageing Communication Channels in Healthcare.

Paging Report