Readers' letters – 12 July 2012

Set the bar high

The recent announcement from NHS chief executive Sir David Nicholson calling for GS1 barcoding standards to be adopted within NHS procurement should be welcomed by trusts, practitioners and any organisation or individual involved in the delivery of healthcare in the UK.

An integral part of the £20bn Nicholson challenge savings may be achieved through increased procurement data which will drive price transparency, collaborative procurement and improved stock control.

However, the current fragmented nature of the NHS means that the underlying architecture and coding standards that could facilitate data insight, management information and subsequent efficiency gains are fundamentally lacking.

The NHS relies on a heavily manual process for drug labelling and syringe applications, especially in a perioperative environment. This labour-intensive, manual process leads to significant numbers of out-of-date drugs, poor stock management and supply chain inefficiencies. It is estimated that through the adoption of an automated labelling solution based upon GS1 barcoding standards, trusts could achieve a 7 per cent decrease in the amount of time taken to label drugs and significantly reduce the number of drugs that go out of date before they are used; a figure currently estimated to be up to 40 per cent.

In addition, the adoption of such technology would enable trusts to reduce the number of intravenous medication errors and improve patient safety, which in turn would reduce risk and subsequently the amount of money that the trust would be required to pay into the clinical negligence fund.

The NHS is in a unique position to achieve huge efficiencies through the adoption of common coding standards and technology innovation. Adoption of GS1 barcoding standards, among others, will provide a comfort zone that will enable trusts to aggressively pursue these efficiency gains within a relevant architecture.

Unfortunately, there must be the expectation that the NHS will have to go through a reasonable amount of “pain” before it stands to “gain”. However, the numbers are irrefutable; the bottom line is that the NHS must act collaboratively through the adoption of international standards and common coding in order to achieve the efficiency targets demanded of it. And it is the responsibility of solution providers to deliver relevant, fit for purpose and simple commonsense systems that are built upon these standards to help pave the way.

Steve Larder, general manager - UK division, PRISYM ID

Get round the table

Your leader on medical leadership rightly highlights the important issue of relationships between fellow clinicians. What is going to be just as important in the new commissioning system, but is sadly often forgotten, is the relationship between health and social care professionals. There will be challenges, but people who use services deserve the better deal that more effective joint working can bring.

GPs tell us that people often have many social issues that block them from moving forward in their health. There are some great examples of how local teams have worked together to deliver a more seamless experience for patients and service users. 

On our Social Care TV website we have a film about the Bromley-by-Bow Centre and GP partnership where co-location and a joint reception have improved coordination and access to services between health and social care; the film also shows how multidisciplinary teams in Norfolk have reduced emergency referral rates by meeting as a commissioning group, once a week, over sandwiches.

A good reminder that social care and health need to be around the table like never before.

Andrea Sutcliffe, chief executive, Social Care Institute for Excellence

Feel the fear

Might I point out one of the glaring problems with clinician-to-clinician decision making and performance management: it just doesn’t happen widely enough.

And herein lies the problem with the latest reforms, how many health managers have been left high and dry when clinical directors refuse to stand up to their colleagues on issues which cost the health economy serious money - whether it is not turning up to clinics or using the latest piece of kit at twice the price of the old one? Clinicians still fear managing each other as they either don’t have the skills or are afraid of being ostracised from their peer group for making a stand.

Andrew Atherton, former acute operations manager