RE: NHS Wales Informatics Services

Royal College of Nursing Ty Maeth

King George V Drive East

Cardiff

CF14 4XZ

Tina Donnelly CBE, TD, DL, FRCN,

CCMI, MSc (ECON), BSc (Hons), RGN, RM, RNT, RCNT, Dip N, PGCE

Director, RCN Wales

Telephone 0345 772 6100

Fax 029 20680750

Email tina.donnelly@rcn.org.uk

Thank you for your invitation to submit written evidence in relation to the current inquiry into informatics in the NHS in Wales. This is an important area and it is widely acknowledged that improved ICT infrastructure across health and care services in Wales is key to transforming and improving services for the future. Indeed, we echo the Auditor General for Wales report on NHS Wales Informatics Services which states that informatics services “can help the NHS to deliver better outcomes for patients and to make more efficient and effective use of scarce financial and human resources.”

Nursing staff form the largest group of health care professionals, and because of their particular role in co-ordinating, assessing and delivering care to patients, they are major generators and users of information. High-quality patient care and nursing practice have always relied on the effective management of information. They now increasingly rely on appropriate health information technology systems and eHealth applications for effective communication, collaboration, monitoring and decision making.

The effective use of ICT in healthcare settings can make a difference to the way care is delivered in several ways. Today, all nursing staff recognise the importance of evidence-based practice, where every care decision is informed by accurate and upto-date knowledge. In a world where the knowledge base is expanding and changing so rapidly, ICT and access to the internet can give nurses access to a world of knowledge and resources, including recent research findings, protocols and guidelines. ICT also offers nursing a great opportunity to take on the role of ‘knowledge broker’, actively helping patients to access the information they need, and deciding how to use it.

The benefits of access to ICT and eHealth applications include:

• patient safety: patients’ demographic and clinical information is more legible, accessible and shareable, thereby giving clinicians more accurate, timely and complete data on which to base decisions

• effectiveness: clinical pathways and decision support systems can be embedded in electronic patient systems to give easy access to best practice evidence

• efficiency: more efficient work processes due to increased availability of clinical information, for example electronic transmission of prescriptions direct to the pharmacy

• patient centred: information about patient’s preferences more easily available

• timeliness: access to up-to-date information on which to base clinical decisions

• equitable: ensuring that all people have the same level of access to services

At a recent meeting of the Cross Party Group on Nursing & Midwifery, the value of effective ICT services within community nursing teams was discussed. It was noted that enabling community and district nurses to have access to laptops, equipped with all clinical programmes and linked to GP records, means that nurses working within people’s homes have access to patient records (including test results, details of medications etc.) This enables better and well-informed clinical decision making. Whilst this was a costly system to have in place, it was considered to worth the investment, and yet access to ICT systems within the community nursing teams are still far from commonplace.

With the increasing shift towards delivering care in community settings, the availability of these kinds of technologies within the Welsh NHS should no longer be considered a luxury, but rather should be seen as a necessity in today’s world. There is therefore a need for clarity and transparency around the timetable for rolling out, adapting and maintaining suitable informatics systems across community settings and we would urge the Welsh Government to set out this timetable as soon as possible.

Finally, because staffing nurse make up the largest proportion of healthcare staff working in the NHS, it is vital that nurses are involved in the design of these systems. The involvement of nurses in the design of informatics systems is critical for ensuring the clinical information required by nurses is incorporated into the system. It can often be the case that ICT systems are designed from the perspective of senior medics or NHS managers, and this can sometimes result in systems not being fit for purpose in terms of streamlining processes and reducing paperwork. By including nurses and the wider healthcare team in the design, the effectiveness of the system can help to be ensured.

If you would like any further information or detail please contact the Policy & Public Affairs team – Policy.PublicAffairs.Wales@RCN.org.uk or call 02920 680 738.

Kind regards

Yours sincerely

TINA DONNELLY, CBE, TD, DL, FRCN, CCMI

RE: NHS Wales Informatics Services

DIRECTOR, RCN WALES