By Dr Satya Raghuvanshi, head of clinical, Accurx.
Patient flow: improvements needed
Ask any recent patient of the NHS about their experience and they’ll be sure to give you an account of the services and healthcare professionals they came into contact with. But you can also expect to hear about another key part of patient experience — the speed and efficiency with which they moved along their patient journey.
They may tell you how long it took them to be referred, how many phone calls and letters it took to make an appointment, whether they had to wait for a hospital bed, whether they could’ve been discharged days before they actually were.
These experiences all centre on the ease with which a patient has progressed through the NHS — what we often call ‘patient flow’. Indeed, the underlying metaphor of ‘patient flow’ provides a standard of what good looks like. It indicates that patients should be able to flow quickly, seamlessly — and with a clear direction of travel — through the system.
But for many patients today, this picture of patient flow simply doesn’t align with personal experience. For these patients, any progress in treatment is often punctuated by long periods of waiting or by back-and-forth interactions with their healthcare providers. This can leave their patient journey feeling like a staggered, stop-start exercise, one they continually need to nudge forward with a new phone call or by finding some alternate touchpoint into the NHS.
Whatever one’s involvement in healthcare, we all see news headlines routinely filled with stories of sky-high waiting lists and chockablock hospital beds. The pressing need to improve patient flow has therefore become one of the core symptoms of an NHS ‘at breaking point’ in our shared consciousness. There are many complex reasons contributing to poor patient flow in the NHS, which includes everything from a depleted workforce and the use of legacy systems to the inadequacy of the social care system in its current form.
The other big reason for poor patient flow…
Yet there’s another, often overlooked factor which contributes hugely to the poor patient flow seen in the NHS day-to-day. Communication. Or rather, the difficulty which those working in — and using — the health system have communicating. While significant investment in the NHS App is a much-welcome step in helping healthcare staff and patients communicate, this on its own won’t solve the problem. Without firming up the basic communication infrastructure used every day across the NHS, ‘good’ patient flow looks sure to remain out-of-reach.
At Accurx, we have the privilege to work with 98 percent of GP practices and 68 percent of NHS trusts. We’ve often seen how, in today’s multi-disciplinary NHS, there’s no such thing as good patient flow without good communication. That’s because patient flow depends on easy collaboration and information sharing between multiple care settings. It depends not only on the expertise and remarkable diligence of NHS professionals but on having the right tech in place so they can seamlessly communicate around a patient.
But as it stands, many services across the NHS don’t have the communications technology they need. They can’t easily contact the right person in any organisation, to view the necessary information about a patient — no matter where that patient is registered. For proof that this impacts patient flow, we only need to look at the fact that delays to treatment invariably increase as a patient continues further through their journey.
It’s easy to see why. As a patient’s care becomes more complex and increasingly dependent on good collaboration across more people and teams, the wait time for responses or requests for information goes up. Like all advanced healthcare systems, the NHS functions on a principle of coordinated care delivery — but such coordination simply isn’t practicable without quick, easy communication. To revisit the earlier metaphor, it can therefore be useful to think of quick, easy communication as the current which gently pushes patient flow along at each stage.
Many of the big contributors to poor patient flow — such as the need to scale up social care — present challenges so great that they require thinking and reform at a near revolutionary scale. But that’s not the case with communication reform. Improving the NHS’s communication practices doesn’t need a revolution. It doesn’t need the latest cutting-edge tech innovations to have a quick and sizeable impact. It can involve modest improvements to staff workflows and run on simple tech such as SMS.
Patient flow impacts patients outcomes
Ultimately, patient flow doesn’t just matter in terms of patient experience and the ability of healthcare staff to meet and regulate demand. It also makes an all-important difference when it comes to patient outcomes.
By equipping healthcare professionals with the communication software they need, we can drive forward vital improvements to patient flow and help patients receive the care they need at the pace they need it.