​Celebrating 70 years and the rich history of the NHS

Improving patient safety is a long-standing concept that originated with the revolutionary advances brought about by Florence Nightingale.

High Five Branding

Improving patient safety is a long-standing concept that originated with the revolutionary advances brought about by Florence Nightingale. Nightingale implemented rigorous standards for environmental cleanliness and for improving personal hygiene and nutrition for patients. These improvements dramatically reduced mortality in military hospitals by nearly 60% in less than a year.

Following on from this miraculous improvement, the National Health Service (NHS) in the UK was founded by Aneurin Bevan in 1948. He had one key ambition to bring good healthcare to all. Hospitals, doctors, nurses, pharmacists, opticians and dentists were all brought together for the first time under one organisation to provide services that are free for all at the point of delivery.

On the 5th July 2018 the NHS turned 70 and to celebrate this momentous occasion we wanted to take a look back at the NHS and how the patient safety movement has evolved since its inception. We also wanted to investigate the important role that Datix has played in this crusade and what the future holds for the NHS, Datix and the patient safety cause.

Since its establishment, the NHS has delivered huge improvements and medical advances to public health. This means we can all expect to live longer lives. It is thanks to organisations like the NHS that pioneering treatments like the world’s first liver, heart and lung transplant have taken place and diseases such as diphtheria and polio have been all but eradicated. In the last 30 years alone, the NHS has been responsible for much ground-breaking work, such as:

• The first heart, lung and liver transplant in 1987.

• Establishing NHS Organ Donor Register in 1994.

• The first successful gene therapy in 2002.

• The first-hand transplant in 2012.

The introduction of The Health & Social Care Act in 2012 brought about the most wide-ranging reforms in the NHS since its founding. For the first time ever, this placed clinicians at the centre of commissioning, giving a new focus to public health and increased flexibility.

Learning valuable lessons from Incident reporting.

In year 2000 the report commissioned by The Department of Health, chaired by the Chief Medical Officer and entitled “An organisation with a memory” was released. This report clearly discussed the opportunity to learn lessons from incident reporting. The report focused on adverse events in healthcare and why some will never be completely eliminated, but how understanding and learning from incidents can help to reduce risk and improve safety. This report resonates strongly with Datix, who have championed learning from harm to improve safety since 1986.

One of the most significant introductions to the patient safety movement was the development of the National Reporting and Learning System (NRLS). Since 2003 more than 4,000,000 incident reports have been submitted and this collection of data continues to be a source of envy for countries around the world. The NRLS was an important advancement in national reporting systems, providing opportunities to continuously improve the safety of patient care.

More recent ground-breaking work includes the Duty of Candour legislation in 2014 and NHS England’s National Guidance on Learning from Deaths in 2017. These have both changed the patient safety landscape for the NHS by ensuring openness and transparency with patients and families and ensuring that all avoidable deaths are investigated in an appropriate manner and that all lessons learned are properly documented.

What role has Datix played in supporting the NHS?

Founded in 1986, Datix was at the forefront of the patient safety movement in the United Kingdom. Most of the earliest Datix customers are well known names in healthcare in the UK and are still using the Datix software today.

In 1992 Datix signed its first patient safety contract with the NHS, this was an important milestone and at a time when the idea of reducing harm to patients by analysing the factors contributing to incidents was revolutionary. Since then Datix has always been closely involved with the patient safety movement, not only reacting to recommendations and guidelines imposed on the NHS, but also pioneering technological advancements.

In 2004, the introduction of DatixWeb to the NHS enabled people to record incidents from any terminal in the hospital, revolutionising the process of incident reporting and eliminating the backlog of paper incident reports. The further inclusion of the DatixWeb Claims module significantly helped the NHS supply the right information to the authorities when the NHS Litigation Authority was launched in 1995. Now under the newly formed NHS Resolution, Datix continues to support the NHS by providing continuous improvement in managing and analysing adverse events.

The Datix software continued to evolve as our customer base grew and changed, with modules to analyse risk, manage complaints, handle patient experience and support the Care Quality Commission (CQC) when inspections were introduced. The Dashboards module revolutionised the way our customers work, with information about patient safety being instantly available to whoever needs it.

Datix has now introduced the next step in patient safety software; Datix Cloud IQ enables healthcare organisations to go beyond the capture of simple incident data, to actually uncover “why” mistakes happen and help prevent them happening again in the future. Reflecting the future of healthcare Datix Cloud IQ contains deep learning algorithms that constantly evolve and learn over time to better understand your data.

With Datix Cloud IQ, organisations can reverse the negative and increasing trend of preventable patient harm. The ground-breaking software provides the means for organisations to significantly improve institutional learning, resulting in better patient outcomes, enhanced efficiency and reduced cost.

The Datix Cloud IQ Mortality Review module offers the ability to capture and review mortalities and undertake necessary investigations and outline lessons learned. The CQC’s ‘Learning, Candour and Accountability’ report highlighted poor quality investigations and barriers to identifying opportunities for learning. This report resulted in the mandatory collection of specified information and the evidence-based demonstration of improvements in patient care.

Where to from here?

In looking to the future, we can see that there are various themes that are going to affect the NHS and patient safety in the future. These range from advances in technologies and the increased use of mobile devices and the cloud, to the extended use of data and artificial intelligence in predicting diseases. Datix has been present in the patient safety and healthcare field for the last 30 years and we are continuing to grow and change as the market demands. We will continue to constantly gather experience, seek knowledge and provide a better understanding of our customers in order to deliver the best software and solutions available. The next phase of Datix development will be even more exciting, as we continue to innovate with the goal of eliminating avoidable harm from healthcare worldwide.

Some of the emerging themes and technologies that will change the way we manage patient safety and patient data are listed below:

• Devices: By 2019 the number of mobile phone users is expected to surpass the five billion mark and this reflects technological changes that are already happening when it comes to the healthcare industry. Not only are health apps contributing to improved patient health, but they are also helping to provide better medical information and connectivity with medical providers, freeing up staff to concentrate on their specialisms. In addition, not only will it make the reporting of incidents much more efficient and effective, but it will also increase reporting. With more data easily available to analyse, organisations will be able to more accurately detect contributory factors and assess risk, making it easier to predict the likelihood of an incident taking place before it happens.

• Data: There is huge potential to tap into large amounts of data that have previously been under-utilised. By using the incident as the key and linking to data such as medical records, faculty data, staff records and medication history, which organisations already have at their disposal, will allow them to more easily uncover contributory factors and eventually predict risk before an incident can even take place. Better understanding readily available data will allow faster diagnoses to take place and the likes of readmissions will be reduced, decreasing the pressures on stressed staff members.

• Consolidation of Software/Systems: In the past many data collection processes used within healthcare were manual and siloed from other systems, resulting in a fragmented approach to safety. Many pieces of software now include modules for multiple and varied organisational processes – payroll and HR, procurement and finance. Closely-connecting information can have huge benefits when it comes to securing the safety of patients across healthcare. Not only will it reduce duplication of data entry required and an overview of all necessary information, but with links to systems like policies and guidelines staff can be assured that they are always acting in the most appropriate manner. For many years, the creation of an organisation with a memory has been seen as the holy grail, the likes of Datix Cloud IQ will move the NHS and other healthcare organisations one step closer to this ideal.

• Artificial Intelligence (AI): There are many ways in which AI is going to transform healthcare in the UK as we know it. From apps being able to encourage healthier behaviour, to predictive analytics supporting clinical decision-making. One of the most important impacts will be the early detection and diagnosis of diseases such as cancer. Theresa May is quoted as saying “the development of smart technologies to analyse great quantities of data quickly and with a higher degree of accuracy than is possible by human beings opens up a whole new field of medical research.“

• Combined Devices and AI: By combining AI with consumer wearables and medical devices, there is the potential to spot early-stage heart-disease, allowing doctors to monitor and provide better care, earlier on. There are many challenges ahead to successfully integrate AI within the healthcare industry, perhaps the most important being the creation of the right infrastructure.

Conclusion

These future factors offer a great opportunity for the NHS and other healthcare organisations like Datix to really leverage the power of data. The use of digital technologies for faster incident reporting, diagnosing disease faster thanks to AI, the extended use of data and the ability to turn it into actionable intelligence can only progress the patient safety movement forward. Datix will remain a constant advocate for the movement, pushing it forward with advances in its software and striving for safer healthcare.

In the past decade there have undoubtedly been improvements across many healthcare systems in the processes and infrastructure needed to collect incident and other data. The challenge ahead must now be to match this with the improvements needed in culture, systems, resources, expertise and wider infrastructure needed to assure high quality analysis, inquiry and improvement.

The NHS has come a long way since its inception in 1948 and will continue to champion innovations in care and surgical breakthroughs, by continually investing in new medicines, research and digital technologies like apps and artificial intelligence. Advances in technology, information and science, and innovations such as artificial intelligence will transform healthcare as we know it. Early detection and the use of preventative care is vital to the future of healthcare, allowing patients access to more personalised and expert care on demand.