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The power of standards to transform the NHS
Glen Hodgson, head of Healthcare at GS1 UK, analyses the current state of barcoding in hospitals.
GS1 standards offer the healthcare industry the same benefits that have been embedded in every stage of the retail supply chain over the past 40 years – improving operations and inventory management, and saving time and money. Applying the same standards in healthcare, means that the trusts can save time, money, prevent mistakes, improve patient care, outcomes and – most importantly – increase patient safety.
In 2014, the Department of Health introduced a change for hospitals that – if the experiences of the retail sector are anything to go by – can be transformational. What has now changed, as suggested by the eProcurement strategy, is that GS1 standards have been introduced into all acute trusts in England.
Both the eProcurement strategy and the subsequent review into NHS productivity, led by Lord Carter, have emphasised the need for a big change in how our hospitals are run. Their publication represents a fundamental shift to integrated, patient-centric care, through the better integration of technology – the Carter Review highlighted that this transition has the potential to release £5 billion of efficiency savings over the next three to four years alone.
Wasting time and money can no longer be an option. And of course, there are a lot of new challenges that trusts need to deal with through this cultural change but they shouldn’t be put off by them. Instead, they should use this opportunity to make better use of the technology and data they have available – to offer better and safer care. The trusts need to gain greater control over their supply chain, save money and help eliminate wastage – and the introduction of GS1 standards is a fundamental driver for this.
When referring to GS1 standards, Lord Carter’s review couldn’t have been any clearer: it states that the introduction of GS1 standards will allow every NHS hospital in England to save an average up to £3 million each year, while improving patient care.
But what does it really mean in practice to implement GS1 standards in healthcare? In practice, it means having a barcoded wristband on every patient. And having barcodes on all medical supplies, equipment, assets and pharmaceuticals. And it also means using a barcode to identify every physical and operational location. Their adoption and implementation allow hospital managers and clinicians to know at all times who did what to whom, when, why and where they did it and with which medical device, implant, pharmaceutical drug and dose.
The 2014 eProcurement strategy mandated the use of GS1 standards in all acute trusts in England by 2019/20 but much of the positive impact is already being felt across the industry. For example, at Derby Teaching Hospitals NHS Trust, since the introduction of GS1 standards in April 2014, they’ve saved at least £25,000 per month just in the consumables they’re using in general surgery, imaging and cath labs. That’s an annual saving of £300,000, with more to come when fully rolled out. At Barking, Havering & Redbridge University NHS Trust, they’re implementing GS1 standards through a health records tracking solution and they’ve identified three-year net cumulative savings of £1,444,690. And these are just some examples of how GS1 standards can help.
Earlier this year, in January, Jeremy Hunt, Secretary of State for Health, announced the six GS1 demonstrator sites of excellence, each with a share of a £12m investment from the Department of Health. Those sites are tasked with demonstrating the benefits, as well as challenges, they encounter from using the standards. The six demonstrator sites are: Derby Teaching Hospitals NHS Foundation Trust; Leeds Teaching Hospitals NHS Trust; North Tees and Hartlepool NHS Foundation Trust; Plymouth Hospitals NHS Trust; Royal Cornwall Hospitals NHS Trust; and Salisbury NHS Foundation Trust.
As shown by the eProcurement strategy, GS1 standards will be used for three core enablers to drive operational efficiencies, improved patient safety and regulatory compliance:
Firstly, every person: identifying patients with a wristband, which includes a GS1 barcode, and staff enables accurate and consistent information to be captured and stored about the patient and the caregiver – a major driver for patient safety.
Every product: easily accessing accurate and transparent product information for medical supplies, equipment and pharmaceuticals enables precise ordering, improved product availability and lower transaction costs.
Thirdly, every place: identifying every physical and operational location within the healthcare system enables information to be collected and stored where each event occurs.
These three core enablers will then underpin three primary use cases identified by the Department of Health as areas where GS1 standards will have the biggest and most immediate impact in acute trusts. These are: purchase-to-pay, which enables the acute trusts to manage their procurement processes more efficiently while providing improved product availability; inventory management, which ensures the acute trusts keep fewer products in stock and reduce wastage, yet ensuring products are readily available where and when needed; and patient safety recall, which makes it easier to identify and remove all recalled products across all acute trusts, or even when with the patients once they’ve been discharged.
Putting ideas into practice
The opportunity to have more efficient processes across all these areas isn’t just a great idea in theory, in practice it also offers tangible benefits. In the last few months, all 154 NHS acute trusts in England have become GS1 UK members and many have already written, or are currently writing, their plans for the implementation of GS1 standards. This means that suppliers to these trusts now also need to become GS1 compliant so they can keep trading with them.
Over the next four years, we’ll see these efficiencies come into practice and manage to measure the true impact they’ll have across all NHS processes. Just some of the benefits that trusts will have is complete traceability, ability to capture and share information automatically, whether it’s between departments and care professionals or between hospitals and their suppliers – in other words, true interoperability is achieved between people and systems.
But a shift in procurement processes is not just what will occur – implementing GS1 standards means that more time will be freed up for patients, there will be a better understanding of costs, better comparison of clinical performance and of exposing variations in clinical practice. But of course, it’s not just about finance or procurement, this impacts the whole hospital. And everyone must play their part – from executive boards and managers to nurses and clinicians.
Clinical engagement will be fundamental and it was a key focus of our recent healthcare conference, as our keynote speaker – Lord Prior, Parliamentary Under Secretary of State for NHS Productivity – made clear: “If we’re really going to embed GS1 barcoding into hospitals, we have to accept this is a behavioural or cultural issue, not a technological issue. If you have clinicians who can see the real value in GS1, then we’ve got a real chance of getting it established. I think the way forward is to expose unwarranted variation. And one of the reasons why I believe exposing variation is the most powerful lever for improvement is I think it’s the only way we’ll get true clinical engagement. If we can’t engage clinicians, we’ll never get real, sustainable improvement.”
If we can engage clinicians, we’ll see lasting change made to the everyday processes and functioning of hospitals across the country, and savings of billions of pounds in the years to come. In a time where there’s increasing pressure to do more for less, this can be transformational.
But, more importantly, this isn’t just about money - it’s about making hospitals safer – and by doing that, we’ll save thousands of lives too.