From monthly board meetings to almost-daily committee meetings, decision making in the NHS is reliant upon the effective co-operation and collaboration of groups of people at every level. Yet whether the decision is to sign off on a multi-million-pound piece of machinery or a new care plan for a specific patient, far too many meetings are constrained by a continued reliance upon paper documentation. In this article Alister Esam, managing director of BoardPacks, insists that, for an organisation that is focused heavily on the effective management of risk, the continued reliance on paper documentation for key decision making is arguably one of the biggest risks still in place for the NHS
NHS Managers are being pulled from pillar to post in an attempt to respond to escalating patient demands and increasing public and government scrutiny, against a backdrop of unprecedented budgetary pressure.
Monthly board meetings are routinely hijacked by urgent matters, leaving critical decisions to be pushed back to the next meeting.
On a purely financial basis, the cost of managing these meetings is horrendous: teams of individuals within the secretariat spending days in preparation and distribution of the meeting packs that can run to hundreds of paper pages. However, in the wake of the Francis Report into Mid Staffordshire Trust, there is also a growing recognition of the risk associated with this paper-based culture on the effectiveness of decision making.
NHS Managers are being pulled from pillar to post in an attempt to respond to escalating patient demands and increasing public and government scrutiny, against a backdrop of unprecedented budgetary pressure
A lack of transparency and understanding throughout the management structure is simply no longer acceptable – especially in an era where ubiquitous access to up-to-date information should be a given. Today, everyone involved in the NHS meeting culture, whether at board level or below, wants a better system and a more-effective way of working both during the meeting and in between.
Improving governance
Replacing paper-based meeting papers and agenda with online information and meeting management is an obvious step. There are clear cost savings to be achieved – not least from releasing the secretariat from the onerous job of printing and collating hundreds of pages of meeting documents. And, in the process, the organisation can move a step closer to meeting the 2018 deadline for a paperless NHS.
But these benefits, while important, are just side issues. The key requirement is to enable highly-intelligent, highly-influential individuals to operate at maximum capacity. By providing anytime anywhere access, not only to the meeting agenda and associated documentation, but also links to the latest regulations or strategy documents, an online meeting forum enables board members to prepare and collaborate with colleagues before the meeting even begins. Less time is wasted on fact finding - and far more is spent on taking those critical decisions that have a real impact on the quality of patient care.
All about risk
A full audit trail is also key to providing the required decision making transparency and demonstrating the strength of the processes in place. With the right meeting structure board members can understand and address the key risks, including strategy, financial, commissioning, urgent care demand and partner organisations. Rather than relying on Excel spreadsheets or antiquated risk software that does not feed into the board information pack, a meeting system that follows the Assurance Frameworks laid down by NHS England can embed risk information and provide members with that essential Red, Amber, Green measure, enabling effective prioritisation.
A lack of transparency and understanding throughout the management structure is simply no longer acceptable – especially in an era where ubiquitous access to up-to-date information should be a given
Rather than trawling though hundreds of pages of paper, members can understand immediately the current risks, the controls that are in place and identify gaps that need to be addressed. They can use the real-time search to locate relevant information and gain the insight required to make a decision immediately – rather than re-tabling the issue for a subsequent meeting.
Effective decision making requires more than access to up-to-date information to enable people to have confidence in their grasp of the matters to be discussed. It also requires effective collaboration and co-operation between board members before the meeting even begins. With a clearly-structured meeting agenda, supported by up-to-date papers, with links to relevant sites – including regulatory bodies or policy rules – individuals can ensure they are up to date and prepared before the meeting starts. They can check information with colleagues, share notes and ideas, and come to the meeting with a clear, well-reasoned and well-informed position. This ensures delays are avoided, and the board meeting can concentrate on the top strategic issues, rather than risk being derailed by minor-yet-pressing concerns.
Conclusion
Senior managers across the NHS want to make more-efficient decisions. They want to use the iPads and other mobile devices that are already key tools used on a daily basis. Yet, with a focus on patient-first spending, how can any NHS environment justify an investment in such technology?
The bottom line is that it is impossible to not justify it. Not only does it tie into the Government’s paperless NHS by 2018 target and can deliver proven cost savings – around £175,000 in the case of Luton & Dunstable NHS Foundation Trust - but, most critically, it can enable decision makers to be far more effective; to respond to emerging challenges, and make essential decisions quickly and effectively based on clearly prioritised risks. And that should be the driving force for any NHS organisation.
