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Bureaucracy busters

30 May 2013

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Neil Darvill has a self-confessed passion for records management. He hopes his solution for digitising, archiving and hosting Lloyd George packets could eventually eliminate the need for a paper-based central distribution system. 

The new system created by St Helens and Knowsley Health Informatics Service, part of the NHS Trust, tested its mettle while digitising clinical records in secondary care. Now reborn as the Electronic Lloyd George Records Service (e-LGS), it currently supports 85 GP practices and almost 500,000 patients. 

St Helens and Knowsley help GP practices to box up and order the records. An audit is of the GP computer system is then completed so that the Lloyd George records can be linked to the register on the system. NHS-employed drivers collect the records, which are scanned and securely hosted on an electronic web system. 

There is a quarterly collection of new patients’ Lloyd George packets. Once scanned, the records are destroyed and the packets returned to the surgery so that the information can be printed or burned to CD and placed into the envelope if another NHS service needs them. 

Darvill believes e-LGS could replace the current, cumbersome system of sending patient records around the NHS.

He said: “I don’t think the way it works is very efficient at the moment, you can’t be efficient when you have such a huge logistics exercise in paper movements. 

“There’s a huge industry of bureaucratic paper exchange across all GP practices that sorts out patient movements and moves the Lloyd George envelope from practice to practice. This system could easily pick up that overhead and significantly reduce the time and the cost that all of that information exchange takes.” 

But the cost savings aren’t just for the wider NHS, Darvill claims. The system, which costs 60p per record, could have benefits for practice managers too. 

“Some practices I’ve worked with have had very poor storage for their records, some have come in to us and they’ve been a bit water damaged, a bit chewed… practices end up spending a considerable amount of time, effort and money on that resource.  

“We explain to the practice manager that this costs less than half the whole time equivalent of a clerical worker, not to mention the freeing up of space and making access available instantly to GPs. They’re the kind of things that practice managers are generally supportive of.”

As Darvill himself admits, e-LGS is not a clinical tool, it’s a business service. “It’s intended to make the practice environment more efficient, to reduce overheads, all of those kinds of benefits. But having said that, the feedback we’ve had from practices that are live on the system has said that they use the records significantly more than they used to. But I’d accept that this is by no means a real-time patient system. That’s taken care of by the GP computer system and this is just supplementary to that.” 

Moving towards a system where all information is shared electronically is part of the paperless NHS dream Health Secretary Jeremy Hunt is currently pushing for. Although Darvill doesn’t have “any immediate plans” to develop e-LGS as a way to share information with patients, he says that practices without the system in place could “struggle” to get their information online. 

Darvill said: “One of the greatest challenges in providing access isn’t how to do it but whether or not you have the records online. If the practices that adopt this solution go through a mechanism to provide access to their GP computer clinical record they could very easily add access to these records because they’re all online, stored securely. The opportunity now is very real and relatively straightforward compared to what it was before.”