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The new drive seeks to empower frontline health and care staff by reducing unnecessary bureaucracy and locking in positive change seen during the pandemic.

• New bureaucracy-busting strategy will lock in positive changes seen during the COVID-19 pandemic, saving staff valuable time
• Changes include freeing up doctors’ time by shortening lengthy appraisal processes, and cutting the amount of paperwork required for qualified international GPs to work in the NHS
• More than 600 frontline health and care staff responded to call for examples of unnecessary bureaucracy, resulting in 8 priority areas for action

The Health and Social Care Secretary Matt Hancock yesterday announced a new drive to empower frontline health and care staff, by reducing unnecessary bureaucracy and locking in positive change seen during the pandemic.

Stripping back excess bureaucracy means hardworking frontline staff can spend less time on paperwork and more time with their patients.

The new bureaucracy-busting mission follows a call for evidence over the summer from frontline health and care staff, through which over 600 respondents identified 1,000 examples of excess bureaucracy that they face in their day-to-day jobs, such as improving the way data is collected and shared to allow our frontline staff to focus more on patient care. A wide range of other stakeholders in the health and care system also contributed, including professional bodies, commissioners, academics and providers.

Yesterday’s report sets out a new, comprehensive strategy to streamline processes and reduce bureaucracy. It identifies 8 priority areas for action to save hardworking staff valuable time as they work around the clock to care for people and save lives. These include:

• rethinking medical staff appraisals by putting an end to lengthy paperwork and ensuring a more meaningful assessment of professional development and progress. The new process currently being evaluated would mean quicker, more useful appraisals lasting just 30 minutes, down from 3 to 5 hours
• modernising outdated and prescriptive professional regulation. This includes reforming the legislation which sees specialist doctors, including GPs, from outside the UK who want to work in the NHS, submitting up to 1,000 pages of evidence to support an application. This will enable the General Medical Council to adopt different, more flexible routes to registration while still assuring the same high standards of knowledge, experience and skills
• reducing duplicative or repetitive data requests which can take up a huge amount of frontline staff’s time. NHSX and Department of Health and Social Care will launch a data strategy in the coming months to harness the power of data for better patient outcomes and to build on the approach to effective data sharing across the system seen during the COVID-19 response

Speaking at the NHS Confederation’s NHS Reset Conference, Health and Social Care Secretary Matt Hancock yesterday said:

Of course, rules and regulations have their place. They can be the cornerstone of safe and high-quality care. But when left unchecked, rules and regulations can outgrow their original purpose – and they can stifle innovation and damage morale.

Learning from the first peak, in July we set up a call for evidence on reducing bureaucracy in the health and social care systems. And I mean the system as a whole. We engaged with staff on the front line and spoke with dozens of stakeholder groups.

The contributions we received have been so vital in lifting that x-ray up to the light, and illuminating those daily irritations that make people’s lives harder. Like onerous clearance processes, complicated appraisals, and slow discharges.

And of course the changes we need to make don’t always have to be big. In the pandemic, we’ve seen that little things can make a big difference, for instance letting doctors and nurses communicate with patients securely over WhatsApp or providing single logins across multiple different computers.

I’m determined that we seize this moment and build on the very best of what we have seen over these past 9 months.

Some bureaucracy is essential for a safe, well-functioning health and care system and the UK spends only around 2% of healthcare expenditure on administration, a third less than the Organisation for Economic Co-operation and Development (OECD) average.

However, approximately a third of a community-based clinician’s time is spent on administration and patient coordination and over half of doctors report that at least one hour of their work each day could be carried out by non-clinical staff.

The review identified changes that occurred during the pandemic to streamline processes and reduce demands on staff’s time so they could focus on providing vital patient care. For example, letting doctors and nurses communicate with patients securely over WhatsApp or providing single logins across multiple different computers.

The report includes 8 priorities for the health and care system to build on and reduce bureaucracy in the short to medium term:

1. Data and information will be shared, asked for and used intelligently
2. System and professional regulation will be proportionate and intelligent
3. Day-to-day staff processes will be simple, helpful and effective
4. The government will legislate to make procurement rules more flexible
5. GPs will have more time to focus on clinical work and improving patient care
6. Medical appraisals will be streamlined and their impact increased
7. There will be greater digitisation of services
8. A supportive culture is needed at a national and local level

The actions outlined will require commitment from all levels of the system and will be achieved through a mixture of digital, behavioural and legislative change, with bureaucracy reduction continuing to be a central strand of health and care reform.

Background information

See the full report: Busting bureaucracy: empowering frontline staff by reducing excess bureaucracy in the health and care system in England.

A third of a community-based clinician’s time (or 88 days per working year) is spent on administration and patient coordination.

Over half of doctors report that at least one hour of their work each day could be carried out by non-clinical staff.

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