Patients are put off seeking healthcare due to ‘dysfunctional’ NHS admin that traps them in a ‘doom loop’ and puts safety at risk, patient groups and healthcare think tanks have warned.
Research from the King’s Fund, National Voices and Healthwatch England shows that letters arriving after appointments, lack of update on waiting times and having to chase test results, are all commonplace problems that affect large numbers of patients.
This also has an impact on NHS staff who bear the brunt of people’s frustration with admin headaches, the report authors said.
In response to the research, the RCGP said GPs were ‘just as frustrated as patients’ and often involved in chasing up results, letters and appointments.
Admin issues are worse for those with long-term health conditions, people from ethnic minority backgrounds and people who are struggling financially, the researchers noted.
A poll done by Ipsos as part of the report found 64% ofpatients and carers have experienced at least one admin problem over the last year such as lost test results, inability to change or cancel appointments, or receiving incorrect information.
A third of the 1,888 surveyed had to chase results after a test, scan or X-ray and the same proportion had received no update about how long they would have to wait for treatment.
One in five received an appointment invitation in the past 12 months that arrived after the date they were supposed to attend. One patient received an appointment for the 99th January.
In all 23% said they did not know who to contact while waiting for care.
The report found that it also puts people of seeking care in the future and poor communication is also driving public perception of NHS waste.
Many patients described being unable to cancel or reschedule appointments and one person told researchers how they had been automatically discharged from a service when they did not attend an appointment they had been unable to cancel.
Pulse has reported on a string of very similar incidents in which hospital trusts failed to deliver patient documents to GPs, creating huge backlogs and potential risks to patient safety.
Julia Cream, a policy fellow at The King’s Fund and co-author of the report said: ‘The number of people affected by poor admin is stark.
‘Today’s results lay bare the day-to-day dysfunction of an NHS that is too often not meeting people’s needs and highlights the deep inequalities people experience when they are trying to access and engage with health services.
‘Behind these numbers are stories of people who are worried about their health and struggling to get through the NHS’s front door.’
Efforts to bring down waiting lists and improve access will fail if the NHS cannot communicate effectively with people, she added.
Jacob Lant, chief executive of National Voices, added the research showed people stuck in an ‘admin doom loop’ unable to access answers.
‘This goes beyond inconvenience, often risking people’s quality of care. For people with multiple long-term conditions, the burden of managing admin is multiplied for each interaction with the system.’
Louise Ansari, national director of Healthwatch England, said: ‘Poor admin puts the onus on the patient or their families, who often have to sort out the problems that NHS systems have created, while at the same time struggling with the health condition they need treatment for.
‘Moving to a system that gets admin right and invests in admin staff development would have the potential to transform people’s experience of care, ensure equal access, and stop people getting lost in a system which is in desperate need of an overhaul.’
All three organisations called for admin to be prioritised in the upcoming government ten-year health plan expected later this year.
RCGP vice chair Dr Victoria Tzortziou-Brown said: ‘GPs get just as frustrated as our patients when their care is disrupted by admin issues and IT failures. It can cause delays, confusion, and as this polling shows, can deter patients from seeking care when they need it, and often impacts on our most vulnerable patients most.
‘GPs and our team members are often involved in chasing up test results, missing letters, and appointments with our patients, adding to our bureaucratic workload at a time when need for our care is rocketing, and we have a severe shortage of GPs.
‘These issues aren’t the fault of hardworking administrative staff across the NHS, but a symptom of a system that is chronically overstretched and understaffed, relying on patchy, out-of-date processes and digital infrastructure. Ultimately, it’s our patients who are bearing the brunt when they receive disjointed or delayed care.
‘If we are going to give patients the experience they deserve, then we need to invest in general practice – including in our IT infrastructure. The upcoming 10-year Health Plan is an opportunity for the government to follow through on their commitment to bring more care into the community and support general practice. We need to see a greater portion of the NHS budget spent on primary care to rectify our workforce crisis and rebuild our infrastructure, so we can provide the safe and timely care patients need.’
