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NHS still reliant on paper patient notes and drug charts despite electronic upgrades, The BMJ finds

BMJ 2023; 382 doi: (Published 13 September 2023) Cite this as: BMJ 2023;382:p2050
  1. Jo Best, freelance journalist and doctor
  1. Sussex

A continued reliance on paper, revealed by a BMJ survey, is less safe and efficient. And difficulties with sharing electronic records are preventing even the most advanced trusts from realising their full potential, writes Jo Best

Three quarters of trusts in England that responded to a BMJ survey are still reliant on paper patient notes and drug charts, despite progress towards electronic records and prescribing. The survey results came in just as an expert panel convened by a House of Commons committee concluded that the UK government had failed to meet a key target to eliminate paper prescribing in hospitals and to introduce digital or electronic prescribing across the entire NHS by 2024.1 Going paperless has been an NHS dream for some years: in 2013, then health secretary Jeremy Hunt challenged the NHS to go paperless by 20182; migration to electronic patient records (EPRs) remains a priority for the NHS today.

Under the NHS Long Term Plan, trusts are being challenged to achieve “a core level of digitisation by 2024” and to “accelerate the rollout of EPR systems and apps.”3 The current targets are that 90% of NHS trusts should have an EPR system by the end of 2023,4 and 95% by March 2025. In England, the NHS says that it is investing nearly £2bn to encourage trusts to adopt EPRs; £440m was spent last year to help hospitals install or upgrade, according to NHS England. NHS figures from May this year show that 88% of trusts in England now have EPRs.5

Yet The BMJ’s survey shows that paper notes remain prevalent. The BMJ asked 211 acute, community, and mental health trusts whether they used patient notes and drug charts in paper, electronic, or both formats (fig 1). Two trusts, the Royal …

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