Behind every NHS appointment, there are admin processes that ensure that those that need care, staff to provide it, and any resources necessary are in the right place at the right time.
Across the NHS, many administrative systems carry out tasks such as holding patient data, making referrals, booking appointments, keeping test results, and prescriptions.
We know that when people have a bad experience of these processes, it can change how they feel about their care. More importantly, ineffective processes can lead to delays in receiving care and serious implications on people’s health outcomes.
Working in partnership with the King's Fund and National Voices, we worked to understand people's experiences of NHS admin. We shared what we have heard about people's experiences nationally and more in-depth research from Healthwatch in Brent , Lambeth, Newham, Northamptonshire, North Yorkshire and Surrey.
The impact that poor admin can have on people’s care
- Time and money spent - People described spending a long time trying to navigate the health service, and in some cases, also facing financial costs for travel or loss of salary. Some people described taking time off work or needing to secure cover for caring commitments to find their consultation had been cancelled or delayed at short notice.
- Poor emotional wellbeing - People told us they often felt frustrated, stressed or anxious when trying to book appointments. For people with additional needs interacting with admin systems that don't adapt to their needs is particularly stressful.
- Negative impact on health - Delays in diagnosis or treatment and medication mistakes are examples of how administrative errors can have significant consequences on people’s health.
Overall, poor admin can undermine people’s confidence in the health service, leaving them feeling disempowered in managing their care.
What would good admin look like?
While our work focuses on the issues that patients and staff face, it’s clear that policy makers and those in charge of designing and delivering services need to take time to involve people who actually use them to make them better.
These five principles should guide steps that NHS services take to make things better.
- Admin systems and processes that put patients at the centre of their design.
Testing with people who need to use and interact with admin systems will help ensure they meet people's needs and are easy to use.
- Admin that promotes two-way interaction with patients.
People should be able to get the communication they need in a way that suits their preference and allows for them to respond if they have any questions or concerns.
- Admin that promotes understanding and confidence.
People should receive communications designed with accessibility and usability in mind. The NHS should provide information that helps them understand the care they are likely to receive and the next steps they can expect.
- Admin that promotes equal access.
Systems need to be intuitive for people and not be an additional barrier to accessing care. People should be able to receive communications that are inclusive and meet their needs. The NHS should work with patients to understand what works for them.
- Admin processes that invite people to share their views and use them to improve.
People should feel empowered and be supported and encouraged to share their opinions and ideas of how services can be better.
Our National Director, Imelda Redmond said:
“Often when we think about people’s experiences of the NHS, we think of their interactions with clinical staff. However, people’s first point of contact is often using an administrative process, which can have a negative impact on their experiences and their health if they’re not properly designed.
“Bad admin can be experienced as frustrating red tape that undermines people's confidence in the health service. But getting admin right can vastly improve the experience of getting care and can help to reduce costs, tackle health inequalities, improve people’s experiences, their health and working experience for staff.
“Especially given the well-known shortages of clinical staff in the NHS, a focus on improving admin processes with the involvement of patients and staff could go a long way to improving the quality of care.”
Find out more
Efficient administrative processes are essential for quality care. They have the potential to improve people’s experiences, reduce inequalities, promote better care and contribute to a better working environment for staff.
We’re calling on NHS services to involve patients and staff in how processes are designed and delivered to help make sure they work for everyone.
- Read Admin Matters: the impact of NHS administion on patient care from the King's Fund.
- Read Paper Works: the critical role of administration in good quality care from National Voices.