Tackling the backlog: technology

by Gareth Oelmann

Giving doctors, and patients, the support they need

Location: Wales
Published: Tuesday 29 March 2022
Gareth Oelmann

As pandemic restrictions continue to be lifted, the number of patients awaiting treatment and diagnosis has never been higher.

To ensure that doctors and staff across the Welsh NHS have the support they need to help patients, we must be given the right tools. A medic’s armoury has thankfully evolved over the centuries, and so too must the technology available to us.

This means accelerating the roll-out of electronic prescribing and the introduction of shared referral dashboards and patient update systems. This will enable primary and secondary care to communicate fully, manage patient conditions, and start to reduce the backlog.

Welsh Government has made significant progress with its plans for electronic prescribing. Through a series of meetings between BMA Cymru Wales, partner organisations, and the minister, we have ensured a timetable for the development and roll out of electronic prescribing has been agreed, and we have gained commitments from the Minister that BMA Cymru Wales will be a key member of Welsh Government’s professional engagement group which will help develop the programme. 

We are conscious that this work needs to continue at pace, something the Auditor General for Wales has previously raised (1). We are already well behind England and Scotland as e-prescribing has been in place in England since 2014, while Scotland has introduced Electronic Transfer of Prescriptions.

The benefits of electronic prescribing are clear. With patients able to access their prescription at a pharmacy of their choice, it reduces the need to attend their GP surgery for prescriptions following remote consultations and for those with repeat prescriptions. This of course also increases our opportunities as GPs to carry out consultations with other patients in need.

Improving access to patient information – such as medication allergies – when a prescription is needed away from a GP practice, such as in the community or at the patient’s home, electronic prescribing will allow safe regulated access to appropriate information. This means that the correct prescription, taking into consideration their other prescriptions and past medical history, can be provided for the patient. 

Electronic prescribing will therefore not only improve patient safety and reduce medication wastage, but contribute to improved access to care services.

While much of the technology needed for this is already in place in primary care, secondary care colleagues regularly raise the significant need for improved technology. Their need, however, goes beyond electronic prescribing. 

Secondary care needs significant investment so that consultants can communicate effectively with primary care, and to allow patient records to be quickly updated.

Patients rightly get frustrated when they can’t find their position on an outpatient waiting list. This is just as frustrating for healthcare staff as well.

Patients should be able to easily find out how long they are likely to wait, with primary and secondary care communicating and providing updates via a shared referrals dashboard. In reality, secondary care receives a patient referral, which then gets added to the list. Progress after this is however inaccessible to either the patient of the referring clinician.

To find out where they are in the list, patients then often need to contact the waiting list clerk, who in turn advises them that they need to contact their GP again and request that an expediting letter is written to the consultant. Patients then need to wait until their GP has received a response or they repeat the process of contacting the waiting list directly for an update.

This process can take weeks and sees thousands of pieces of paper and emails being moved across health boards, all while patients continue to have to live with their condition, with little detail of when they will get assistance.

When it comes to other industries, such as retail, technology is in place to update consumers on their waiting list position. Healthcare should be no different. In fact, it should be a priority and, furthermore, it should be independent of primary care to ensure valuable GP appointments can be freed up throughout the day. 

Again, there has been progress from UK Government in this area as their recently announced My Planned Care scheme plans to allow patients across England to access support and check waiting times via a new online platform (2).

Welsh Government need to provide patients and staff with similar support. While the National Planned Care Recovery Plan is due to be published later this year by the health minister, it must include details and plans for the roll-out of digital technology.

While we must of course remember that not all patients will have the digital access and capabilities to themselves access these new advances in technology, the benefits will nonetheless be clear as healthcare staff across the system will be in a better position to support these patients.

Progress has been made by Welsh Government but it needs to go further. The pandemic has shown us that we must continue to invest if we are to have a modern health service fit for the 21st century, which is able to give staff and patients the assistance they so desperately need.

Gareth Oelmann is deputy chair of the BMA Welsh GPs committee


1) National Health Executive: NHS Wales must speed up electronic prescribing, says auditor general

2) NHS England: NHS launches online platform to empower patients as they wait for care